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Smokeless tobacco can cause white or gray patches inside the mouth (leukoplakia) that can lead to cancer Smokeless tobacco can cause gum disease, tooth decay, and tooth loss Using smokeless tobacco during pregnancy can increase the risk for early delivery and stillbirth Nicotine in smokeless tobacco products that are used during pregnancy can affect how a babys brain develops before birth Using smokeless tobacco increases the risk for death from heart disease and stroke E-Cigarettes The Ohio Department of Health identified that the e-cigarette aerosol that users breathe from the device may contain potentially harmful substances, including: Nicotine Ultrafine particles that can be inhaled deep into the lungs Flavoring such as diacetyl, a chemical linked to a serious lung disease Volatile organic compounds Cancer-causing chemicals Heavy metals such as nickel, tin, and lead Tobacco Cessation Ohio Tobacco Quit Line Stopping the use of tobacco, nicotine, and related products helps to reduce the risk of developing serious health conditions

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Stronger tobaccos, such as "Ajami," gained popularity, and the Persians played a pivotal role in shaping the hookah"s design and the culture surrounding its use