Four case-control studies in different Latin countries have reported risks of bladder cancer 2-3 times higher for smokers of black (air-cured) than for smokers of blond (flue-cured) tobacco. This observation is interesting in the light of a higher concentration of arylamines in black tobacco. The relative risk dropped very rapidly after discontinuation of smoking, and there was also an effect of age at start, with higher risks associated with earlier onset of the habit. Overall, black tobacco seems to act both on early and late stages of bladder carcinogenesis.