Considerable concern has been expressed about the use of illicit drugs like heroin and cocaine among disadvantaged, minority youth and young adults in America's inner cities. Often overlooked in this research and associated public response are the far greater health consequences that stem from the use of legally sold drugs like alcohol and tobacco (Baer, Singer, and Susser, 2003, Singer, 2004). Recently, based on research in Miami/Dade and Alachua, Florida, Page and Evans (2003) have drawn attention to the significant rise in small cigars use among urban youth, especially African Americans between 11 and 15 years of age. They note that "a cigarillo called 'Black 'N Mild' that contains between five and twelve times the nicotine of cigarettes has become the product of choice among African American and other youth" in the counties under study (Page and Evans, 2003:64). To date, there has been only limited research on the existence of this practice among inner city youth and young adults in other locales (Malone, Yerger, & Pearson, 2001). This paper reports on findings on Black 'N Mild use from a study of changing licit and illicit drug use among inner city populations in Hartford, CT; these findings include similarities to and differences from the findings reported by Page and Evans. The study highlights the importance of examining regional differences in drug use patterns (Singer et al., 1992).