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266,267 Another Lebanese study found that while smokers of either hookah or cigarettes were partially knowledgeable about the health risks of cigarette smoking, they knew virtually nothing about the harmful ingredients of hookah smoking and had many misconceptions regarding how hookah worked or how it could produce harm

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Despite these positive trends we cannot overlook the fact that in the United States more than 49 million adults and nearly 11 million youth and young adults reported using a tobacco product in 2018 and 2019, respectively (116)(132)

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Nutt said meth in particular would likely be scored as more dangerous, since its use is more common in the states