The Risks of Cigar Smoking

Q: What are the hazards of cigar smoking, and are they safer than smoking cigarettes? Also, is it true that one cigar is the equivalent of 20 cigarettes, creating the same damage to blood vessels that can lead to cardiovascular disease?

A: Smoking cigars is no safer than smoking cigarettes. A cigar smoker is exchanging one health threat for another. Both contain the addictive ingredient nicotine, and both produce secondhand smoke, which is packed with toxic fumes. Also, those who smoke at least one large cigar per day or are regularly exposed to its fumes have a higher risk for developing cardiovascular disease, which is something that is clearly associated with cigarette smoking.  And for guys, there is a strong link between regular cigar smoking and erectile dysfunction. Needless to say, safe is a word that is never used when discussing cigarette or cigar smoking.

The tobacco load

The size of cigars vary, as does their tobacco load. For example, large cigars may contain as much tobacco as a whole pack of cigarettes, while cigarillos (little cigars) may be similar in size and tobacco content to that of one cigarette. These products are also different in that cigars are a roll of tobacco wrapped in a tobacco leaf or paper dipped in tobacco, while cigarettes are a roll of tobacco wrapped in a non-tobacco containing cover, usually paper. Yet, despite their differences, both release smoke packed with more than 4,000 chemical compounds (including some with the potential to cause cancer) within seconds of lighting up.

But that's only part of the story. One cigarette contains one to two milligrams of nicotine, while one large cigar contains 100 to 200 times that amount. However, this difference may be deceptive. While the cigarette smoker inhales and gets a substantial "hit" of nicotine from each cigarette, the amount of nicotine delivered to a cigar smoker varies and depends upon many factors, according to the American Cancer Society.

• How long the cigar is smoked (15, 30, 60, 120 minutes or more)
• How many puffs are taken
• Whether or not the smoker inhales (if they do the nicotine is quickly delivered to the lungs, if they don’t the nicotine is slowly absorbed through the lining of the mouth)

It is also important to know that the younger a person is when starting to smoke, the more likely they are to become addicted to these nicotine-containing products.

Cigar-specific health concerns

While many cigarette smokers inhale the smoke directly into their lungs, most cigar smokers puff the smoke, resulting in most of the chemical compounds filling their mouth and throat and less getting into the lungs. As a result, cigar smokers are more likely to develop an oral type of cancer, while cigarette smokers have the additional risk for lung cancer. If it turns out the cigar smoker puffs and inhales, they have an increased risk for lung cancer.

Getting to specifics, a person who smokes a cigar on a daily basis is at a greater risk for health concerns compared to the occasional cigar smoker. Either way, cigar smokers experience a higher risk than non-smokers for the following health concerns:

• Cancers of the lips, mouth, tongue, throat, larynx and esophagus. If the smoker inhales, cancers of the lungs, bladder and pancreas can be added as additional health risks.
• Nicotine addiction
• Early tooth loss and gum disease
• Lung disease including chronic bronchitis and emphysema
• Circulatory disorders, including erectile dysfunction and heart disease
• Increased risk for breast cancer in males
• Increased risk for infertility

Smoke screens

Once a large cigar is lit, it produces a huge amount of highly concentrated second-hand or environmental tobacco smoke (ETS); much more than that of a single cigarette. This is very concerning for smokers and non-smokers alike, as there is no getting around the smoky fog of harmful chemicals. These include irritants and toxins, as well as those with the potential to cause cancer.

• Tobacco-specific nitrosamines (TSNAs)
• Benzene
• Chromium
• Cadmium
• Vinyl chloride
• Arsenic
• Ethylene oxide
• Polynuclear aromatic hydrocarbons
• Aromatic amines

The toxins and irritants include carbon monoxide (increases the risk for heart attacks), hydrogen cyanide, nicotine, tar and ammonia.

It's important to know that cigar smoke can linger for five hours or more. When it settles, it is known as third-hand smoke, a scent or remnant of chemicals that cling to clothing, cloth, furniture and even the family pet. Needless to say, once lit, a cigar can set off a whole chain of hazardous triggers.

Fortunately, there are good options available to help you quit the cigar habit. These include medications, behavioral modification, hypnotherapy and acupuncture. For further information, speak with your family physician and try the American Cancer Society, the American Lung Association, or Nicotine Anonymous.

More on MSN Health & Fitness:

• The Hazards of Hookah
• Marijuana's Memory Paradox
• Third-Hand Smoke Is a First-Class Problem

Find all articles by Dr. Rob.

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Robert Danoff, D.O., M.S., is a family physician and program director of The Family Practice Residency, as well as the combined Family Practice/Emergency Medicine Residency programs at Frankford Hospitals, Jefferson Health System, Philadelphia, Pa. He is the medical correspondent for CN8, The Comcast Network, a regular contributor to Discovery Health Online and a contributing writer to The New York Times Special Features. (Read his full bio.)