Cigars: Not the Safe Alternative!

OncoLink Team
Abramson Cancer Center of the University of Pennsylvania
Last Modified: July 21, 2016

Many people view cigar and pipe smoking as safer than cigarette smoking, but this is not true. Cigars are often thought to be safer than cigarettes because most smokers do not inhale them. However, cigars are particularly dangerous due to the process of aging and fermenting the tobacco, which creates carcinogenic compounds (such as tar, carbon monoxide and ammonia) in cigar smoke in much higher levels than found 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. Smoker's saliva contains the chemicals from the tobacco smoke, exposing the mouth, lips, tongue and throat to these carcinogens.

Although lung cancer rates are lower in cigar and pipe smokers than in cigarette smokers, they are still significantly higher than nonsmokers. Cigar and pipe tobacco contain many of the same carcinogens (substances that are known to cause cancer) that are found in cigarettes. With or without inhalation, cigar and pipe smoking causes cancer and is not a "safe" alternative to cigarettes. The most common cancers associated with cigar and pipe smoke are those of the lung, oral (lip, tongue, mouth) and nasal (nose) cavity, sinuses, pharynx (throat), larynx (voice box), esophagus (tube from the throat to the stomach) and possibly pancreas and bladder.

The chance of developing cancer increases with the amount of tobacco someone has used and for how many years. Inhaling the smoke produced when a cigar or pipe is burned (how could you avoid it?) adds to the risk of developing tobacco-related illnesses. Cigar smokers are more likely to develop heart disease 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.

More information from the National Cancer Institute, the American Cancer Society and Action on Smoking and Health about the dangers of cigar and pipe smoking.

Quitting is beneficial, no matter how long a person has smoked for. Quitting smoking has major health benefits that start right away. This is true even for people who already have a smoking-related disease. The argument that it is too late to quit smoking because the damage is already done is not true. It is never too late to quit smoking!

Learn more:

How does tobacco cause cancer?

Tobacco and tobacco smoke cause cancer because they contain many chemicals that are known carcinogens (cancer causing agents). Cigarettes, cigars, chewing and pipe tobacco are made from dried tobacco leaves, as well as ingredients added for flavor and other reasons, such as making smoking more pleasant. More than 7,000 different chemicals have been found in tobacco and tobacco smoke -- among them are more than 60 known carcinogens. Some of the substances that are released by cigarettes and make up tobacco smoke include: ammonia, arsenic, benzene (like that found in pesticides and gasoline) cyanide, formaldehyde (a known carcinogen chemical used to preserve dead bodies), tar, and carbon monoxide. Similar substances are found in smokeless tobacco, including Polonium 210 (nuclear waste), cadmium (used in car batteries), lead (which causes nerve poison), nitrosamines, arsenic, and cyanide.

The chemicals in tobacco and tobacco smoke cause damage in the most basic level of our bodies, the cells and genes. Normally, the body has systems, controlled by genes, which regulate cell growth, repair and death. The genetic damage caused by smoking causes this regulation to malfunction, leading to uncontrolled growth. This uncontrolled growth can, in turn, lead to the formation of tumors that grow and spread throughout the body because they are not detected or repaired by the body's normal monitoring systems.

Are You Ready to Quit Smoking?

Quitting is beneficial, no matter how long a person has smoked tobacco. Quitting smoking has major health benefits that start right away. This is true even for people who already have a smoking-related disease or cancer. The argument that it is too late to quit smoking because the damage is already done is not true. It is never too late to quit smoking!

The Benefits of Quitting Tobacco

Your risk of having lung cancer and other smoking-related illnesses and cancers depends on how much you have been exposed to tobacco smoke over your lifetime. However, the good news is that the risk of these diseases is reduced when you stop smoking. The risk of lung cancer is less in people who quit smoking than in people who keep smoking. The risk of cancer becomes less as the number of years you have been smoke-free increases. People who stop smoking while they are young get the greatest health benefits from quitting. Those who quit in their 30s may avoid most of the risk due to tobacco use. But even smokers who quit after age 50 largely reduce their risk of dying early.

