Well this is interesting - cigar smoking and cancer risks


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very interesting.

I suggest you to chance your topic title and include words like risk, cancer, tobacco... so more people can find it in the future.

I dont know how serious this study is but it's always good to have some ammunition against tobacco haters.

I love this paragraph:

Still, even moderate cigar smokers had a 20% increase in heart disease risk, which is consequential.  That increased risk is, however, of the same magnitude that most Americans experience when they eat meat (as compared to heart disease risk for vegetarians).  Lifestyle choices have consequences; consumers should use research results to inform their choices, including those concerning tobacco.

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Excellent analysis and scrutiny, @MD Puffer, on which I can only wholeheartedly agree! Typical basic issue of epidemiology on parameters with small effects to begin with, and in addition issues of poor study design. Both met in a perfect flapdoodle effect.
 

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As long as we are adding on to the problems with the study: It looks like the used self-reports to tobacco use status of health plan subscribers. An old study but people were not that much stupider in the 90s. If you health plan provider or insurance agent asks if you smoke you tell them no. 

 

All this being said I don't really doubt that smoking cigars, even fine Cubans, will increase my risk for certain diseases. I try to offset that by exercise, healthy eating and moderation. 

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There will NEVER be a scientific study with a handle on ALL relevant controls and variables. We can’t gather enough empirical data, but only jump to conclusions based on observations... which are mostly biased. Any volunteers to sit in a controlled environment and be told when/ what/where to smoke, eat, drink, sleep, exercise, take drugs, induce stress, etc., etc.???

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5 hours ago, RDB said:

So, are there any good studies of the health effects of cigar smoking? 

It's probably relative to stress levels, I know @MD Puffer will be able to chime in, but I've always been under the impression that high levels of stress opens you up to horrific diseases and conditions, if you can do something to reduce stress then it's almost always a positive thing..

  But obviously it is relative; yoga will be far better for you than a cigar but a cigar will be far better for you than shooting up heroin. The grey area is balancing it; cycling outside is a great stress reliever, but if you cycle to work everyday stuck behind vehicles pumping out pollution right into your face, then are a few cigars a week more healthy than that?! I'd hazard a guess you'd be better off with the cigars!

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3 hours ago, CaptainQuintero said:

But obviously it is relative; yoga will be far better for you than a cigar but a cigar will be far better for you than shooting up heroin. 

Can't disagree with this, but there's no way I'm ever wearing yoga pants...

 

meninyogapants_img12.jpg

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9 hours ago, RDB said:

So, are there any good studies of the health effects of cigar smoking? 

I still like the original bedtime read that was the Surgeon General's report on smoking from 1968.  What I liked about it was that it was huge, and a straight up mortality test; almost no "massaging" of the numbers.  They took a lot of smokers; cigar, pipe and cigarette, on multiple continents and the analysis was "live or die" and at what age.  Cause of death was not used to mess with the numbers.  So for example, the guy who died smoking his cigar when the hot ash dropped in his lap while driving 100mph through the desert to Vegas wasn't moved from the "smoker" column to the "car accident" column.

The end result of that study was that cigar smokers (and pipe smokers) who did not inhale (yes they asked that) and who smoke 5 or fewer cigars per day (considered "moderate" back then) had the same longevity, or in some cases slightly longer,  than non smokers.  Also interesting was the cigarette smoker curve: those who started late in life (after 30) and smoked modestly (I forget the number but less than a pack a day) also showed no increase in mortality, however someone who started at 15 and smoked 2 packs a day tripled their risk of early death.

And this was all in a day and age when people smoked indoors (whether you were a smoker or not :P ) , so clearly there is some benefit to the relaxing practice of cigars that outweighs the harm from second hand smoke.

Here's a clip of the Surgeon General's mortality table for cigars:

Cigar Surgeon General.pdf

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@MD Puffer if you want a so meticulous study about everything in life it will be hard even to breath.

cool down, bro, not everything in life must have a PhD tesis. maybe you are in academia and you get pissed when you see an out of parameter study.

every article that from time to time crosses the forum show that low level cigar smokers dont experience so bad consequences.

