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67 Use of waterpipe has been shown to be a novel risk factor for people who have never smoked to initiate combustible cigarette smoking as well as a predictor of subsequent initiation of other tobacco products and e-cigarettes among young people

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Immediately after The Lancet, another prestigious scientific journal, the British Medical Journal (BMJ), also criticized Nutts pseudo-study [27]

"It doesn't inspire a lot of confidence," he said

This study found that filtered khaini contains significantly higher concentrations of toxic heavy metals and associated health risk indices compared to traditional khaini, indicating a greater potential for systemic toxicity and cancer risk, thereby underscoring the urgent need for regulatory oversight and public health interventions