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It is possible that those interviewed may have considered water pipes, also known as hookahs, in their responses for pipes. According to the CDC, between 2011 and 2014, high school students use of hookahs showed a statistically significant increase, while their current use of more traditional products such as cigarettes and cigars decreased, resulting in no change in overall tobacco use

When lighting the cigar, grip it around the band with thumb, index finger, and middle finger and place into your mouth

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