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With respect to carcinogenicity of hookah, it was reported that carcinoembryonic antigen (CEA) levels were higher in hookah smokers, in comparison to non-smokers, yet not as high as in cigarette smokers [133]

Furthermore, smoking can also affect pain perception and management

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Over the next five years, forecast revenue has been slashed by $12.5 billion a "significant downward revision" according to the budget papers, reflecting "weaker than expected tobacco imports and consumption"

CDC, Behavioral Risk Factor Surveillance System, 2017