Updated 18 February 2006 Printer-friendly version www.endsmoking.org.nz/cigarrisk18Fe06.pdf

Cigars

Cigar smoke is different

Cigars and cigarillos produce harsh alkaline smoke, which allows nicotine absorption through the mouth but which is much less likely to be inhaled into the lungs

Cigarette smoke is milder, acidic, and usually inhaled into the lungs, with much greater risk to the smoker.

  • Risks of cigar smoking one-sixth the risks of cigarette smoking, but it depends how much smoke is inhaled.
  • Risks for non-inhaling cigar smokers one sixteenth that of cigarette smokers.
  • Risk for cigar smokers who inhale cigar smoke is equal to about 10 cigarettes a day.

The risk of cigar smoking is much less than for cigarettes. The extra risk from smoking cigars of dying early from this habit was 10% compared with not smoking ever. However Figure 1 shows that it all depends on the amount inhaled into the lungs.

For cigar smokers who inhaled the risk was 138% extra, similar to smoking 10 cigarettes a day, and compared with 240% extra risk for 20 cigarettes a day smokers.

For cigar smokers who did not inhale the risk was only 4% in excess of not smoking.

Figure 1. Cigar smoking: relative risk of dying early from any cause, by level of inhalation , where never smoker’s risk =100

Figure 2. Cigar smoking: relative risk of dying early, by cigars per day  

Figure 1. Cigar smoking: relative risk of dying early from any cause, by level of inhalation , where never smoker’s risk =100

Figure 2. Cigar smoking: relative risk of dying early, by cigars per day

Cigar smoking risks: Cigars, health effects and trends. Monograph 9, National Cancer Institute USA , 1998, based on follow-up of 1 million US subjects for 12 years, including 22,000 cigar smokers, in Cancer Prevention Study I, 1959-72 , relative to cigarette risks at that time, and adjusted to cigarette risks in Bjartveit K, Tverdal A. Health consequences of smoking 1-4 cigarettes per day. Tobacco Control 2005; 14: 315-20.

Note:

         Most (78%) of cigar-only smokers do not inhale.

  • Over half (58%) of those who were also ex-cigarette smokers, do not inhale their cigar smoke.
  • If smokers smoke both cigars and cigarettes, the risk is intermediate between cigar and cigarette smoking risk.
  • In thecigar study, 5 or more cigars a day, including those inhaled and not-inhaled, had a combined risk one-quarter that of cigarette smoking 20 cigarettes a day.

Figure 3. Cigarette and cigar smoking risks of dying early compared with not ever smoking.

Figure 3. Cigarette and cigar smoking risks of dying early compared with not ever smoking.

         This graph compares the risks of smoking cigarettes with all cigar smokers, including those who inhale the cigar smoke.

         The cigar smokers who have been cigarette smokers have increased risk due to their past cigar smoking.

         They also tend to inhale the cigar smoke more.

 

Cigar smoking risks: Cigars, health effects and trends. Monograph 9, National Cancer Institute USA , 1998, based on follow-up of 1 million US subjects for 12 years, including 22,000 cigar smokers, in Cancer Prevention Study I, 1959-72 , relative to cigarette risks at that time, and adjusted to cigarette risks in Bjartveit K, Tverdal A. Health consequences of smoking 1-4 cigarettes per day. Tobacco Control 2005; 14: 315-20.

Clearly, as Figure 3 shows, the excess risk of cigar smoking is one-sixth or less than that of smoking cigarettes.

 

Cigar warnings

NZ Ministry of Health is expected to announce new pictorial warnings for all tobacco products in early 2006, for implementation later.

These warnings (see below) on cigar packets went on display in retail outlets in mid-October 2005, under an arrangement whereby Australian warnings are permitted for imported brands with small market share. New Zealand warnings are expected to be similar though not identical.

Cigars and cigarillos, for which these warnings are designed, produce harsh alkaline smoke, which allows absorption through the mouth. Cigar smoke is much less likely to be inhaled into the lungs.

Cigarettes and cigarette tobacco will carry similar warnings (and more besides).

Cigars need only to rotate five warnings over a two year period whereas, cigarettes and RYO tobacco must rotate 14 different warnings (seven in year 1 and the remaining seven in year 2 and then repeat those used in year 1 in year 3 and so on).

 

PICTURE HEALTH WARNINGS – FRONT

CIGARILLOS Package size: 111 X 100 mm Warning size: 29.7 x 94.2 mm

La Paz cigarillos new labels.pdf

CIGAR SMOKING CAUSES MOUTH AND THROAT CANCER

CIGAR SMOKING CAUSES MOUTH AND THROAT CANCER

Health Authority warning

Health Authority Warning C

CIGAR SMOKING CAUSES LUNG CANCER

CIGAR SMOKING CAUSES LUNG CANCER

Health Authority warning

 

 

DON’T LET CHILDREN BREATHE YOUR SMOKE

DON’T LET CHILDREN BREATHE YOUR SMOKE

Health Authority warning

 

 

CIGAR SMOKE IS TOXIC

CIGAR SMOKE IS TOXIC

Health Authority warning

 

 

F

For For cigars:

 

 

 

CIGARS ARE NOT A SAFE ALTERNATIVE TO CIGARETTES

Tongue cancer

 

CIGARS ARE NOT A SAFE ALTERNATIVE TO CIGARETTES

Health Authority warning

 

 

 Dr Murray Laugesen QSO chair; Prof Ross McCormick, Sir John Scott KBE, Trish Fraser MPH, Dr Marewa Glover, Trustees

Making it easier to quit smoking for good 2009 End Smoking NZ