Cigar and Pipe Smoking and Cancer Risk
Many people view cigar and pipe smoking as safer than cigarette smoking. While the risk of developing cancer as a result of smoking cigars and pipes is lower than with cigarettes, it is not zero. An increased risk of cancer is seen in cigar and pipe smokers, compared to non-smokers. How high a risk is dependent on how many pipes/cigars one smokes and how deeply they inhale. Even smokers who do not inhale are at increased cancer risk. The good news is that the risks are highest in current cigar and pipe smokers, so quitting does reduce risk.
What causes increased cancer risk with cigars & pipes?
Cigars are dangerous due to the process of aging and fermenting the tobacco, which creates nitrates and nitrites, which are known to be carcinogenic. When a cigar is burned, it produces more cancer-causing compounds, such as nitrosamine, tar, carbon monoxide and ammonia. These are found in higher levels in cigar smoke than in cigarette smoke.
One large cigar can contain as much tobacco (up to 20 grams) as an entire pack of cigarettes (1 gram of tobacco per cigarette)! Even though many cigar smokers do not inhale, the amount of nicotine is higher in a cigar (1-2 milligrams in a cigarette versus up to 400 milligrams in a single cigar) and this nicotine is quickly absorbed in the saliva. For this reason, the addiction to cigars is just as strong as to cigarettes. A smoker's saliva contains the chemicals from the tobacco smoke, exposing the mouth, lips, tongue and throat to these carcinogens.
What cancers are cigars and pipes associated with?
Although lung cancer rates are lower in cigar and pipe smokers than in cigarette smokers, they are still significantly higher than nonsmokers. The cancers associated with cigar and pipe smoking are: lung, oral (lip, tongue, mouth) and nasal (nose) cavity, sinuses, pharynx (throat), larynx (voice box), esophagus (tube from the throat to the stomach) and bladder. More research is needed to prove the links seen between cigar and pipe smoking and cancers of the stomach, pancreas, colon and rectum.
What other health concerns are cigars and pipes associated with?
The chance of developing cancer increases with the amount of tobacco someone has used and the number of years they have smoked. Cigar and pipe smokers are more likely to develop heart disease, stroke and lung diseases than those who do not smoke. Additionally, cigar and pipe smoking can result in gum disease and tooth loss. Because cigars contain more tobacco than cigarettes, and burn for much longer, they also give off greater amounts of secondhand smoke, negatively affecting those around you.
Resources for more information:
Chang, C. M., Corey, C. G., Rostron, B. L., & Apelberg, B. J. (2015). Systematic review of cigar smoking and all cause and smoking related mortality. BMC Public Health, 15(1), 390.
Christensen, C. H., Rostron, B., Cosgrove, C., Altekruse, S. F., Hartman, A. M., Gibson, J. T., ... & Freedman, N. D. (2018). Association of cigarette, cigar, and pipe use with mortality risk in the US population. JAMA internal medicine, 178(4), 469-476.
Harmful Chemicals in Tobacco Products. The American Cancer Society. https://www.cancer.org/cancer/cancer-causes/tobacco-and-cancer/carcinogens-found-in-tobacco-products.html
McCormack, V. A., Agudo, A., Dahm, C. C., Overvad, K., Olsen, A., Tjonneland, A., ... & Hallmans, G. (2010). Cigar and pipe smoking and cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC). International Journal of Cancer, 127(10), 2402-2411.
Tobacco Products: Products, Ingredients & Compounds. US Food & Drug Administration. https://www.fda.gov/TobaccoProducts/Labeling/ProductsIngredientsComponents/default.htm
Tverdal, A., & Bjartveit, K. (2011). Health consequences of pipe versus cigarette smoking. Tobacco control, 20(2), 123-130.
Wyss, A., Hashibe, M., Chuang, S. C., Lee, Y. C. A., Zhang, Z. F., Yu, G. P., ... & Sturgis, E. M. (2013). Cigarette, cigar, and pipe smoking and the risk of head and neck cancers: pooled analysis in the International Head and Neck Cancer Epidemiology Consortium. American journal of epidemiology, 178(5), 679-690.