“…However, it is established that shisha smoke contains the same toxicants as cigarette smoke (Shihadeh, 2003;Shihadeh and Saleh, 2005). Not surprisingly, carbon monoxide is found in shisha users' breath Ward et al, 2006;Chaouachi, 2007) and nicotine is found in shisha users' blood ; blood nicotine of a daily shisha user is of the similar level to that of an individual who smokes cigarettes every day (Maziak et al, 2004;Neergaard et al, 2007). Shisha smoking leads to substantial health harm including cancer, cardiovascular disease, decreased pulmonary function and nicotine dependence (Jabbour et al, 2003;Maziak et al, 2004;Knishkowy et al, 2005;Ward et al, 2006).…”