Are cigars healthier than cigarettes?

In this brief guide, we will answer the question, “Are cigars healthier than cigarettes?”. We will elaborate on the differences between cigars and cigarettes and the harmful effects of cigars and cigarettes. 

Are cigars healthier than cigarettes? 

No, cigars are not healthier than cigarettes. It is a common misconception that cigars cause less harm than cigarettes. In reality, cigars are more dangerous, even for people who do not purposely inhale.

It has been found that cigar smoke consists of toxic, cancer-causing substances that are dangerous for both smokers and non-smokers. Cigars may be more harmful as compared to cigarettes.

What makes cigars harmful? 

Like cigarettes, cigars contain over 4,000 compounds, many of which are carcinogenic. In contrast to most cigarette tobacco and like some smoke tobacco, cigar tobacco is cured and fermented. This is the process of drying leaves and then humidifying them to allow bacterial conversion of tobacco carbohydrates to polyphenols and other compounds. The curing and fermentation processes engender N-nitrosation of nicotine leading to tobacco-specific nitrosamines, including N′-nitrosonornicotine and others. In cigars, these tobacco-specific nitrosamines are often present in higher amounts than seen in cigarettes because there are more nitrates produced in tobacco during fermentation (1).

Similar to cigarette smoking, cigars also puts you at the risk of:

Nicotine:

Cigars, in the same way as cigarettes, consist of nicotine, the chemical that can cause tobacco dependency. One single big-size cigar can have about as much nicotine as does a packet of cigarettes. 

By smoking cigars, you can obtain as much nicotine as smoking cigarettes. And even if a person does not inhale purposely, considerable amounts of nicotine can be absorbed via the lining of his mouth. It must be kept in mind that smoking cigars rather than cigarettes do not lower the risk of tobacco dependency.

Nicotine delivery from cigars compared to cigarettes differs. Due to slow burning time, cigars develop a higher pH than cigarettes, which creates an unprotonated form of nicotine, which, present only in the vapor phase of smoke, absorbs quickly into the oral mucosa. Thus, even if cigar smokers do not inhale deeply, they are still exposed to higher nicotine levels and any untoward effect this may cause (1).

Passive smoking: 

Passive smoking from cigars possesses the same toxic substances that passive cigarette smoking does. This kind of smoking can increase the risk of lung cancer and cardiovascular diseases. It also raises the risk and severity of preadolescence asthma, ear disorders, and upper and lower respiratory tract illnesses in children.

More than 50 studies on passive smoking and lung cancer risk in never smokers, especially spouses of smokers, have been carried out and published within the past 25 years. These studies show that there is a statistically significant and consistent association between lung cancer risk in spouses of smokers. The excess risk increases with increasing exposure (2).

Cigar smoking exposes us to severe health problems, that include:

Cancer:

Whether you smoke cigarettes or cigars, you should never forget the fact that all tobacco smoke includes substances that can induce cancer. Frequent cigar-smoking raises the risk of various cancers, for instance, mouth, throat, esophagus and larynx cancer. 

Smoking causes 30% of all cancer mortality in developed countries, and smokeless tobacco use is an important cause of cancer, particularly in southern Asia. Tobacco smoke contains more than 4,000 chemicals and some of them are carcinogens (2).

Lung and heart disease:

People who are frequent cigar smokers have an increased risk of lung disorders, which include emphysema and chronic bronchitis, development of chronic obstructive pulmonary disease and lung carcinoma; increased incidence and severity of childhood asthma; worsening control of adult asthma; an accentuated inflammatory response to respiratory tract infections and increased likelihood of developing infections (1). They are also at a greater risk of heart problems, for instance, coronary artery disease.

Oral disease:

Individuals who frequently smoke cigars are at a higher risk of experiencing oral and dental problems, for instance, gum disease and tooth loss.

Cigars versus cigarettes

Cigars are made from tobacco rolled in a leaf of tobacco, as opposed to cigarettes which are tobacco rolled in non-tobacco paper. However, there is no doubt that cigar smoking causes a number of the same adverse health effects as cigarette smoking. Key differences between smoking cigars and cigarettes are inhalation depth, nicotine delivery, carbon monoxide formation, and smoking frequency. You may be surprised to know the distinctions between the cigar and cigarette, which are discussed below (1).

• Cigars have an increased potential to induce oral cancer, whereas cigarettes have an increased potential to induce lung cancer.
• Both consist of tobacco. The major difference is that a cigar is enveloped in a tobacco sheet, but cigarettes are enveloped in paper that does not have tobacco. 
• Cigars possess unfiltered ends whereas many cigarettes possess filtered ends. 
• Cigars are typically larger and wider as compared to cigarettes, last for a long time when smoked and comprise more tobacco.
• There is a prominent difference in the quantity of nicotine in both cigars and cigarettes. Cigars can have between 100 to 200 mg of nicotine and cigarettes have nearly 8 mg. That indicates smoking one cigar can deliver as much nicotine as smoking more than one packet of cigarettes. Alarmingly, even small cigars contain higher levels of tobacco specific nitrosamines, and deep inhalation (i.e., that of filtered cigarettes) may expose cigar smokers to more tobacco specific nitrosamines than cigarettes
• One more distinction lies in the way they are inhaled. While cigarette smoke is absorbed into the lungs, cigar smoke generally remains in the mouth. 
• As cigarette smoke traverses into the lungs, the intake of nicotine into the bloodstream is considerably greater as compared to cigars, which absorbs nicotine via the tissues in the mouth.

Different types of cigars 

Below is a brief description of the various kinds of cigars:

Large cigars can have a length of more than 7 in. and include 5-20 g of tobacco. They can take nearly 1-2 hours to smoke. 

Premium cigars mostly consist of an equal quantity of one whole packet of cigarettes.

Cigarillos are a smaller variety of cigars that are larger than little cigars. One cigarillo consists of about 3 g of tobacco.

Little cigars are the exact shape and size as cigarettes and are packaged alike, typically with 20 in every package. Some contain filters, which tends to make them more viable to be inhaled. A little cigar has roughly 1 g of tobacco.

Swapping from cigarette to cigar smoking can be extremely detrimental since you might inhale cigar smoke just like you did cigarette smoke. The more cigars you smoke and the stronger you inhale, the more you will be at risk.

Though the health consequences of infrequent cigar smoking are not as evident, the only secure level of cigar smoking is no smoking at all. Rather than attempting to decide between cigarette smoking and cigar smoking, do your best to avoid smoking tobacco completely. No single type of tobacco is harmless.

Conclusion

In this brief guide, we have answered the question, “Are cigars healthier than cigarettes?”. We have elaborated on the differences between cigars and cigarettes and the harmful effects of cigars and cigarettes. 

References 

1. Schivo, M., Avdalovic, M.V. & Murin, S. Non-Cigarette Tobacco and the Lung. Clinic Rev Allerg Immunol, 2014, 46, 34–53. 
2. Lodovici, Maura, and Elisabetta Bigagli. Biomarkers of induced active and passive smoking damage. Int j environ res public health, 2009, 6, 874-888.