Pipe smoking and the risk of lung cancer

The Abramson Cancer Center of the University of Pennsylvania
Last Modified: May 8, 2013


My husband smokes a pipe, and he is always dismissing the risks of getting cancer. Despite the recent death of a fellow pipe collector, he insists cancer is relegated to cigarette smoking. I am hoping you can connect me with some solid facts/ stats on cancer related to pipe smoking. He is now 50 years old, but he has been smoking for at least 20 years. He smokes about three hours a day on average.


Barbara Campling, MD, Medical Oncologist, responds:

Your husband should not dismiss the risks of pipe smoking. For some reason, pipe smoking is perceived as being less dangerous than cigarette smoking. This is not the case. It is true that the majority of cases of lung cancer are attributable to cigarette smoking. It is also true that cigarette smoking is far more prevalent than pipe smoking. It has been difficult to estimate the risk of lung cancer attributable to pipe smoking alone, since many pipe smokers also smoke cigarettes. The most comprehensive study of which I am aware estimated that pipe smokers have about an 8-fold increased risk of getting lung cancer compared to non smokers (reference 1). This compares to about a 15-fold increased risk of lung cancer in cigarette smokers. However, this risk of pipe smoking may be an underestimate, since the amount of tobacco smoked was not quantitated, and pipe smokers tend to smoke less tobacco than cigarette smokers. My opinion is that pipe smoking is every bit as dangerous as cigarette smoking.

Another study showed that lung cancer accounted for the majority of pipe smoking-related deaths (reference 2). Pipe smoking is also associated with an increased incidence of chronic obstructive pulmonary disease, oral cancer, laryngeal cancer, esophageal cancer, and heart disease.

I hope that you are able to convince your husband that the time to stop smoking is right now. It sounds like he smokes a pipe quite heavily and is likely very dependent on nicotine. Once he makes the decision to quit, this is only the first step. Tobacco smoking is a very powerful addiction, and smoking cessation is a very difficult process. He will need all the help that he can get, including the support of his family. He should see a physician to get advice about medications to facilitate smoking cessation-such as the nicotine patch, and Zyban. His physician will also know what resources are available in your area for smoking cessation, including smoking cessation programs and support groups.

Learn more about pipe smoking and cancer on OncoLink.

  1. Boffetta P, Pershagen G, Jöckel KH, et al. Cigar and pipe smoking and lung cancer risk: a multicenter study from Europe. J. Natl. Cancer Inst. 1999;91:697-701.
  2. Nelson DE, Davis RM, Chrismon JH, et al. Pipe smoking in the United States, 1965-1991: Prevalence and attributable mortality. Preventive Medicine. 1996;25:91-99.


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