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A network meta-analysis performed in 2013 analyzed 63 RCT of nicotine medications including 21 NRT studies, 28 bupropion studies and 18 varenicline studies and found no significant increase in major adverse CV events (death, myocardial infarction, or stroke) with any of the three therapies, but a slight increase in less serious CV events (e.g

Other studies have also linked hookah to transmission of Helicobacter pylori (main cause of peptic ulcer) and Aspergillus spores (cause of pneumonia in immunocompromised patients) [102, 103]

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