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Interestingly, and contrary to the hypothesis that hookah decreases myocardial blood flow because of the charcoal combustion nanoparticles (vasoconstrictor), a study found that hookah use acutely increased myocardial blood flow

DOI: 10.1093/ntr/ntu078

This harm can contribute to age-related hearing loss and an increased risk of hearing loss at a younger age

Most ex-smokers report comparable satisfaction within 12 weeks of switching, though the experience differs in throat hit pacing

Namely, this theory doesnt really claim that Sanjis smoking is related to his trauma but rather to his personality and his relationship with Zeff, which, albeit full of mutual respect, wasnt always the smoothest