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in some cases, it can even be fatal

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In addition, intention to quit smoking was self-reported which may not reflect or lead to actual cessation seeking behavior and may be subject to social desirability response bias

It is possible that those interviewed may have considered water pipes, also known as hookahs, in their responses for pipes. According to the CDC, between 2011 and 2014, high school students use of hookahs showed a statistically significant increase, while their current use of more traditional products such as cigarettes and cigars decreased, resulting in no change in overall tobacco use