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=== Addiction to and dependence on hookah === Hookah smokers inhale [[nicotine]], which is an addictive chemical. A typical hookah smoking session delivers 1.7 times the nicotine dose of one cigarette<ref name="Eissenberg09">{{cite journal|last1=Eissenberg|first1=T|last2=Shihadeh|first2=A|date=December 2009|title=Waterpipe tobacco and cigarette smoking: direct comparison of toxicant exposure|journal=American Journal of Preventive Medicine|volume=37|issue=6|pages=518β23|doi=10.1016/j.amepre.2009.07.014|pmc=2805076|pmid=19944918}}<!--|access-date=13 June 2015--></ref> and the nicotine absorption rate in daily waterpipe users is equivalent to smoking 10 cigarettes per day.<ref name="Neergaard07">{{cite journal|last1=Neergaard|first1=J|last2=Singh|first2=P|last3=Job|first3=J|last4=Montgomery|first4=S|date=October 2007|title=Waterpipe smoking and nicotine exposure: a review of the current evidence|journal=Nicotine & Tobacco Research|volume=9|issue=10|pages=987β94|doi=10.1080/14622200701591591|pmc=3276363|pmid=17943617}}<!--|access-date=13 June 2015--></ref> Many hookah smokers, especially frequent users, have urges to smoke and show other [[Drug withdrawal|withdrawal]] symptoms after not smoking for some time, and it can be difficult to quit.<ref name="Aboaziza15">{{cite journal|last1=Aboaziza|first1=E|last2=Eissenberg|first2=T|date=March 2015|title=Waterpipe tobacco smoking: what is the evidence that it supports nicotine/tobacco dependence?|journal=Tobacco Control|volume=24|issue=Suppl 1|pages=i44βi53|doi=10.1136/tobaccocontrol-2014-051910|pmc=4345797|pmid=25492935}}<!--|access-date=13 June 2015--></ref><ref name="Asfar14">{{cite journal|last1=Asfar|first1=T|last2=Al Ali|first2=R|last3=Rastam|first3=S|last4=Maziak|first4=W|last5=Ward|first5=KD|date=June 2014|title=Behavioral cessation treatment of waterpipe smoking: The first pilot randomized controlled trial|journal=Addictive Behaviors|volume=39|issue=6|pages=1066β74|doi=10.1016/j.addbeh.2014.02.012|pmc=4141480|pmid=24629480}}<!--|access-date=13 June 2015--></ref><ref name="Rastam2011">{{cite journal|last1=Rastam|first1=S|last2=Eissenberg|first2=T|last3=Ibrahim|first3=I|last4=Ward|first4=KD|last5=Khalil|first5=R|last6=Maziak|first6=W|date=May 2011|title=Comparative analysis of waterpipe and cigarette suppression of abstinence and craving symptoms|journal=Addictive Behaviors|volume=36|issue=5|pages=555β9|doi=10.1016/j.addbeh.2011.01.021|pmc=3061840|pmid=21316156}}<!--|access-date=13 June 2015--></ref><ref name="Ward05">{{cite journal|last1=Ward|first1=KD|last2=Hammal|first2=F|last3=VanderWeg|first3=MW|last4=Eissenberg|first4=T|last5=Asfar|first5=T|last6=Rastam|first6=S|last7=Maziak|first7=W|date=February 2005|title=Are waterpipe users interested in quitting?|journal=Nicotine & Tobacco Research|volume=7|issue=1|pages=149β56|citeseerx=10.1.1.625.4651|doi=10.1080/14622200412331328402|pmid=15804687}}<!--|access-date=13 June 2015--></ref> People who become addicted to hookah may be more likely to smoke alone.<ref name="Maziak05">{{cite journal|last1=Maziak|first1=W|last2=Eissenberg|first2=T|last3=Ward|first3=KD|date=January 2005|title=Patterns of waterpipe use and dependence: implications for intervention development|journal=Pharmacology Biochemistry and Behavior|volume=80|issue=1|pages=173β9|doi=10.1016/j.pbb.2004.10.026|pmid=15652393|s2cid=22556876}}<!--|access-date=13 June 2015--></ref> Hookah smokers who are addicted may find it easier to quit if they have help from a quit-smoking counseling program.<ref name=Asfar14 /><ref name="Dogar14">{{cite journal|last1=Dogar|first1=O|last2=Jawad|first2=M|last3=Shah|first3=SK|last4=Newell|first4=JN|last5=Kanaan|first5=M|last6=Khan|first6=MA|last7=Siddiqi|first7=K|date=June 2014|title=Effect of cessation interventions on hookah smoking: post-hoc analysis of a cluster-randomized controlled trial|journal=Nicotine & Tobacco Research|volume=16|issue=6|pages=682β8|doi=10.1093/ntr/ntt211|pmid=24376277}}<!--|access-date=13 June 2015--></ref><ref>{{Cite journal|last1=Maziak|first1=Wasim|last2=Jawad|first2=Mohammed|last3=Jawad|first3=Sena|last4=Ward|first4=Kenneth D.|last5=Eissenberg|first5=Thomas|last6=Asfar|first6=Taghrid|date=2015-07-31|title=Interventions for waterpipe smoking cessation|journal=The Cochrane Database of Systematic Reviews|volume=2015 |issue=7|pages=CD005549|doi=10.1002/14651858.CD005549.pub3|issn=1469-493X|pmc=4838024|pmid=26228266}}</ref>
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