Cigar and pipe smoking: Safer than cigarettes?

Originally Published: March 31, 2000 - Last Updated / Reviewed On: August 17, 2012
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Dear Alice,

Do people get cancer from cigar smoking? I never hear about it. Is cigar smoking or pipe smoking healthier than cigarette smoking? And is smoking all natural cigarettes ok? Because it can't be the tobacco that's killing you, right? I mean, I've never heard from back in the old days of Indians dying from tobacco smoke! I think it's the wrapping paper. What do you think?

Dear Reader,

Cigar smokers may think they have a free pass when it comes to the negative health effects of tobacco use, but the sad reality is that cigar, pipe, and cigarette smoking can all lead to cancer. The latest research (2010) shows that exclusive cigar smokers are 2.2 times more likely than never smokers to develop cancers of the lung, upper aerodigestive tract, and bladder. What’s more, exclusive pipe smokers were three times as likely as never smokers to develop the aforementioned cancers. As a result, it is clear that cigars and pipes are not safe alternatives to cigarettes. They all contain tobacco, the cancer causing agent, and they all have nicotine, which causes addiction and dependency.

According to the National Institute on Drug Abuse, tobacco use kills more than 430,000 people a year in the United States. That’s more than alcohol, cocaine, heroin, homicide, suicide, car crashes, fire, and AIDS combined. The National Cancer Institute reports that tobacco use is also the single greatest cause of excess cancer deaths and the leading preventable cause of death in the U.S. And don’t forget about the second-hand smoke repercussions! The Environmental Protection Agency states that second-hand smoke causes about 3,000 cases of lung cancer a year in non-smoking adults, 40,000 cases a year of cardiovascular disease, and contributes to respiratory illness and Sudden Infant Death Syndrome (SIDS) in children.

The difference between a cigar and cigarette is that a cigar is a roll of cut tobacco wrapped in leaf tobacco or a tobacco product. Cigarettes are rolls of tobacco wrapped in paper or any other non-tobacco product. Natural cigarettes are made without chemical additives or flavorings, using full tobacco leaves rather than reconstituted sheet or scrap tobacco. The only possible advantage to natural cigarettes seems to be an earth-friendly one, since fewer chemical by-products result from their manufacture, and some natural cigarette companies produce their tobacco organically. However, natural cigarettes still pose major health risks.

Cigar smoking may have the reputation of being less harmful because most cigar smokers are only "occasional" users, and most do not inhale the smoke into their lungs when puffing. (Although some cigar smokers may inhale smoke, usually out of habit if they have previously smoked cigarettes.) However, with frequent use, cigar smoking can be just as, if not more, harmful than cigarette smoking. Consider the following:

  • Smoking five cigars a day and inhaling moderately produces the same lung cancer risk as smoking a pack of cigarettes a day.
  • Since cigars are much larger than cigarettes, each one packs more punch. Some large cigars contain as much tobacco (and nicotine) as an entire pack of cigarettes.
  • Cigar smoking can be a gateway to cigarette smoking. One study has shown that cigar smokers are more than twice as likely to take up cigarette smoking for the first time as people who have never smoked cigars.
  • Cigars produce even more environmental tobacco smoke (ETS) than cigarettes, due to their size, long aging and fermentation, and long burning time. In addition to these factors, the fact that the wrapper of a cigar (made of tobacco leaf) is not very porous and burns less completely than cigarettes, the air surrounding a cigar smoker has higher concentrations of nitrogen oxides, ammonia, carbon monoxide, and tar than the air around a cigarette smoker.
  • The relapse rate of former cigarette smokers who smoke cigars is twice as great as the relapse rate of former cigarette smokers who do not smoke cigars.

Even if the cigar smoker doesn’t inhale, the carcinogens in the smoke touch the lips, mouth, tongue, throat, and larynx. Though lung cancer risk for non-inhaling cigar smokers is lower than that of cigarette smokers, cigar smoking has comparable health problems (including deaths) related to oral, esophageal or laryngeal cancers. Lung cancer risk for non-inhaling, daily cigar smokers is over double that of nonsmokers. In fact, cigar smokers place themselves at risk for:

  • Lung cancer as well as cancers of the mouth, lip, tongue, throat, pharynx, larynx, esophagus, stomach, and pancreas
  • Chronic bronchitis, emphysema, chronic obstructive pulmonary disease (a lung disease) and the exacerbation of asthma
  • Coronary heart disease, including stroke and heart attack
  • Vascular diseases, including aneurysm — a dilation of the wall of a blood vessel, often resulting in rupture and hemorrhage or obstruction of smaller blood vessels
  • Oral diseases, tooth erosion, tooth and supporting bone loss, stained teeth, and chronic bad breath

The possibility of becoming addicted to cigars is also a concern — each cigar contains between 100 and 200 milligrams of nicotine (in some cigars up to 444 milligrams), where as one cigarette contains about 8.4 milligrams. Since nicotine is absorbed very easily through the tissues of the mouth a cigar smoker can become addicted even without inhaling. Cigar addiction can lead to health risks with long-term use, dependency, and even have a financial impact on the user.

Although we may not hear much about Native Americans dying as a result of tobacco use in the 'old days', the likelihood is that it did affect their health, and maybe even their mortality rate. However, Native Americans mainly used tobacco for religious and celebratory purposes; their use was not nearly as heavy or chronic as it is for people today, so it is difficult to understand the impact of tobacco on disease and health in that time. However, lung cancer is currently the leading cause of cancer death among American Indians and Alaska Natives.

If you are a Columbia student and are looking to quit smoking, Medical Services sponsors a Tobacco Cessation Program for those students who want to quit or support someone who is quitting. MS can connect you with a variety of resources such as support groups, relaxation techniques, acupuncture, nicotine replacement and other medication options. Columbia students can make an appointment online through Open Communicator or by calling x4-2284.

Simply put, there is no safe form of tobacco. Good luck as you weigh the facts and make decisions about whether to use tobacco in any form.

Alice

January 6, 2014

547793
Thank you for the information My husband quit smoking cigarettes and now smokes 3 to 5 cigars a day. This information was great in helping me to ask him to quit that as well..
Thank you for the information My husband quit smoking cigarettes and now smokes 3 to 5 cigars a day. This information was great in helping me to ask him to quit that as well..

September 3, 2013

536276
I quit smoking some time ago, 15 years or so. Lately I've been trying to justify smoking a cigar on special occasions. By the time I begrudgingly finished reading your article I decided it would be...
I quit smoking some time ago, 15 years or so. Lately I've been trying to justify smoking a cigar on special occasions. By the time I begrudgingly finished reading your article I decided it would be foolish to toy with my addictive nature. Thank you for writing this article. It made me think and I decided to chew a stick of gum instead. Take care!

June 25, 2012

512937
GREAT INFORMATION! PLANNING TO QUIT THROUGH A SMOKING CESSATION PROGRAM THROUGH MY HEALTH CLINIC NEXT MONTH...I LEARNED A LOT READING THIS.
GREAT INFORMATION! PLANNING TO QUIT THROUGH A SMOKING CESSATION PROGRAM THROUGH MY HEALTH CLINIC NEXT MONTH...I LEARNED A LOT READING THIS.