Does anyone else ponder this?

[Buffalo]

I see my cigar boxes adorned with glaring health warning stickers. I read that the Mayo Clinic website states, “Despite what you might have heard, cigar smoking isn't safer than cigarette smoking — even if you don't intentionally inhale the smoke.” But then I consider that Arturo Fuente and Gilberto Oliva lived for 86 years, Alejandro Robaina made it until 90, and Ramón Cifuentes Toriello lived until 91, and those long lives seem improbable in light of the lurking hazards of cigar smoking.

I am curious as to what you think about the health risks of smoking cigars. Personally, I smoke approximately 5 cigars per week. I know that there is a risk factor involved, but I enjoy a good cigar anyway. What are your personal experiences in regard to your health, and the health of your cigar smoking friends? Do you have any concerns? And if you are a doctor or a nurse, and smoke cigars, do you feel conflicted about it?

I often wonder if anyone else ponders these things.

[Dusk]

I do, but with the million & one things that could take you out, the pleasure cigars gives me makes it a calculated risk worth taking.

I usually only smoke about 2 a week ( excluding holidays when I will indulge a bit more )

Sometimes I wonder if genitics plays a part,  like people who get sick from just the general pollution in the environment but have never really indulged many vices.

 

[KCCubano]

I'm more concerned about the 10 cans of Skoal I go thru in a week. 

[Shrimpchips]

54 minutes ago, Dusk said:

I do, but with the million & one things that could take you out, the pleasure cigars gives me makes it a calculated risk worth taking.

42 minutes ago, Lrabold89 said:

Moderation is the key with everything

These two together is the key really.  Most studies on cigar smoking show increased risk of many diseases, likely direct effects as well as  the lifestyle choices and characteristics of cigar smokers in general vs non-smokers.  But for the most part, if you’re not smoking multiple cigars every day, there’s probably a host of other things that’ll impact your health just as much if not more than having a few cigars a week.  In the end we’re all going to die, so might as well enjoy it a little more before we go.

Id have to think as a healthcare professional you’re aware of the risks, but there is always a trade off in life. I look at respiratory diseases everyday - but it doesn’t stop me from having a few cigars.  If anything I’m more motivated to work - finding cures means I’ll be able to freely smoke more cigars ?

[Kaptain Karl]

I’ll try to find a health study I read a year or so ago that studied this exact topic. They found that most cigar smoking had little impact on long term health. Long term health issues in cigar smokers are statistically more significant however when smokers were smoking multiple cigars per day over a long period of time. 
 

https://www.rstreet.org/2016/08/24/fda-study-cancer-risks-nearly-nil-for-1-2-cigars-per-day/

 

I think most of us who are healthy and smoke 3-6 cigars a week have little to worry about. I know the stress relief and psychological benefits I get from how I smoke cigars far outweighs any negatives. 

[Cairo]

I think statistics covering general populations are often not useful for individual people.

My father smoked cigars his entire life, and he is still kicking at age 93--with no lung issues, cancer issues, etc.

Meanwhile there are probably some other folks out there who smoked just a few cigars and croaked from lung cancer at a young age.

My advice--do what you want to do--if it is your time to die, you will die regardless.

[PigFish]

... with no disrespect! Does anyone but one getting a grant to perform one, give a rat's ass about 'studies?'

Do we need a team of self proclaimed experts telling us how to live our lives??? 

I don't know that any cliche here really has much relevance. I think this way because I have an overarching view of, and respect for individualism over tribalism.

I keep a healthy interest (forgive the pun) in statistics. They are certainly useful. However i would prefer to read the statistical information than I would have it 'interpreted' for me.

Anecdotally, I have heart disease. I suffer from many forms of stenosis. Cigar smoking cannot likely be good for me.

Brash statements about myself include; that I am proud to be neither ignorant of statistics nor a coward. I am not afraid of the outside world, my neighbor, nor other individuals being individuals. I have a robust fear of many things however. One is the loss of my freedom. That would lead to a life of shepherded doldrums and reduce life to smokeless, saltless, tasteless, fatless pap.

This pandemic has shown a lot of grit from a lot of people. Imagine if those workers in the market were so scared for their lives that they stayed home. Same of the health workers, emergency responders, etcetera!

Life is an 'at risk' endeavor. If one attempts it at all times based on fear, that person is to be pitied (MHO). Risk assessment is fears wiser sibling. I respect risk assessment until it becomes fear of living.

I have no doubt that living a tasteless, boring, fear-driven life will result in death anyway. Death is the end result for us all. Wishing to live longer than mortal life, I have assessed the value of my faith in God, both in life and after it. I have made at least one wise choice...! Beyond that, I will continue to smoke cigars, use ladders, walk on roofs, ride my Harley and take some calculated risk based on my desire to have something more than a rote, boring life!!!

I hope you will all do the same!

Cheers! -Piggy

[La_Tigre]

? speaking, You are definitely increasing risk. Let’s not rationalize it away. The word is out on tobacco products; let’s not kid ourselves. But, is every action in life not an assessment of risk and quality of life? We all have our versions of risk management and risk/reward. If smoking cigars gives you less QOL due to your concern of risks associated, you should not be smoking cigars. ¢¢

[vhampl03]

What Piggy said!  amen and amen..

