Are Cigars Safe?

By Christine Gorman

Cigar smoke always reminds me of my grandfather. We grandkids used to gather at the foot of his favorite leather chair and beg him to blow hazy blue smoke rings into the air above our heads. It never occurred to us to blow our own smoke rings, even as adults. Cigars, like my grandfather, were from a different era.

I know, I know. Cigars aren't just for grandfathers anymore, or even just for men. And in case you missed the cigar's rebounding popularity, there are plenty of cigar magazines, cigar dinners and cigar charity auctions to remind you. What they don't emphasize--but what doctors have known for a while--is that smoking cigars on a regular basis significantly increases your risk of developing emphysema as well as cancers of the lung, lip, throat and esophagus. Last week the New England Journal of Medicine added to that grim list, reporting that cigar smoking also boosts your risk of heart disease.

The new research is increasing the pressure to require federal warning labels on cigars similar to the ones on cigarettes and smokeless tobacco. California already requires such labels, and may strengthen their wording, spurred in part by reports that more teens are smoking cigars.

The study also highlights the potential for managed-care companies to do good epidemiological studies. Funded by a grant from the National Cancer Institute, Dr. Carlos Iribarren and colleagues from Kaiser Permanente combed through the computerized medical records of the company's health plan in Northern California and found 16,228 men who had never smoked cigarettes or cigars and another 1,546 men who smoked only cigars. Then they studied the men's medical histories from 1971 to 1995 to see how they fared.

What the researchers found, after adjusting for age and other risk factors, was a direct link between how much the men smoked and how sick they got. Patients who smoked fewer than five cigars a day had a 34% greater risk of throat and oral cancers and a 57% greater risk of lung cancer than nonsmokers. Men who smoked five or more cigars a day had a 620% greater risk of throat and oral cancers and a 220% greater risk of lung cancer than nonsmokers. If they also drank more than three alcoholic drinks a day, their cancer risk shot up even higher.

Except for oral cancers, the risks for cigar smokers were still lower than those for cigarette smokers--probably because most cigar smokers don't inhale. Intriguingly, however, the increase in their risk of heart disease, as much as 56%, was similar to that found for heavy exposure to "secondhand" smoke--something cigars generate in abundance.

What about occasional smokers, who light up only a few times a year (and don't inhale)? They simply haven't been studied. Undoubtedly, there is less of a risk at lower doses, though it's not as if anyone is ever going to find that cigars are good for your health. Personally, I'd rather take my chances skydiving.

For more on the health risks of cigars, visit our website at time.com/personal You can e-mail Christine at [email protected]