Cigarette Smoking More Harmful than Pipe or Cigar Smoking

[Jimmy2]

Cigarette Smoking More Harmful than Pipe or Cigar Smoking

According to an article recently published in Lung Cancer, smoking cigarettes is more harmful than smoking cigars or pipes, largely due to inhalation methods.

Lung cancer remains the leading cause of cancer-related deaths in the United States. In fact, lung cancer kills more people every year than breast cancer, prostate cancer, and colorectal cancer combined, the next three leading causes of cancer-related deaths,.

Smoking is known to be a large contributor to the incidence of lung cancers; however, smoking pipes or cigars tends to be associated with a lower rate of death than smoking cigarettes.

The cytochrome P-450-1A (CYP1A) biological pathway converts tobacco into carcinogens (cancer-causing molecules). Researchers from France recently conducted a clinical trial to evaluate CYP1A2 (a measure of activity within the CYP1A pathway) among patients who smoked cigarettes, cigars, or pipes. This trial included 28 individuals who smoked cigarettes only, 30 individuals who smoked pipes or cigars, and 30 individuals who were non-smokers.

Cigarette smoking was the only predictor of CYP1A2 activity.

The researchers believe that the way smoker inhale, versus the means through which tobacco is smoked, is the main reason for differences in CYP1A2 activity.

The researchers concluded that cigarette smokers tend to inhale larger amounts of tobacco smoke than cigar or pipe smokers. They therefore produce more carcinogens when they smoke. This is consistent with data showing fewer deaths among cigar and pipe smokers compared to cigarette smokers

[El Presidente]

Jimmy,

Your investigative journalism makes you the Woodward and Bernstein of our forum ;-)

Keep up the great work

[JMH]

I thought the cytochrome pathway was only found in the lungs however, which would account for a higher degree of lung cancer victims being cigarette smokers. I don't think it relates to throat/mouth cancers.

[anacostiakat]

Yea and Al Gore says cigarette smoking causes global warming! ;-)

[Jimmy2]

;-)

[Ginseng]

» I thought the cytochrome pathway was only found in the lungs however, which

» would account for a higher degree of lung cancer victims being cigarette

» smokers. I don't think it relates to throat/mouth cancers.

I believe you're correct. The various cancer studies relating to smoking in general seem to say that cigar smoking does result in increased risk over non smokers but not as badly as for cigarettes.

Wilkey

[connoiseur29]

Great post. This is true, if you do not inhale cigar smoke your risk of getting lung cancer is pretty small. And we all know lung cancer mortality is high and the clinical course quick (6 months to about a few years if it is typical lung cancer)

The relative risk of getting lung cancer for cigarette smokers is about 16. While for cigar smokers it is about 3. See Prev Med. 1988 Jan;17(1):116-28 in which 6,000 patients were studied. In another study, cigar smokers had about a 5 fold increase in risk for lung cancer development than a non-smoker and a 10 fold increase in risk for laryngeal cancer. See J Natl Cancer Inst. 2000 Feb 16;92(4):333-7. and Eur Respir J. 1992 Oct;5(9):1111-7.

Cancers that cigar smokers are susceptible to are something that cigarette smokers are also susceptible to, mainly laryngeal cancer.

The rate of lung cancer development in the cigarette smoker is about the same or slightly more than the rate of laryngeal cancer development in the cigar smoker, but it is frequent.

A lot of them start in small hidden sites like the base of the tongue, the tonsillar crypt, the vocal cords and folds and in small recesses that a physician cannot see with his eye.

However, if you see your physician or dentist frequently and inform him of any persistent cough or sore throat, ulcers, bumps or nonhealing spots in your mouth that you have noticed say while brushing your teeth, you have a chance of catching it early and getting it cut out before it spreads, if it is not in one of the hidden spots.

Something else will probably get us before the cigars do, but know the warning signs and what to look for and seek treatment.

I love my cigars and staying informed and knowing where to look and what to look for is just something to keep in the back of your mind.

I think I will go have a BBF now. cheers!