[NSXCIGAR]

Here's the kind of nonsense put out by supposedly highly intelligent, well-educated people that I found on WebMD:

A single large cigar can contain more than a 1/2 ounce of tobacco -- as much tobacco as an entire pack of cigarettes. One cigar also contains 100 to 200 milligrams of nicotine, while a cigarette averages only about 8 milligrams. That extra nicotine may be why smoking just a few cigars a week is enough to trigger nicotine cravings.

The number of fallacies in that assessment is astounding. And the same garbage is repeated on dozens of "credible" sources. 

7 hours ago, Kaptain Karl said:

https://www.rstreet.org/2016/08/24/fda-study-cancer-risks-nearly-nil-for-1-2-cigars-per-day/

I believe this stands as the benchmark meta-analysis. Incredibly, the FDA researchers lie about their own findings in the analysis refusing to accept the data right in front of them, naturally. Also, this analysis looks at only cancer outcomes but the author suggests there's additional data regarding other diseases which he states he'll address in a future article but I can't find anything on that. However, based on his statement, I think we can assume the data is positive. 

Just for fun here's an old CA article from 2000 addressing this. Seems like a lifetime ago:

https://www.cigaraficionado.com/article/smokescreens-7265

[RDB]

I’m a professional researcher. Not a medical researcher, but I look at a lot of evidence on many different issues. I also have two small children and a life I enjoy - and I don’t want to die or be crippled by some horrible disease.

I’m struck by the difficulty of getting really good evidence on this issue. My reading of what is available suggests that cigar smoking does increase my risks, but not in a way that makes it unreasonable. Cigarette smoking certainly fails this test.

I smoke about five a week. I don’t feel any negative impact, and I’m very sensitive to my physical state and do a lot of exercise. I do think that at some point the impact would increase, for example from smoking multiple cigars a day. So my current level seems to me a sensible equilibrium.

P.S. I love smoking cigars.

[LordAnubis]

No one should be kidding themselves into thinking cigar smoking or any smoking in any form of moderation is good for you. It isn’t. 

The argument as stated is what’s the risk. I hate reading articles about cigar smokers as we all know for many reasons they’re just flawed. I particularly hate that cigar smokers with the same risk as cigarette pack a day smokers are cigar smokers who smoke three cigars a day. No word on vitola. 

I believe in moderation. I believe with my smoking rate of 1-2 cigars per week yes I am increasing my risk. But equally by getting in my car I am also increasing my risk of dying. 

Both my father and my mother have heart disease. I have high cholesterol despite my pretty good diet and reasonable fitness level. I don’t think cigars will play a huge part in my ultimate demise. 
I’d rather smoke cigars and enjoy time with the Perth boys than sit at home eating salad. 

[Bijan]

12 minutes ago, LordAnubis said:

I particularly hate that cigar smokers with the same risk as cigarette pack a day smokers are cigar smokers who smoke three cigars a day. No word on vitola. 

Based on this Monograph:

https://cancercontrol.cancer.gov/sites/default/files/2020-08/m09_1.pdf

1-2 cigars per day is about 2% increase in mortality from all causes, 3-4 a day is 8%, and 5+ cigars a day is 17%.

Meanwhile <1 pack per day of cigarettes is 46%, 1 pack is 69% and >1 pack is 88%.

However looking at cigar smoking by depth of inhalation, smoking cigars but not inhaling (I'm guessing this is the average over all amounts of cigars per day) is 4%, slight inhalation is 19%, and moderate to deep inhalation is 60%.

Meanwhile none, slight inhalation on cigarettes is 54%, moderate 65%, deep 90%.

The data is interesting to look at in terms of the increase in various causes of death: cancers and other diseases.

[NSXCIGAR]

44 minutes ago, Bijan said:

Based on this Monograph:

https://cancercontrol.cancer.gov/sites/default/files/2020-08/m09_1.pdf

Burns, who authored this monograph, conducted the research with Shanks that is analyzed in the FDA paper above (https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-015-1617-5)

His research and everything else he looked at in that monograph was taken into consideration. I would conclude the BMC/FDA meta-analysis to be more reliable. Again, it appears to be the benchmark analysis.

[...]

My mother’s uncle, who introduced me to cigars in the late 90’, died this past spring on his 103rd birthday. Most folks on both of my parents’ sides live into their 90’ eating cake out of boxes and drinking/smoking.

I plan for the long game ?

[Bijan]

31 minutes ago, NSXCIGAR said:

Burns, who authored this monograph, conducted the research with Shanks that is analyzed in the FDA paper above (https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-015-1617-5)

His research and everything else he looked at in that monograph was taken into consideration. I would conclude the BMC/FDA meta-analysis to be more reliable. Again, it appears to be the benchmark analysis.

Yeah I was just looking at that one.

Edit: The data in Table 3, on all cause mortality as a function of cigars smoked per day and inhalation depth, is essentially the same as from the Burns monograph, which I wrote about. Though more studies are used to gather the data on the other tables.

