Are Cigars Really Safer than Cigarettes?

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Some of my friends tell me they smoke cigars because they believe the risk of lung cancer is smaller for cigars than for cigarettes. Is this true? I checked the medical literature and found a report on the Zutphen Study from The Netherlands. This remarkable study covered a 40-year observation of the health of a cohort of men born between 1900 and 1920. In 1960, the researchers recruited 878 men. In 1985, an additional 939 men of the same age group were added. Data included smoking habits, alcohol consumption, and dietary factors. The research group followed the health of these men until 2000.

To analyze the smoking data, the researchers started with a baseline group of men who never smoked or who had been smoke-free for at least 10 years. Sadly, they couldn't find enough men who never smoked to give them a separate statistical group. The silver lining to this is the result that long-term ex-smokers had significantly better health than those who continued smoking.

Since most of the smokers stopped when they developed a serious illness such as cancer or heart disease, the researchers reported results in terms of disease-free years of life lost to smoking. The results for cigarette smokers depended strongly on the number of cigarettes smoked. Cigar and pipe smokers were all grouped together, since the numbers were too small for separate categories. Here are the results for lost years of health:

1. Cigarettes, 1 – 10 per day: 2.9 years
2. Cigarettes, 11 – 20 per day: 2.1 years
3. Cigars and pipes: 4.7 years
4. Cigarettes, 21 – 30 per day: 8.2 years
5. Cigarettes, > 30 per day: 10.6 years

The data for total life expectancy were similar, ranging from 2.1 to 8.8 years of life lost to cigarette smokers, and 4.7 years of life lost to cigar smokers.

When all the cigarette smokers were grouped in the same category, their average life expectancy was reduced by 6.8 years. This is higher than the average of 4.7 years lost to cigar and pipe smokers. So I would expect a cigar advertiser to claim their product is safer than cigarettes. However, it's not a fair comparison if the cigar smokers just smoked less total tobacco than the average cigarette smokers.

Clearly, smoking less is less dangerous. If switching to a different product helps you to smoke less, then it could be an advantage. But there seems to be nothing special about cigars as opposed to cigarettes.

Reference:

Streppel MT et al, “Mortality and life expectancy in relation to long-term cigarette, cigar and pipe smoking: The Zupphen Study”, Tobacco control 2007; 16: 107-113.

Linda Fugate is a scientist and writer in Austin, Texas. She has a Ph.D. in Physics and an M.S. in Macromolecular Science and Engineering. Her background includes academic and industrial research in materials science. She currently writes song lyrics and health articles.

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