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And the packs produced by roll-your-own shops are generally also being sold without local tax stamps, which in New York include a $1.50 city tax and a $4.35 state tax

Some brands even offered "cigarettes" you could blow through, sending a puff of powder out the end

The difference was particularly noticeable for stroke with the rate in Hull being 37% higher than the local authority which was second highest (22.2 versus 16.2 deaths per 100,000 population)

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[DOI] [PMC free article] [PubMed] [Google Scholar] Gupta A