[Professor Twain]

» Great post. This is true, if you do not inhale cigar smoke your risk of

» getting lung cancer is pretty small. And we all know lung cancer

» mortality is high and the clinical course quick (6 months to about a few

» years if it is typical lung cancer)

»

» The relative risk of getting lung cancer for cigarette smokers is about

» 16. While for cigar smokers it is about 3. See Prev Med. 1988

» Jan;17(1):116-28 in which 6,000 patients were studied. In another study,

» cigar smokers had about a 5 fold increase in risk for lung cancer

» development than a non-smoker and a 10 fold increase in risk for laryngeal

» cancer. See J Natl Cancer Inst. 2000 Feb 16;92(4):333-7. and Eur Respir J.

» 1992 Oct;5(9):1111-7.

»

»

» Cancers that cigar smokers are susceptible to are something that cigarette

» smokers are also susceptible to, mainly laryngeal cancer.

»

» The rate of lung cancer development in the cigarette smoker is about the

» same or slightly more than the rate of laryngeal cancer development in the

» cigar smoker, but it is frequent.

»

» A lot of them start in small hidden sites like the base of the tongue, the

» tonsillar crypt, the vocal cords and folds and in small recesses that a

» physician cannot see with his eye.

»

» However, if you see your physician or dentist frequently and inform him of

» any persistent cough or sore throat, ulcers, bumps or nonhealing spots in

» your mouth that you have noticed say while brushing your teeth, you have a

» chance of catching it early and getting it cut out before it spreads, if it

» is not in one of the hidden spots.

»

» Something else will probably get us before the cigars do, but know the

» warning signs and what to look for and seek treatment.

»

» I love my cigars and staying informed and knowing where to look and what

» to look for is just something to keep in the back of your mind.

»

» I think I will go have a BBF now. cheers!

These comments are interesting.

I do health related research but am not a specialist in cancer epidemiology, or the health effects of smoking. I have been poking around in this literature a bit myself. One of the problems in many of the studies is that they often include people who have a history of cigarette smoking, and pipe smokers, into the cigar smoking category. Most studies also don't look at the degree of exposure, both number of cigars per day, and number of years of smoking.

I have looked closely at the J Natl Cancer Inst. 2000 Feb 16;92(4):333-7 paper that you mentioned, authored by Shapiro et al. This seems to me to be the strongest paper in terms of methodology, e.g. they really look at people who are primary cigar smokers as a separate group, and they do a careful job of sorting out how much exposure subgrous of cigar smokers have.

While they don't mention this in the abstract, or even in the discussion section, if you look closely at their results a few interesting findings are apparent:

There is not a significant increase in risk for lung cancer in people who smoke fewer than 3 cigars per day (risk ratio is 1.3), but for those who smoke 3 or more per day the risk ratio is 7.8 (risk ratio is a comparison to those who never smoked). This is shown in Table 3 of the article. In fact, people smoking fewer than 3 cigars a day do not show statistically significant increased risk of mortality from ANY type of cancer in this study. The only large risk ratio for people smoking less than 3 cigars a day is 6.0 for larynx cancer, but there was only one death among these less frequent smokers so the risk ratio is not statistically reliable. There were 3,541 men in the less than 3 per day category, and 3,945 men in the 3 or more category.

This table also shows that number of years smoking cigars is important, the risk ration for those smoking less than 25 years is 2.1 (not statistically significant) but for those smoking over 25 years, the risk ratio is 5.9. It would be most interesting to look at these data to see whether people who have, say, 10 or less years of exposure show any increased risk. So, it may be that if you start your cigar smoking late enough in life, you may have some protection versus people who started early and smoke cigars for many, many years.

I am not minimizing the health effects of our hobby, but I do find it troubling that people in the anti-smoking business don't seem to want to point out that, for people who smoke relatively small numbers of cigars, these risks are far lower. From a public health perspective, they seem to want to promote a simple message that all smoking is bad. It is probably not good public health policy to communicate a more nuanced message.

Connoiseur29, it might be fun to discuss this back channel, although I don't think I would have the time to do a definitive review of this topic (although I am tempted). I do have a sabbatical coming up...

[connoiseur29]

sounds great!

[Nimrod]

Well, its pretty much what most of us know. Some people are born more likely to get cancer though even if they live like an angel.

I guess the key is not to kick the arse out of smoking cigars which is handy cos I am not rich lol. ;-)