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"While not all hookah pens contain nicotine, this new delivery method might normalize hookah use in everyday settings, and bring use to a whole new level." Hookah pens come in a wide variety of colors and patterns that may appeal to both young people and adults, and could even spark the curiosity of nonsmokers, Palamar said

Non-e-cigarette users who were exposed to secondhand aerosol had higher odds of having moderate to severe emotional and behavioral concerns such as depression, anxiety or social withdrawal , compared to non-e-cigarette users who were not exposed, according to a 2022 study

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In particular, smoking and sleep apnoea are also related through their impact on sleep structure