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It requires more skill to roll evenly, and loosely packed cigarettes can result in uneven burning

Add to it the appetite suppression and increased focus/concentration/energy and you can see why it is a difficult medication to discontinue. Smoking causes harm to nearly every organ in the body

Government Accountability Office reported in 2025 that because pipe tobacco is taxed at a lower rate than roll-your-own tobacco, consumers who hand roll cigarettes may have an incentive to use pipe tobacco, and that manufacturers also had an incentive to relabel products as pipe tobacco

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And 85% of Black smokers use Newport, Kool and other menthol brands that are easier to become addicted to and harder to quit than plain tobacco, according to the Food and Drug Administration