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First of all, remember that pipes may collect bacteria like any other device you use with your mouth, so be careful with giving your pipe to friends without washing it

Tobacco is the leading cause of preventable death in the US, according to the CDC, causing everything from cancer to lung disease to heart disease

Preethi S, Jose JI, Sivapathasundharam B, Sabarinath B (2016) Evaluation of salivary nitric oxide levels in smokers, tobacco chewers and patients with oral lichenoid reactions

The only randomised controlled trial (RCT) of topiramate versus naltrexone showed a non-significant trend towards a superior effect of topiramate, but the sample was small ( n = 28) [12]