Other forms of smoked tobacco are becoming popular, however.

The use of hookah water pipes and small cigars has raised public health concerns and has recently been added to the MTF survey. In 2013, 21.4 percent of 12th graders had smoked a hookah at some point in the past year, an increase from 18.3 percent in 2012, and 20.4 percent had smoked a small cigar.

Courtesy National Institute on Drug Abuse, National Institute of Health

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