Contact: Joann Schellenbach
(212) 382-2169

Cigar Smoking is a Serious Risk to Public Health

Smoking cigars instead of cigarettes does not decrease the risk of nicotine addiction and the health risks associated with tobacco

CHICAGO -- Smoking cigars is not a safe alternative to cigarette smoking, according to an article in the August 9 issue of The Journal of the American Medical Association (JAMA), a theme issue on tobacco.

Frank Baker, PhD, of the American Cancer Society, Atlanta, and colleagues summarized the principal findings from a conference convened by the American Cancer Society to examine the health risks of cigar smoking. State-of-the-science reports were presented, and 120 attendees (representing government and private agencies, academia, health educators, and tobacco control experts) participated in panels and summary development discussions.

The researchers report that cigar smoking is known to cause cancers of the lung and upper aerodigestive tract. The risk of death related to cigar smoking approaches that of cigarette smoking as the number of cigars smoked and the amount of cigar smoke inhaled increases. Smoking cigars instead of cigarettes does not reduce the risk of nicotine addiction, and cigar-smoking can lead to nicotine dependence even if the smoke is not inhaled. The nicotine in the smoke of a single cigar can vary from an amount approximate to that in a single cigarette to the amount generated by smoking a pack or more of cigarettes.

Baker presented the article here today at a JAMA media briefing on tobacco during the World Conference on Tobacco OR Health.

"The available scientific knowledge on the health risks of cigar smoking is more than sufficient to conclude that cigar smoking is a cause of cancer and a serious risk to the public health," the authors write. "Evidence of the health hazards and an alarming increase in rates of cigar smoking underscore the pressing need for cigars to be included in a coherent national policy on tobacco use and dependence."

"Laws and regulations limiting the marketing of cigarettes and access to cigarettes by minors should be applied to all tobacco products," the authors add.

Among other conclusions reported by the authors:

-- Rates of cigar smoking are rising among both adults and adolescents. Between 1993 and 1997, consumption of all types of cigars in the United States increased by 46.4 percent, reversing a steady decline (66 percent) in cigar consumption from 1964 to 1993. The increase came as the cigar industry intensified its public relations efforts, starting in the mid 1980s. Advertising and promotions for cigars, similar to those for cigarettes, routinely include sexual imagery, affluence, and celebrity endorsement (explicitly and implicitly). But unlike cigarette marketing promotions, those for cigars are not required to mention potential health risks.

-- Environmental cigar smoke can be a major contributor to indoor air pollution, in amounts greater than that produced from cigarettes. "Sidestream smoke ... contributes significant pollutants to the environment in the form of carbon monoxide, nitrogen oxides, respirable suspended particulate matter, nicotine, polycyclic aromatic hydrocarbons, and other compounds, and sidestream smoke from cigars does so to a greater degree than the sidestream smoke of cigarettes, when equal amounts of tobacco are burned."

According to the authors, sidestream smoke is the aerosol emitted from the burning cone of a cigar, cigarette, or pipe during the interval between puffs and the portion of the inhaled smoke that is not retained and is exhaled. "Compared with a single cigarette smoked to 70 percent of its mass, a large cigar smoked 70 percent emits about 20 times the carbon monoxide, 5 times the respirable particles, and twice the amount of polycyclic aromatic hydrocarbon," they write. "The research on the heavy impact of secondhand cigar smoke on indoor air pollution is particularly relevant for restricting smoking in restaurants and other public places."

The authors report one study of environmental pollutants from tobacco smoke found the levels of carbon monoxide at cigar banquets and in some cigar smokers' homes equal to carbon monoxide concentrations on crowded California freeways. "The indoor carbon monoxide level measured at a cigar banquet averaged 10 ppm [parts per million] over the 3-hour-20-minute event, and peak levels were comparable to that in a busy parking garage. By comparison, the ambient outdoor carbon monoxide level at rush hour was 1 to 2 ppm," the researchers write.

The authors suggest the need for more research including studies to understand better the nature of tobacco addiction associated with cigar smoking and address the temporal relationships between cigar smoking and the development of disease. They suggest future studies focus on susceptible groups, including younger cigar smokers.

Media Advisory: To contact Frank Baker, PhD, call Joann Schellenbach at 212/382-2169. On Tuesday, August 8, call the Science News Department at 312/464-5374.

(JAMA. 2000;284:735-741)

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For more information about The Journal of the American Medical Association or to obtain a copy of the study, please contact the Science News Department's Jim Michalski at 312/464-5785 or E-mail: Jim_Michalski@ama-assn.org.