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Although we found that shisha use was not related to overall oral microbiome structural changes, taxa relative abundance analysis identified the phyla Cyanobacteria and SR1, and the classes Chloroplast and BD1-5 as significantly depleted in shisha smokers when compared to nonsmokers, The lack of significance observed for the majority of the taxa is likely due to both the low n number available (n = 15) for exclusive shisha users as well as to the infrequency of shisha use, rather than the absence of toxicants in this product 12,42