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Cigars: Behind the smoke screen

Network - Summer 2012

By Johnny Rigg

Cigars have long been symbols of power, wealth and success.

And thanks to several regulation loopholes, they may seem an attractive alternative to cigarettes. Yet they contain many harmful, cancer-causing ingredients.

While rising prices and widespread awareness of health risks have led cigarettes into a decline, “luxurious” fermented cigar products have become a profitable product currently unregulated by the U.S. Food and Drug Administration (FDA).

In 2009, an estimated 13.3 million people, more than 5% of the U.S. population over 12 years old, smoked cigars, while cigarette use has declined from 21.1 billion packs sold in 2000 to 17.4 billion in 2007, according to the American Heart Association.

This increased popularity is likely tied to the lower rate at which cigars are taxed, making them less expensive to smoke.

The federal tax on “cigarette alternatives,” such as cigarillos and little cigars, is just a tenth that of cigarettes, allowing even cash-strapped young adults to smoke more cheaply, according to researchers at the Harvard School of Public Health.

“Cigars and cigarillos have become an emerging issue in tobacco control in recent years, in part because of their appeal to young people through lower prices and sweet flavors,” a 2011 study by the American Journal of Public Health reports.

Though cigar users may believe cigarette alternatives such as smokeless tobacco or filtered cigars are less harmful, each is associated with health risks, including higher risks of developing cancers of the mouth, lung, esophagus and larynx.

The anatomy of a cigar

According to the National Cancer Institute, “cigars contain the same toxic and carcinogenic compounds found in cigarettes and are not a safe alternative.”

There are various cigar types and sizes that appeal to a wide array of users, but all cigars share certain characteristics.

Cigar smoke contains as many as 4,000 chemical compounds, more than 40 of which are identified as cancer-causing agents.

Large cigars, which make up nearly 50% of the current market, contain at least one-half ounce of fermented tobacco, the same amount found in an entire pack of cigarettes. They contain more tar and about 400 milligrams of nicotine — nearly 40 times the amount in a cigarette.

Cigars are commonly sold individually and don’t contain a Surgeon General’s warning, instead displaying only the custom label of the producer. Their ingredients are not disclosed to health authorities, and cigar producers remain unaffected by FDA regulations. While the FDA considers extending a 2009 law allowing the agency to oversee tobacco product sales to include cigars, a new bill is moving through Congress attempting to keep cigars from being regulated by the government.

‘I don’t inhale’

While inhaling cigarette smoke is linked with the development of lung cancers, carcinogens in cigars may be absorbed into the bloodstream through the lining of the mouth and throat, causing exposure to tissues throughout the body.

Moments after ignition, cigars fill the smoker’s mouth and throat with a brown coating containing various cancer-causing compounds. Though the smoke released by cigars is harsh and unlikely to be inhaled, its release can still burn or corrode organic tissue.

The thick smoke breaks down cells, forcing the body to repair itself. And repeated exposure to these chemicals and carcinogens may overwhelm the body’s defenses.

“Cigars are designed to be absorbed through the mucosa in the mouth, while cigarettes obviously enter the lungs,” says Joel Dunnington, M.D., professor in the Department of Radiology and longtime anti-tobacco activist. “You’re still at higher risk for developing cancer, at least three or four times higher, than nonsmokers.”

The power of images

In 2001, the Federal Trade Commission mandated that cigar packaging and advertisements include a Surgeon General’s warning. But since most cigars are sold individually, they don’t display any of the required warning labels.

Cigar manufacturers have also significantly increased their marketing efforts, focusing on celebrity endorsements, cigar magazines and publications and product placements in film and television. Though not as obvious as tobacco campaigns of the past, companies use “stealth advertising” to display their products in a positive light.

“When I was a kid, 50% of ads on TV were for cigarettes,” Dunnington says. “After their ads were cut from TV, tobacco companies moved to sports, adding images and broadcasting them around the world. And they began advertising in magazines.”

Cigarette companies were banned from advertising on television and radio in 1971 after overwhelming evidence that their products are harmful to health.

Not coincidentally, various advertising agencies began airing campaigns for little cigars the same year.

“Some cigars are made to look and smoke like cigarettes. They’re taxed at a lower rate and are about three dollars cheaper than, say, a pack of Marlboros®. This is a way for kids to smoke more cheaply,” Dunnington says.

Enticing the public to buy a dangerous product by relying on celebrity endorsements and sidestepping regulations greatly concerns Dunnington.

“I would like to see all marketing of tobacco products stop,” he says.

Only then, he says, will the association of cigars with glamour and success begin to be replaced with an accurate view of the dangers and health risks they pose.


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© 2015 The University of Texas MD Anderson Cancer Center