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Cannabis use can modulate the immune system, potentially reducing inflammation, while tobacco smoking often impairs immune responses, leading to higher respiratory infections

Retrieved 12 September 2018

Table 1 Socio-demographic profile of the study participants ( n = 422)

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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