Q
I’ve heard that cigars are better than cigarettes because you don’t inhale. Is this true? – Jonathan S. from Sunnyvale, California
A
There is a lot of public awareness about the risks of cigarettes, but far less about the risks associated with cigars. Efforts to remove the “cool” image of cigarettes have reduced their depiction in films and popular culture, yet cigars still appear frequently with celebrities, politicians, and other prominent figures. That visibility contributes to the belief that cigars are safer than cigarettes, and some sources even promote cigars as harmless because many users do not inhale. That belief is a dangerous myth.
Cigar smoke contains many of the same toxic and cancer-causing chemicals found in cigarette smoke. No tobacco product is safe, and there is no safe level of exposure to tobacco smoke. The more you use any tobacco product, the greater your risk of disease. Cigar smoking is linked to cancers of the oral cavity—including lips, tongue, mouth, throat, and larynx—as well as esophageal and lung cancers. Because cigar smokers hold the smoke in and around the mouth, these areas receive direct exposure to carcinogens.
Here are the facts about cigar smoke:
Cigars differ from cigarettes largely in size and composition, and in many respects they are more harmful. Cigars are larger and contain far more tobacco—cigarettes typically contain about one gram of tobacco, while some cigars contain up to 20 grams. Cigars are also wrapped in tobacco leaf or a tobacco-based wrapper, and their tobacco is often fermented. Smoking a cigarette generally takes around 10 minutes; smoking a cigar can take hours. All of these factors affect exposure to harmful substances.
Fermentation and the composition of cigar tobacco increase the concentration of certain carcinogens, such as tobacco-specific nitrosamines, which are produced and released when the tobacco burns. Per gram of tobacco, cigars can produce more tar than cigarettes. Cigar wrappers are typically less porous than cigarette paper, which makes combustion less complete and increases the concentrations of toxins in the smoke. The larger size of cigars and the longer time required to smoke them further increase exposure to toxic substances, including carbon monoxide, hydrocarbons, ammonia, cadmium, and many others.
Cigar smoke contributes significantly to indoor air pollution. Because there is no safe level of exposure to secondhand tobacco smoke, smoking cigars around other people puts them at real risk. The notion that not inhaling protects bystanders is incorrect: toxic compounds affect nearby people whether or not the smoker inhales.
Are cigars addictive? Yes. Nicotine—the substance responsible for tobacco addiction—can be absorbed through the lungs if inhaled and also through the lining of the mouth. Even without deep inhalation, substantial nicotine is taken up through oral tissues; a single cigar can deliver as much nicotine as a pack of cigarettes for some users. That makes cigars potentially highly addictive.
Beyond the health risks, cigar smoking produces long-lasting cosmetic effects. Tar and smoke residues collect in and around the teeth and on oral tissues, causing stains and deposits that are difficult or impossible to remove completely. Professional dental cleaning and whitening can reduce some discoloration, but certain stained areas remain permanently altered.
In summary, cigars are not a safe alternative to cigarettes. They contain many of the same carcinogens and toxins, often in higher concentrations, and they pose significant risks to both smokers and those around them. Avoiding all forms of tobacco is the best way to reduce those risks.
Mark Burhenne DDS
Learn More:No Smoke, But Plenty of Fire: How Do E-Cigarettes Affect Oral Health?