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He’s simply pointing out flaws in the paper. The same flaws that I too, as a man of science and engineering and understanding of statistical analysis, was sceptical/concerned about the validity of the report.

I was glad to see his input. He’s clearly a researcher or something. Great to have the input.


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3 hours ago, oliverdst said:

@MD Puffer if you want a so meticulous study about everything in life it will be hard even to breath.

cool down, bro, not everything in life must have a PhD tesis. maybe you are in academia and you get pissed when you see an out of parameter study.

every article that from time to time crosses the forum show that low level cigar smokers dont experience so bad consequences.

I'm in private practice now, but I spent 9 years in academia and routinely was involved in study design and identifying flaws and biases in studies.  This study may have been one of the publications that were required for one of the author's doctoral degrees (you generally need 4-5 publications in addition to your dissertation).  But this was a big deal- this got published in the New England Journal.  They're a top tier medical journal.  Getting published in journals are the livelihoods of researchers.  Without publications you lose lab space, funding, the ability to hire lab assistants, grad students won't want to work with you, and worst yet- you'll be forced to teach undergraduate classes.  Getting published in NEJM is like getting called up from the minors.  There are few that are more respectable.  The path to getting published in the NEJM, JAMA, Nature, etc is grueling.  Your study gets picked apart like tooth pickin' chicken.  Medicine is also political unfortunately.  And in this case, politics likely had something to do with a poorly designed study with several obvious biases (selection, observer, and cause-effect, confirmation).  If this was any other article that wasn't about a hot topic issue, it wouldn't have been published in the NEJM and would probably have only gotten published in a 3rd tier (or maybe lower) journal- provided the authors paid the publication fees (which is standard).  This is a poor study.

 

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1 hour ago, MD Puffer said:

...This study may have been one of the publications that were required for one of the author's doctoral degrees (you generally need 4-5 publications in addition to your dissertation)...

 

The article stated that the study was performed by Kaiser, which I think is one of the largest and best rated medical providers in the country.  Am I missing something?

I appreciate your comments. Thanks. 

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26 minutes ago, Shelby07 said:

The article stated that the study was performed by Kaiser, which I think is one of the largest and best rated medical providers in the country.  Am I missing something?

I appreciate your comments. Thanks. 

You're not missing anything.  There was also federal grant funding.  Someone had mentioned that this study wasn't a PhD thesis and I just added that these papers very often are a requirement of doctoral candidates.  I didn't mean to confuse thing with an unnecessary remark.   Point is that the NEJM wouldn't have published a cohort study with this data on most other health disorder unless it was a hot topic.  

I don't know how insurance companies are rated.  Kaiser isn't a carrier in my state.  The study could have come out of Harvard and it would still be garbage.  You can't design a study about the effects of tobacco use that is generally non-inhaled and not control for secondary exposure (unventilated indoors or living with other smokers) or control for socioeconomic-related factors.  What information you can get out of this data set isn't fit to publish in NEJM or other top tier journals.

 

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4 hours ago, MD Puffer said:

I'm in private practice now, but I spent 9 years in academia and routinely was involved in study design and identifying flaws and biases in studies.  This study may have been one of the publications that were required for one of the author's doctoral degrees (you generally need 4-5 publications in addition to your dissertation).  But this was a big deal- this got published in the New England Journal.  They're a top tier medical journal.  Getting published in journals are the livelihoods of researchers.  Without publications you lose lab space, funding, the ability to hire lab assistants, grad students won't want to work with you, and worst yet- you'll be forced to teach undergraduate classes.  Getting published in NEJM is like getting called up from the minors.  There are few that are more respectable.  The path to getting published in the NEJM, JAMA, Nature, etc is grueling.  Your study gets picked apart like tooth pickin' chicken.  Medicine is also political unfortunately.  And in this case, politics likely had something to do with a poorly designed study with several obvious biases (selection, observer, and cause-effect, confirmation).  If this was any other article that wasn't about a hot topic issue, it wouldn't have been published in the NEJM and would probably have only gotten published in a 3rd tier (or maybe lower) journal- provided the authors paid the publication fees (which is standard).  This is a poor study.

 

relax and light a cigar, bro.

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