Different forms of tobacco smoking

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Most of data presented on smoking comes from cigarette smoking; however, other forms of tobacco smoking can be just as damaging.


Hand-rolling tobacco smoking

Hand-rolled tobacco is becoming increasingly popular in some countries in Europe.
In the UK, 22% of smokers now choose to smoke hand-rolled cigarettes.
Hand-rolled cigarettes can be dangerous, as they do not comply with the tar, nicotine and carbon-monoxide EU standards.
Not much in known about the exact health effects of hand-rolled cigarettes, but evidence suggest that the risks are as great or even greater than normal cigarettes.

Cigar and pipe smoking

The risks of cigar and pipe smoking depend on whether the individual inhales.
There is a causal relationship between cigar and pipe smoking and cancers of the oral cavity, oropharynx, hypopharynx, larynx and oesophagus.
If the smoker inhales the health risks are comparable to cigarette smokers.

Bidi smoking

Bidis are manufactured in India and exported worldwide.
They are made of tobacco rolled in dried tree leaf and are usually unfiltered.
Bidis are available in a number of different flavours.
Bidis are not yet popular in Europe.
Bidi smoke is carcinogenic.

Water-pipe smoking

Water-pipe smoking is popular is some parts of Europe.
It appears to involve the inhalation of nicotine, carcinogens and toxins to a similar extent as other forms of tobacco use.

Smokeless tobacco

  • Snuff is finely cut or ground tobacco that is dry or moist, loose or portion packed, and is administered to the mouth (moist) or nose and mouth (dry).
  • Chewing tobacco is loose leaf or packaged and comes in plug or twist forms.

Smokeless tobacco does not have the same associated health risks as cigarettes, although they vary considerably.
However, there are concerns about the association between smokeless tobacco and oral cancer and cardiovascular disease.


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