• 4/6/2005
  • Marco Island, FL
  • Virginia Wallace
  • Marco Island Sun Times

Many people perceive cigar smoking as being more “civilized” and less dangerous than cigarette smoking. Yet a single large cigar can contain as much tobacco as an entire pack of cigarettes. The secondhand smoke it gives off and that others breathe in can fill a room for hours.

How are cigars different from cigarettes?

A cigar is defined, for tax purposes, as “any roll of tobacco wrapped in leaf tobacco or in any substance containing tobacco,” while a cigarette is “any roll of tobacco wrapped in paper or any substance not containing tobacco.”

Most cigars are made up of a single air-cured or dried burley tobacco. Cigar tobacco leaves are first aged for about a year and then fermented in a multi-step process that can take from three to five months. Fermentation causes chemical and bacterial reactions that change the tobacco and give cigars a different taste and smell from cigarettes.

Cigars come in different sizes, some as small as a cigarette (called a cigarillo), others much larger. Large cigars typically contain between five and 17 grams of tobacco. It is not unusual for some premium brands to have as much tobacco in one cigar as in a whole pack of cigarettes. Large cigars can take between one to two hours to smoke.

Who smokes cigars?

Cigar smoking continues to be a popular trend in the United States, especially among young men and women. It is fueled in part by the efforts of the tobacco industry to glamorize cigars and the willingness of movie stars and athletes to be paid and photographed smoking cigars. Especially for women, the industry seems to have tapped into an impulse among some to be slightly outrageous, to do something a little over the line, to be freed from old restrictions and stereotypes. Teenagers and young adults may be particularly vulnerable because of the mistaken idea that cigars are a safe alternative to cigarettes.

According to the U.S. Department of Agriculture, the consumption of cigars has been increasing since the early 1990s. Most of this increase was between 1993 and 1999, when use of both large cigars and cigarillos climbed by almost 70 percent. Cigar use has continued to grow (although less rapidly) in recent years. An estimated 5.1 billion cigars are expected to be consumed in the United States in 2004.

Sales of premium cigars, most of which are hand-made and imported, have increased over the last decade. The sharp rise in the popularity of gourmet coffee and microbrewery beers has contributed to the large increase in cigar smoking, particularly among young and middle-aged white men (ages 18 to 44) with higher than average incomes and education.

The rise in cigar smoking is not limited to the adult population, however. According to a survey from the Centers for Disease Control, the level of cigar use among adolescents and teenagers in recent years has been higher than that of smokeless tobacco use.

In 2002, about 6 percent of U.S. middle school students (grades six through eight) had smoked at least one cigar in the past 30 days. Boys (8 percent) were more likely than girls (4 percent) to be cigar smokers. In 2003, about 15 percent of U.S. high school students (grades nine to 12) had smoked at least one cigar within the past 30 days. Male high school students (20 percent) were more likely than female students (9 percent) to smoke cigars.

Among U.S. college students, a recent Harvard study found that 23 percent had smoked cigars at some point in their lives and about 16 percent of men and 4 percent of women were cigar smokers at the time of the survey.

Are cigars addictive?

While the reasons people smoke cigars are varied, the fact is, like cigarettes, cigars can become addictive. Nicotine is the substance in tobacco that causes addiction. Most cigars have as much nicotine as several cigarettes. When cigar smokers inhale, nicotine is absorbed as rapidly as it is with cigarettes. For those who do not inhale, it is absorbed more slowly through the lining of the mouth. People who use smokeless tobacco absorb nicotine the same way. Both inhaled and non-inhaled nicotine are highly addictive.

Do cigars cause cancer?

Cigar smoking increases your risk of death from several cancers, including cancer of the lung, oral cavity (lip, tongue, mouth, throat), esophagus (the tube connecting the mouth to the stomach), and larynx (voice box). If you inhale, cigar smoking appears to be linked to death from cancer of the pancreas and bladder, as well.

How much you smoke is important. Smoking more cigars each day or inhaling cigar smoke leads to more exposure and higher risks. Studies have shown your risk of death is higher if you smoke three or more cigars than if you smoke two or fewer cigars a day. The health risk associated with occasional cigar smoking (less than daily) is not known.

Does inhaling affect the risk of cancer?

While almost all cigarette smokers inhale, most cigar smokers do not. This may be because cigar smoke is generally more irritating. An emerging trend among cigar companies is to change the fermenting process of their products to make them easier to inhale. That same curing and fermenting process further enhances the flavor but also increases the levels of harmful ingredients.

For those who do not inhale, tobacco smoke does not reach the lungs in the same quantity as it does in cigarette smokers. Therefore, the risk of death from lung cancer is not as high as it is for cigarette smokers, but is still several times higher than the risk for non-smokers.

Cigar smokers with a history of cigarette smoking, however, are more likely to inhale. According to a recent American Cancer Society study, those who inhale have an increased risk of death from lung cancer 11 times greater than that of non-smokers.

The study also found that the risks for those who inhale are increased in other types of cancer. Compared to non-smokers, cigar smokers who inhale deeply are six times more likely to die from oral cancer and 39 times more likely to die from cancer of the larynx. They also face more than twice the risk of death from pancreatic cancer and more than three times the risk of death from bladder cancer compared to non-smokers.