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Available in both white and brown rolling paper

Smoking tends to have immediate and severe impacts due to the combustion of tobacco, while vaping may lead to more gradual, yet still significant, changes

Cannabis smoking via combustion, even without cigarette smoking [20], has been associated with respiratory symptoms, chronic bronchitis, changes in lung function testing, risk of developing COPD, worsening of asthma and COPD, bullous disease, and lung and head and neck cancer due to exposure to carcinogens [21], cardiovascular complications, allergy, and respiratory infections [22, 23]

Hand-rolled cigarettes allow control over additives and flavor, but they still carry similar health risks as commercial cigarettes