A stogie is a roll of fermented and dried tobacco wrapped in a tobacco leaf or tobacco-containing material. Unlike cigarettes, cigars vary dramatically in size, with some containing as much tobacco as an entire pack of cigarettes. The smoke contains the same toxic and carcinogenic compounds found in cigarette smoke, including over 7,000 chemicals. Cigar smoking is harmful and poses health risks, regardless of the frequency of use or whether the smoke is inhaled.
Nicotine Absorption and Addiction
The addictive nature of cigars stems from a mechanism of nicotine delivery that bypasses the need for deep lung inhalation. Cigar smoke is more alkaline, or higher in pH, than cigarette smoke. This higher pH converts the nicotine into its un-ionized, or “freebase,” form, which is readily absorbed directly through the mucous membranes lining the mouth and nose. A single large cigar can contain between 100 to 400 milligrams of nicotine, significantly higher than the average 10 to 12 milligrams found in a cigarette. Even without inhaling, continuous contact with the oral lining allows a substantial amount of nicotine to enter the bloodstream, sustaining the addiction.
Localized Cancer Risks in the Mouth and Throat
Holding and puffing cigar smoke subjects the upper aerodigestive tract to prolonged, direct exposure to carcinogens. Regular cigar smokers face risks for cancers of the oral cavity and the esophagus similar to those of cigarette smokers. This includes elevated risk for cancers of the mouth, tongue, lips, larynx, and pharynx. Cigar smoke contains higher concentrations of cancer-causing agents, specifically tobacco-specific nitrosamines (TSNAs), compared to cigarette smoke. The fermentation process used to cure cigar tobacco is responsible for producing these high concentrations. The longer burning time and larger volume of smoke generated by a single cigar increase the total duration of contact between these potent carcinogens and the lining of the mouth and throat.
Systemic Damage to the Heart and Lungs
While localized cancers result from smoke contact, cigar smoking also causes damage to the heart and lungs through systemic exposure. Toxins are absorbed into the bloodstream through the oral lining and the shallow inhalation that often occurs involuntarily. Nicotine absorbed this way stimulates the sympathetic nervous system, causing an increase in heart rate and blood pressure, which places a greater workload on the heart. The smoke also contains carbon monoxide, which is absorbed into the blood and reduces the capacity of red blood cells to carry oxygen. Chronic exposure to these chemicals impairs endothelial function, the lining of the blood vessels, contributing to the development of atherosclerosis. This increases the risk for coronary heart disease and stroke. For those who regularly smoke and inhale, the risk of lung cancer and Chronic Obstructive Pulmonary Disease (COPD) can rise to levels comparable to those of a moderate cigarette smoker. Even without deep inhalation, the risk for lung cancer remains higher than that of a non-smoker.
Addressing the Myth of Occasional Use Safety
The notion that smoking a cigar only occasionally is safe is a misconception that overlooks the non-linear relationship between exposure and risk. Data shows that current cigar smokers face a 20% greater risk of death from all causes compared to people who have never smoked. For tobacco-related cancers specifically, the risk of death is increased by approximately 60% for current cigar smokers. Even low-intensity cigar use increases the risk of oral and esophageal cancers because the smoke’s carcinogens are in direct contact with the tissue. While the risk is dose-dependent, there is no established safe threshold for tobacco consumption. Smoking up to two cigars per day still carries an elevated risk for localized cancers.