Cigars may be as bad for your health as cigarettes, particularly among experienced smokers who deeply inhale the toxic substances they contain.
Cigar smokers have elevated levels of potentially cancer-causing ingredients in their blood and urine, a study from the U.S. Food and Drug Administration found. The amount of NNAL, a carcinogen which comes only from tobacco, was as high in daily cigar smokers as those who regularly smoke cigarettes, according to the report in Cancer Epidemiology, Biomarkers & Prevention.
While cigar aficionados are supposed to puff rather than inhale, studies show they breathe smoke particles into their lungs even when they think they aren’t inhaling.
“There is no safe level of cigar smoking,” said Jiping Chen, the lead author and an epidemiologist in the FDA’s Center for Tobacco Products. “Even cigar smokers who don’t smoke every day are exposed to substantially higher levels of toxic compounds.”
The FDA is planning to expand its tobacco regulation to include cigars and e-cigarettes, a move that will likely ban sales to minors and require addiction warnings. The study, involving investigation of 25,522 people, confirms earlier findings that cigar smoking can cause cancer, heart disease and early death.
13 billion cigars
“It’s important the public receives clear and consistent messaging from public health authorities about the health risks of smoking,” said Simon Evans, a spokesman for Imperial Tobacco Group Plc, the world’s biggest cigar maker. “Adults should be guided by those messages when deciding whether or not to smoke.”
Americans smoked more than 13 billion cigars in 2010, double the 6.2 billion consumed in 2000, according to the U.S. Centers for Disease Control and Prevention. Young adults and teenagers appear particularly taken, with 16 percent of those ages 18 to 24 saying they smoked a cigar within the past month.
Workers make cigars in Havana, Cuba.
They may be under the misperception that cigars are less dangerous and less addictive than cigarettes, perhaps because the smoke is more irritating and harder to inhale, the researchers said.
Younger smokers are also attracted by the way some cigars are made and marketed, said Joanna Cohen, a professor of disease prevention and director of the Institute for Global Tobacco Control at Johns Hopkins Bloomberg School of Public Health. They often contain flavors like grape and cherry that are popular with youth and can be sold one at a time, making them more affordable, she said.
“When people say cigars, you think of the traditional big Cuban cigar that men generally smoke around poker games,” said Cohen, who wasn’t involved in the study. “But cigarillos, these small cigars, are what’s popular among youths. They are easily accessible with youth-oriented flavors, and that’s one of the big concerns.”
Despite the booming demand for cigars, studies examining exposure to their toxic ingredients have fallen far short of the extensive research into cigarettes. Even with less investigation, it’s known that cigar smokers are more vulnerable than non-smokers to lung, pancreas and bladder cancer, as well as heart and lung disease.
The results may quantify the risks of cigars and help implement regulations that address the “alarming” issue of cigar smoking, especially among young people, the researchers said. Efforts should be made to prevent people from starting cigar smoking and to encourage others to quit, they said.
In the study, cigar aficionados had higher levels than non-smokers of cotinine, cadmium, lead and NNAL, all potential cancer-causing agents or toxic substances that have been linked to cardiovascular and respiratory complications. Those who had stopped smoking cigarettes and picked up cigars had significantly higher levels of cotinine, a metabolite of nicotine, and NNAL, a byproduct of the cancer-causing agent NNK.
The results stem from the National Health and Nutrition Examination Survey conducted from 1999 through 2012. It’s the first to examine markers of health among cigar smokers in the U.S. The findings covered all types of cigars, including cigarillos and premium cigars.
The risk of routine smoking may even be higher than the study indicates because the researchers couldn’t filter the data to leave out people who enjoyed cigars only occasionally. The study also found that former cigarette smokers were more vulnerable, perhaps because they were more likely to deeply inhale the cigar smoke.
“These are terrible things to have in your body,” Cohen said. “Any exposure to these chemicals isn’t going to be good for you, and the longer the exposure and the higher the exposure, the worse it is.”