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Cochrane review: mass media interventions for preventing smoking in young people

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In our study, although we did not find a statistically significant relationship between anxiety and changes in CC or nargila smoking, the elevated anxiety rates we observed may still be cause for concern since increased anxiety levels are associated with higher smoking consumption, higher rates of COPD and lung neoplasms, and stress has been shown to play a role in perpetuating drug use and relapse [52,53,54,55]

Chemical Additives Some brands add flavorings or preservatives, increasing potential harm