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There are more than 73,000 smokers among the 1.2 million NHS employees in England and the lost working hours from their combined smoking breaks add up to 99m a year, the Royal College of Physicians tobacco advisory group has said

Since hookah and tobacco cigarettes contain many of the same substances and can pose similar cardiovascular risks, smoking hookah in combination with estrogen contraceptives may have the same risks as smoking cigarettes

They may have already crossed-over into personal nicotine dependency for a many years before reverting back to occasional use

Dental Decay: The sugar and abrasive particles present in chewing tobacco cause damage to the tooth structure leading to erosion and decay