3.27.1 Manufactured loose tobacco
Manufactured loose tobacco, hand-rolled into cigarette paper and smoked with or without a filter, causes the same range of diseases as smoking manufactured cigarettes. Variations in quantity of tobacco used per cigarette and filtration make measurements of individual exposure more difficult to assess, but the directly comparable exposure to harmful constituents and method of consumption means that smokers of these products have at least an equivalent risk of developing disease as do smokers of conventional cigarettes. Several decades of research on the health effects of tobacco use have enabled comparisons between products with and without filters, and with high and low nicotine and tar yields. Overall, neither has the incidence of lung cancer varied with tobacco product used, nor have other health benefits become apparent.8