Cigars Add to Cancer Risks, Study Finds

Across the nation, debate rages over whether cigar-smoking is swanky or stinky. But the National Cancer Institute, weighing in on the trendy habit for the first time, has pronounced it simply deadly.

Smoking one or two cigars a day, even if the smoke is not inhaled, doubles a person’s risk of developing cancer of the esophagus and oral cavity (including the mouth, throat, lips or tongue). And such a regular cigar smoker is six times more likely than a nonsmoker to develop cancer of the larynx, an institute study concludes.

And those who inhale cigar smoke, or who smoke more than two a day, boost their risk of developing such cancers astronomically. For inhalers, the likelihood of developing laryngeal cancers increases 53-fold, and inhalers are 27 times more likely to suffer from oral cancers.

For those who share the air with a cigar smoker, the health picture is also less than glamorous.

Compared to a cigarette, a large, lighted cigar emits 20 times the ammonia, up to 10 times more cadmium and methylethylnitrosamine (both cancer-causing agents), and as much as 90 times the highly carcinogenic nitrosamines specific to tobacco, according to the cancer institute’s 232-page report.

Researchers also found that the concentrations of carbon monoxide at two cigar social events in San Francisco exceeded those found on a busy California freeway and that smoke from a single large cigar took five hours to dissipate inside a home.

The findings come at a time when cigar-smoking--a habit that fell steadily out of favor from 1973 to 1993--has regained cachet from barrooms to boardrooms, as well as among both sexes. Since 1993, cigar sales in the United States have risen about 50%.

Indeed, for the beleaguered tobacco industry, the small and specialized cigar market is a rare bright spot.

The growing popularity of cigars has given rise to cigar bars across the country and spun off such boutique enterprises as Cigar Aficionado, a glossy magazine that features cigar-smoking celebrities striking urbane poses on its cover.

Institute officials surmised that much of the increase in cigar-smoking, especially a boomlet among teenagers, has taken place in the mistaken belief that cigars are a safe alternative to cigarettes.

“To those thinking about smoking cigars, our advice is--don’t,” said Richard D. Klausner, the institute’s director.

The cigar industry responded to the report with a statement that congratulated the good taste of cigar aficionados while making no direct comment on the study.

“Cigar smokers are mature, well-informed individuals who freely choose to enjoy a product that has brought pleasure to millions of people over the past 500 years, and to the extent that this report adds to their knowledge, we welcome it,” said Norman F. Sharp, president of the Cigar Assn. of America.

But the report prompted John R. Garrison, chief executive officer of the American Lung Assn., to warn that far from being “one of the finer things in life,” cigars “are simply a more malodorous version of cigarettes. Both cause cancer, both are addictive and both are major sources of harmful secondhand smoke.”

Donald R. Shopland, who coordinated the study, suggested it could compel the government to impose advertising restrictions or warning labels on cigars. The report comes at a time when the tobacco industry is engaged in a high-stakes struggle over federal regulation and the industry’s legal liability for the health consequences of cigarette-smoking.

As many as three-quarters of cigar smokers light up a pungent brown cylinder only occasionally--some only a couple of times per year. Among such casual smokers, it is common not to inhale. For those who indulge sparingly in the habit, the report offered little guidance. It merely noted that the health risks of such occasional use are not known.

What is clear from the report is that, while cigar-smoking can be harmful, cigarettes continue to exact a higher toll. That is partly because cigarette smokers tend to smoke more, and more often, than cigar smokers, and they almost always inhale.

For instance, while the report found that regular cigar smokers have risks of oral and esophageal cancers similar to those of cigarette smokers, they have lower risks of lung and laryngeal cancer, coronary heart disease and chronic obstructive pulmonary disease.