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Hookah users however are exposed to many of the same toxic compounds/by-products as cigarette users, but at dramatically higher levels, which might lead to more severe negative health effects

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We are continuing to propose this measure despite the do not recommend vote from the PRMR committee because we continue to believe in the use of this measure based on the empiric testing results discussed in this section, including indications of moderate to high reliability, and because of the importance of capturing this clinical area of care