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In contrast, tobacco-free shisha flavors are genuinely nicotine-free from the start, providing an alternative for those who want the flavor experience without the effects of nicotine

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(The paper says use is highest of all among those who play ice hockey and baseball and those who participate in wrestling or rodeos.) The authors Ben Chaffee , Elizabeth Couch and Margaret Walsh also write that boys are more likely to start using smokeless tobacco if they see family, friends, coaches or elite athletes using it