The Risks of Cigars

As any cigar lover will tell you, cigars and cigarettes are in two different leagues. Cigarettes come with a warning label; cigars come with a fancy box. A cigarette might last five minutes; a good cigar can last an hour or more.

While cigarette smoking has steadily declined over the years; cigar smoking has become more popular, increasing by more than 33 percent between 1996 and 2006. And, of course, cigars have an aura of pomp and ceremony. Few people would celebrate a new baby with a pack of Winstons.

But cigars are dangerous. According to the National Institutes of Health, a cigar emits up to 90 times a cigarette’s level of nitrosamines, which are potent cancer-causing compounds.

Thanks to clever marketing and magazines such as Cigar Aficionado, cigars have come to symbolize the good life. But some of the glamor has already started to fade, says Ron Todd, MS Ed, director of tobacco control for the American Cancer Society. “People are realizing that these are big, expensive things that stink,” he says. “Hopefully, more people will see through the fog of propaganda used to promote these things.”

Advertising tries to hide cigars’ biggest shortcoming: If lit up often enough, they can be deadly. Puffing a cigar to celebrate a new baby may be harmless, but just one cigar a day on a regular basis poses a serious threat to health, both to the smoker and anyone exposed to the secondhand smoke. If you regularly smoke cigars — or live with someone who does — you should take a close look at this highly toxic status symbol.

Chemical stew

Cigars are essentially clumps of aged tobacco wrapped in a tobacco leaf. A premium cigar may hold as much tobacco as a whole pack of cigarettes. Because leaves are much less porous than cigarette paper, the tobacco in a cigar smolders. This slow burn releases a stew of compounds that’s even more dangerous than cigarette smoke. In addition to nitrosamines, cigar smoke is loaded with tar, carbon monoxide, and ammonia.

The only saving grace is that most cigar smokers don’t inhale. (Unlike cigarette smoke, cigar smoke doesn’t need to reach the lungs to provide a nicotine kick.) For this reason, regular cigar smokers are only about twice as likely as people who don’t smoke cigars to develop one type of cancer — lung cancer. By contrast, male cigarette smokers are 22 times as likely as nonsmokers to get lung cancer, and female smokers are 12 times as likely to develop it.

But even if you take dainty puffs, you’re still bathing your mouth and throat in at least 60 cancer-causing compounds. According to the NIH, smoking one or two cigars a day doubles the risk of cancer of the lips, tongue, mouth, throat, or esophagus. If you smoke more than two of them daily, the risk rises dramatically.

And for cigar smokers — often ex-cigarette smokers — who do draw the smoke into their lungs, the danger of cancer goes sky high. Deep inhalers are about five times as likely as nonsmokers to die of lung cancer. And then come the truly scary numbers: They’re about 27 times as likely as nonsmokers to have cancer in the oral cavity, 15 times as likely to have cancer of the esophagus, and 53 times as likely to have cancer of the larynx.

But cancer is only part of the story. Like cigarettes, cigars are hard on the heart. A study of nearly 18,000 men published in the New England Journal of Medicine found that cigars raised the risk of coronary heart disease by 30 percent. As if that weren’t enough, the risk of emphysema rose 45 percent.

In an editorial in the New England Journal of Medicine, former U.S. Surgeon General David Satcher, MD, says it is time to hold cigars and cigarettes to the same standards. Specifically, cigars should come with warning labels and should be taxed just as heavily cigarettes. “It’s critical that cigars not be [seen] as a safe or less costly alternative to cigarettes,” he wrote.

If you smoke cigars, do whatever it takes to quit. Cigars generally aren’t as addictive as cigarettes or chewing tobacco, so it should be easier to stop. You may lose a status symbol, but you’ll gain a whole lot more.


NIH Cigar Monograph. Cigars: Health Effects and Trends. 1998.

NIH Backgrounder. Background on NIH Cigar Monograph. April 10, 1998.

Iribarren, C. et al. Effects of cigar smoking on the risk of cardiovascular disease, chronic obstructive pulmonary disease, and cancer in men. New England Journal of Medicine. June 10, 1999. 340(23): 1773-1779.

Satcher, D. Cigars and Public Health. New England Journal of Medicine. June 10, 1999, 340 (23): 1829-1831.

Delnevo CD et al. Trading tobacco: Are Youths Choosing Cigars over Cigarettes? American Journal of Public Health. 95(12):2123. December 2005.

USDA. Tobacco Outlook. October 24, 2007.

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