[Buffalo]

I have to say that I am impressed with the thoughtful, insightful, and informative responses that I have read in this thread. There are many a smart folk on this forum.

[Bijan]

What I'd really want to see is the absolute risks, rather than relative risks.

For example the data says that smoking 1-2 cigars per day you're 6 times more likely to die of cancer of the larynx, and 2 times more likely to die of cancer of the mouth or pharynx.

And at 5+ cigars per day you're 26 times more likely to get laryngeal cancer and 16 times more likely to get oral/pharyngeal cancer. But what are those odds in terms of the chance that you die of either of those.

Maybe I'll try to calculate them roughly at some point.

In terms of general incidence of all these causes of death, it looks like there are about 4,000 laryngeal cancer deaths in the US per year (though that is dropping due to smoking going down over time) and about 11,000 deaths per year for oral + pharyngeal cancer combined. 16,000 deaths for esophageal cancer. 47,000 deaths for pancreatic cancer. 154,000 deaths for lung cancer. Then there's COPD (140,000 deaths per year) and heart disease (655,000 deaths per year). Though COPD mortality increases in the study weren't statistically significant. Total deaths per year in the US are around 2,800,000, and covid this year has been 261,000 so far (so trailing 12 month mortality is over 3,000,000 right now).

There is a lot of variation between how common these different causes of death are (with the ones with the biggest mortality ratio increase being the rarest overall, so that they might not be much of an absolute risk). And this is why the absolute risks of smoking in terms of each cause of death would be interesting.

Smoking in general in terms of cigarette smoking is down from 20% of adults to about 15% of adults (I think this is the data from roughly 2005 to 2015). Cigar smoking is something like 3%. You could use these rates and assume the worst case that some of these diseases are mainly/only happening in smokers to get an idea of the odds/numbers. However some of them like laryngeal and esophageal cancer can also be due to heavy drinking, so maybe you'd want to take that into account.

Then of course beyond mortality rates there's also quality of life issues you may face if you get hit by one of these health problems and survive.

[NSXCIGAR]

59 minutes ago, Bijan said:

What I'd really want to see is the absolute risks, rather than relative risks.

This stuff is just extremely difficult to get data on. First, where are these people that smoke 5 cigars a day? My god. I'd venture to guess anyone smoking like that isn't at the gym 2 hours a day either if you know what I mean. 

I addition, all the data I've seen over the years indicates that something like 10% of cigar smokers inhale. Are they screening for that? I would imagine that could certainly produce a statistically significant influence.

At this point I think it's accepted that the amount of harm caused by tobacco's chemicals are dose-dependent. If 2 cigars per day (14 per week) is not even statistically significant then one per day is almost certainly immeasurably harmful. Diet almost without question would rank higher in influence. 

I smoke a lot, and I'm not exceeding 14 cigars per week. 2 cigars per day, every day, isn't easy to do. Believe me, I try!

[Hammer Smokin']

we had a thread in the last year about numbers of cigars per day. 

I was shocked how many people said they smoked 3-4 (or more) cigars per day. 

[NSXCIGAR]

4 minutes ago, Hammer Smokin' said:

I was shocked how many people said they smoked 3-4 (or more) cigars per day. 

Yes, but all cigars are not equal. I could smoke 7 Perlas a day. That's another issue with the data. Cigars are not uniform as cigarettes generally are. What does "2 cigars per day" really mean? 

[Bijan]

13 minutes ago, NSXCIGAR said:

In addition, all the data I've seen over the years indicates that something like 10% of cigar smokers inhale. Are they screening for that? I would imagine that could certainly produce a statistically significant influence.

Yes as I cited above they looked at self reported inhalation depth and though one can expect it to be not entirely accurate it was highly correlated with mortality risks. 4% risk at no inhalation. Slight inhalation at 19% and moderate deep inhalation at 60% increase in all cause mortality.

[NSXCIGAR]

1 minute ago, Bijan said:

Yes as I cited above they looked at self reported inhalation depth and though one can expect it to be not entirely accurate it was highly correlated with mortality risks. 4% risk at no inhalation. Slight inhalation at 19% and moderate deep inhalation at 60% increase in all cause mortality.

Well, there it is. To me, that's irrefutable, direct evidence that cigar smoking as generally practiced is exponentially safer than cigarette smoking.

Not all tobacco products are created equal despite what the medical technocratic overlords continue to falsely maintain.

[ReelMan]

Those gentlemen, and many like them, have had the advantage of living in countries in which there is very little processed food.  Although there may not be studies done, we don't, as consumers, know what harmful ingredients are contained within those packages.  When you are eating fresh farm vegetables, lettuce and meat, there has to be an advantage that in turn helps the aging process.  A lack of pesticides, GMO's and the like would, I believe, make a difference.  Who knows what heavy metal particulates are contained in foods (or in the food processing)?

We do our bodies no favors by ingesting the crap that we casually pass off as "food".  I am surprised that we live to 30.  It may be that cigars are negating the harmful effects of the other stuff we ingest.?

[Ej456]

It’s hard to fraction out the risk of daily activities when you need to earn a buck 

 

I’ll probably regret that statement someday