Interesting Health Data On Cigar Smokers

http://www.bigredcigar.com/2010/01/h...moking-cigars/

There is absolutely no doubt that smoking cigars is not good for your health. Let’s get that much clear right from the start.

However, in all likelihood it’s not as bad as you might think. The extent of the negative effect on your health from cigar smoking depends primarily on two things:

1. The amount of smoke that is inhaled
2. The number of cigars that are smoked

For those who do inhale and smoke several cigars daily, the health risks approach that of regular cigarette-smokers. The extent of risk, on average, is dependent on an individuals’ smoking habits (as can be seen in the below data tables).
Do not inhale cigar smoke

So, the first tip for remaining healthy is an obvious one: do not inhale.

Unlike cigarette smoke, cigar smoke is not even intended to be inhaled. (For a thorough discussion of the inhalation of cigar smoke, see my article, Do you inhale cigar smoke?).
Smoke cigars in moderation

The second is also rather obvious, but less important: smoke cigars in moderation.

This is a “given” for most cigar-smokers, who smoke them as a hobby rather than because of addiction or habit. Although I don’t deny that they exist, I’ve never met anyone who habitually smokes (real*) cigars in the same manner as cigarettes. The majority of cigar smokers, even those who have been doing it for forty or fifty years, do not smoke more than two or three cigars per day. In fact, my guess is that the majority smoke significantly less than one cigar per day.

(* i.e. large, premium cigars. Small “cigarillos”, which are designed to compete with cigarettes are not “real” cigars, and the majority of people who smoke them do so habitually as well as inhaling the smoke.)
Cigar smoking health statistics

Below I have provided two tables of information resulting from a 1998 NCI study of cigar smoking vs cigarette smoking.
Mortality ratios for select causes of death in male cigar-only vs cigarette-only smokers by amount
smoked daily. Cancer Prevention Study I, 12 year follow-up.

Amount Smoked Daily

Cigars per day

Cigarettes per day
Cause of death Non-smoker 1-2 cigars 3-4 cigars 5+ cigars < 1 packet 1 packet > 1 packet
All causes of death 1.0 1.02 1.08 1.117 1.46 1.69 1.88
Cancer of buccal cavity & pharynx combined* 1.0 2.12 8.51 15.94 5.93 6.85 12.04
Cancer of esophagus 1.0 2.28 3.93 5.19 2.14 4.3 5.6
Cancer of larynx 1.0 6.46 no data 26.03 8.7 25.69 23.59
Cancer of lung 1.0 0.99 2.36 3.4 6.75 12.86 20.23
Cancer of pancreas 1.0 1.18 1.51 2.21 1.69 2.17 2.41
COPD 1.0 1.39 1.78 1.03 8.86 12.51 15.04
Coronary heart disease 1.0 0.98 1.06 1.14 1.4 1.58 1.65
* excludes salivary gland
Information is sourced from the article, Cigar Smoking: Overview and Current State of the Science, by David M. Burns.
Mortality ratios for select causes of death in male cigar-only vs cigarette-only smokers by depth of inhalation.
Cancer Prevention Study I, 12 year follow-up.

Self-Reported Depth of Inhalation

Cigars

Cigarettes
Cause of death Non-smoker none slight moderate-deep none-slight moderate deep
All causes of death 1.0 1.04 1.19 1.6 1.54 1.65 1.9
Cancer of buccal cavity & pharynx combined* 1.0 6.98 7.83 27.88 6.26 8.43 12.48
Cancer of esophagus 1.0 3.4 1.9 14.84 2.94 4.06 4.95
Cancer of larynx 1.0 10.6 no data 53.26 22.19 13.49 27.54
Cancer of lung 1.0 1.97 1.89 4.93 9.33 13.13 17.11
Cancer of pancreas 1.0 1.55 2.16 2.26 1.99 2.01 2.38
COPD 1.0 1.09 2.05 4.52 8.8 12.28 16.07
Coronary heart disease 1.0 1.01 1.23 1.37 1.45 1.52 1.71
* excludes salivary gland
Information is sourced from the article, Cigar Smoking: Overview and Current State of the Science, by David M. Burns.
Interpreting the statistics

The statistics show the increased risk a smoker has of death caused by a select group of common smoking-related diseases when compared to a non-smoker.

As you can see in the highlighted cell on the first table, a cigar-smoker who smokes 1-2 cigars per day is only 2% more likely to die of smoking related diseases than a person who has never smoked in their life. Likewise, a cigar-smoker who does not inhale is only 4% more likely to die of smoking related diseases than a non-smoker.
What it means…

The statistics should not be interpreted as (for example), “someone who smokes 3-4 cigars per day has a 51% chance of dying from cancer of the pancreas”. Rather that, going on statistical averages, “someone who smokes 3-4 cigars per day is 51% more likely to die of cancer of the pancreas than a non-smoker“.
Considerations

These statistics might be a little misleading if not properly considered.

For example, the first table relates only to “cigars smoked per day”, and has no relation to the second table, which relates to “self-reported depth of inhalation”.

What does this mean? It means that for the first table, the highlighted cell showing that a 2-per-day cigar smoker is 2% more likely to die of smoking related diseases is not accounting for depth of inhalation at all, only the fact that they smoke 1-2 cigars per day. Likewise, the second table that shows that a non-inhaling cigar smoker is 4% more likely to die of smoking related diseases does not account for the amount they smoke, only the fact that they don’t inhale.

In other words, the 2-cigar-per-day group may contain some people who “deeply inhale”, and the “do not inhale” group may contain some people who smoke 5+ cigars per day.

But what if you fit into the lowest-risk category for both tables, not just one or the other?
For the majority of cigar-smokers

I believe that the majority of cigar smokes do not inhale any smoke and they smoke less than 2 cigars per day. Even though it would be the most useful number, there is not a statistic recorded for those who fit into both groups. However, it’s an effortlessly logical assumption that if you fit into both groups then the statistic for “all causes of death” must be below the 4% mark for the group who do not inhale, and below the 2% mark for the group who smoke less than 2 cigars per day.
For more frequent smokers

Even for fairly heavy cigar smokers, the health risks don’t appear to be as high as one might have otherwise thought, if they don’t inhale the smoke. We can see from the above statistics that someone who smokes 5+ cigars per day (and does not inhale) is 11%-12% more likely than a non-smoker to die of smoking related causes. Considering that smoking 5+ decent-sized cigars per day would mean that one would be without a smoke for only half – or less – of his waking hours, that is probably a very surprising statistic.

Note however, that only applies for smokers who, rightfully, do not inhale. As the statistics demonstrate, someone who deeply inhales the cigar smoke is probably increasing their chances of early death by 60% or more. The data just keeps pointing to the same conclusion: do not inhale cigar smoke.
Conclusion

In my opinion, the incontestable conclusion – backed-up by scientific research by the NCI – is that those who enjoy cigars in moderation and do not inhale, are not exposing themselves to any statistically significant risk.

I also would dare a guess that the majority of cigar smokers fit into that category.