Yeah, as said before this is not applicable to American style hookah (or probably many other countries). I am under the impression that the stuff they smoke in Egypt and nearby regions is basically high-nicotine, unflavored tobacco that they just pile the coals on without foil. This means that the tobacco is burnt, releasing much more tar, and the overall amount of nicotine released is higher. I remember a while ago we did some calculations, and in a regular bowl of most tobaccos (especially low nicotine ones like Al Amir, Al Fakher, etc) there just plain isn't enough nicotine by mass in the tobacco to equal a pack of cigarettes. Not to mention the fact that some of the nicotine can burn off, and hookah tobacco isn't burnt as heavily as cigarettes anyway. Also, again as said before, the content of other chemicals can be a higher concern. Right now it seems like the coals are likely to contain heavy metals that cause all kinds of shit in the body that you don't want, but I have yet to read anything conclusive about what they do and do not give off. In hookah, or anything smoked, there is all kinds of factors and health concerns that are unknown, so basically the best you can do is to assume it's harmful until proven otherwise. I think the nicotine stuff is BS, but there's a chance that other things about it could be worse, so just assume it's bad for you.