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Tobacco Control, 2013

Regardless whether hookah is as toxic or less toxic than cigarettes, its harm is evident to certain extent, and it can still extend to innocent/bystander non-smokers through passive exposure, including children, pregnant women, housekeeping workers, and people with pre-existing cardiovascular and other diseases

"But realistically, the decline in smoking might very well have had some effect on the rise of obesity." Baum, along Shin-Yi Chou, a research associate at the National Bureau of Economic Research (NBER), wondered what, if any, changes in human behavior have played a role in the growing pervasiveness of obesity, which has doubled over the past quarter century

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While some may embrace the smokers culture associated with the game, others denounce it due to health concerns or personal disapproval