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youth and young adults Not a safe alternative to cigarettes Emit secondhand smoke that may be harmful for nonsmokers Health Hazards of Hookah Hookah smoke contains the same toxins as cigarette smoke including: Carbon monoxide Nicotine Tar Heavy metals Cancer-causing chemicals Toxic agents that can cause heart disease Because hookahs are smoked for longer periods of time, hookah users may inhale as much smoke as if they smoked 100 cigarettes or more in a single session