GHall - the smaller the bore, the higher the pressure. At some point, the gas pressure will get past the paper wadded up, start it on fire, cause innacuracy, that sort of thing. I don't know of anyone who's tried them smaller than .54. They were tried a few years back by a board memeber in his Kodiak .54 and he reported same qccuracy as patched ball. I know for a fact they wonderful accuracy in a 12 bore, 16 bore and a 14 bore rifles.
DP- you bite and tear off the smaller end, then shove it into the bore, smaller end down. By the time you get the wiping stickout, the powder has dribbled down to the breech. I then choke up on the rod to start the ball into the muzzle as it's quite snug, then shove it down onto the powder, wadding the paper between powder and ball. At the shot, only confette blows out onto the ground, none of which are on fire. After each shot, Bruce S. ended up with the entire tube from his 12 bore, with rifling marks imprinted on the paper tube. My 14 bore left me with confette - small pieces, as I noted. with practise, I was able to load and fire an aimed shot in 8 seconds after the first. I was able to shoot 10 ctgs. without loss of accuracy before loading became difficult, then loaded and fired a 3 dram load with sopping wet cloth patch. This cleaned the bore allowing another 10 shots with paper ctgs. Paper ctgs. have been used by the various militaries of the World since the 18th century and even carried on into the black powder and bullet military pre-fixed ctg. era, ie: civil war.
I saw a flim on TV a few years ago of some guy who was claimed to be an antique weapons expert. He had a table of muskets, Bess's I think they were. The blokes he was teaching to shoot, were Bikers. He showed them to bite off the powder end, pour the powder in, tear off the ball and shove that in, then stuff the rest of the paper in on top of the ball, claiming the paper above the ball build pressure to ensure full power of the charge and improve accuracy. Such are some of the experts on TV today.