• "It is not unusual for some premium cigars to contain the tobacco equivalent of an entire pack of cigarettes."
  • "Cigars are a major source of secondhand smoke which contains over 4,000 chemicals - 200 are poisons, 63 of which cause cancer."

It is a common misconception that smokers, particularly those who smoke pipes or cigars without inhaling, are excluded from physical harm or danger. In fact, anytime smoke touches living cells, it harms them. Even if cigarette, pipe or cigar smokers never inhale, they are at an increased risk for lip, mouth, tongue, throat and larynx cancers. Because it is virtually impossible to avoid inhaling any trace of smoke, these smokers are also increasing their risk of getting lung and esophageal cancer.

There are, however, some differences between cigar and cigarette smoke due to the different ways cigars and cigarettes are made. Cigars go through a long aging and fermentation process. During the fermentation process, high concentrations of carcinogenic compounds are produced. These compounds are released when a cigar is smoked. Also, cigar wrappers are less porous than cigarette wrappers. The nonporous cigar wrapper makes the burning of cigar tobacco less complete than cigarette tobacco. As a result, compared with cigarette smoke, the concentrations of toxins and irritants are higher in cigar smoke. In addition, the larger size of most cigars (more tobacco), and longer smoking time, produce higher exposures to nonsmokers of many toxic compounds (including carbon monoxide, hydrocarbons, ammonia, cadmium and other substances) than a cigarette.

Like cigarette smoking, the risks from cigar smoking increase with enhanced exposure. For example, compared with someone who has never smoked, smoking only one to two cigars per day doubles the risk for oral and esophageal cancers. Smoking three to four cigars daily can increase the risk of oral cancers to more than eight times the risk for a nonsmoker, while the chance of esophageal cancer is increased to four times the risk for someone who has never smoked. Both cigar and cigarette smokers have similar levels of risk for oral, throat and esophageal cancers.

Although cigar smoking occurs primarily among males between the ages of 35 and 64 who have higher educational backgrounds and incomes, recent studies suggest new trends. Most new cigar users today are teenagers and young adult males (ages 18-24) who smoke occasionally (less than daily). According to two large statewide studies conducted among California adults in 1990 and 1996, cigar use has increased nearly five times among women and appears to be increasing among adolescent females as well. Furthermore, a number of studies have reported high rates of use among not only teens, but also preteens. Cigar use among older males (age 65 and older), however, has continued to decline since 1992.

Celebrities have recently publicized cigar smoking, and multiple nightclubs and restaurants are promoting new cigar smoking sections. The introduction of "cigar bars" and the sub-culture of cigar paraphernalia such as humidors and clippers have combined to create a glamorous aura around a deadly product. Total cigar consumption declined by about 66 percent from 1973 until 1993. Cigar use has increased more than 50 percent since 1993. The increase in cigar use in the early 1990's coincided with an increase in promotional media activities for cigars. Many new cigar aficionados may not be aware that smoke from cigars contains the same deadly carcinogens as those from cigarettes. Congress did not explicitly include cigars in the 1984 law requiring health warnings on cigarettes, so cigar packages bear no warning from the US Surgeon General. Overall cancer deaths among men who smoke cigars are 34 percent higher than nonsmokers. Studies also indicate that cigar smokers have 4-10 times the risk of nonsmokers of dying from laryngeal, oral, or esophageal cancers. According to the U.S. Department of Agriculture Economic Research Service, cigar consumption hit an estimated 3.7 billion in 1999.