Within minutes of smoking the last cigarette, the body begins to restore itself. Just look at these facts from the U.S. Surgeon General's reports and the American Cancer Society:

20 minutes after quitting

Your heart rate and blood pressure drop. (Effect of smoking on arterial stiffness and pulse pressure amplification, Mahmud A, Feely J. 2003. Hypertension:41:183)

12 hours after quitting

The carbon monoxide level in your blood drops to normal. (US Surgeon General's Report, 1988)

2 weeks to 3 months after quitting

Your circulation improves, meaning your blood is pumped better and your lungs work better. (US Surgeon General's Report, 1990)

1 to 9 months after quitting

Coughing and shortness of breath decrease; Lung function improves increasing the ability to handle mucus, clean the lungs, and reduce the risk of infection. (US Surgeon General's Report, 1990)

1 year after quitting

The excess risk of coronary heart disease is half that of a smoker's. (US Surgeon General's Report, 2010)

5 years after quitting

Your risk of stroke is reduced to that of a non-smoker 2-5 years after quitting. The risk of cancer of the mouth, throat, esophagus and bladder is cut in half after 5 years. (US Surgeon General's Report, 2010)

10 years after quitting

The lung cancer death rate is about half that of a person who is still smoking. (US Surgeon General's Report, 2010)

15 years after quitting

The risk of coronary heart disease is that of a non-smoker's. (US Surgeon General's Report, 1990)

These health benefits are certainly appealing. In addition, keep in mind the day to day benefits of better smelling breath, hair and clothes; further, your senses of smell and taste may improve, and you may begin to notice less shortness of breath when doing simple activities. You will be setting a great example for other smokers who want to quit and your family and friends will be proud of your achievement, not to mention the benefits for them. In addition, you will be saving lots of money; set aside what you would usually spend and do something nice for yourself with the money!

Symptoms of withdrawal from tobacco

Stopping or cutting back on smoking cigarettes, or any other type of tobacco, causes symptoms of nicotine withdrawal, which can affect a person both physically and mentally. Physically, the body is reacting to the absence of nicotine. Mentally and emotionally, one is faced with giving up an addiction, which calls for big changes in behavior and routine. Both the physical and mental factors must be dealt with to quit and stay quit.

Those who have used tobacco regularly for a few weeks or longer, and suddenly stop or greatly reduce the amount used, ,may have withdrawal symptoms. Symptoms usually start within a few hours of the last cigarette, dip or chew and get worse about 2 to 3 days later when most of the nicotine and its by-products are out of the body. Quitters may experience: dizziness (which may last 1 or 2 days after quitting), depression, feelings of frustration, impatience, anger, anxiety, irritability, trouble sleeping (including trouble falling asleep, staying asleep and having bad dreams or nightmares), trouble concentrating, restlessness, headaches, tiredness and increased appetite.

Withdrawal symptoms can last for a few days to up to several weeks. These uncomfortable feelings can lead you to start using tobacco again, but remember: They will get better every day that you stay tobacco-free! Nicotine replacement products and other medications can help you get through the tough times. There are also wonderful resources available online and in the community - learn more in the resources for quitting below.

Resources for Quitting

Quitting tobacco is not easy, but you can do it! Whether you're a smoker or someone who uses smokeless tobacco, to have the best chance of quitting and staying quit, you need to know what you're up against, what your options are, and where to go for help. Below are some resources that will help you.

Smoking cessation. Where do I start?
Start here for help in creating a quit plan, tips to coping with common obstacles and resources for support and smoking cessation programs.

Smoking Cessation Aids
This article reviews the available treatments, both pharmacologic (drug) and non-pharmacologic, to aid in successful smoking cessation.

Life After Tobacco

Unfortunately, quitting tobacco cannot completely erase the damage done from previous smoking. You should always be honest with healthcare providers about your smoking history and be aware of the risks associated with this history.

As recommended by the American Cancer Society, you should tell your healthcare provider about any of the following symptoms:

  • Any change in a cough (for example, you cough up more phlegm or mucus than usual)
  • A new cough
  • Coughing up blood
  • Hoarseness
  • Trouble breathing
  • Wheezing
  • Chest pain
  • Loss of appetite
  • Weight loss
  • Feeling tired all the time (fatigue)
  • Frequent lung or respiratory infections (like pneumonia or bronchitis)
  • Development of sores or white patches in your mouth.


Click on any of these terms for more related articles


Daily Cancer Risk Fact: Cigars vs. Cigarettes
by Carolyn Vachani, MSN, RN, AOCN
April 2, 2012

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