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The heat and chemicals from the smoke can cause dry mouth, which decreases saliva production

[20] While most cigars are now made by machine, some, as a matter of prestige and quality, are rolled by handespecially in Central America and Cuba, as well as in small chinchales in sizable cities in the US

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(2007) find that counterfeit cigarettes can have as much as seven times the lead of legitimate brands, and close to three times as much thallium.[13] Other sources report finding insect eggs, dead flies, mold, and human feces in counterfeit cigarettes.[14] As was the case during the prohibition of alcohol in the United States during the 1920s, increased enforcement has not yielded beneficial results for decreasing the prevalence of bootlegging because the profit margins are so large and the distribution networks are growing more sophisticated