You can get cancer from smoking cigars. A cigar is a roll of tobacco wrapped in a tobacco leaf or substance containing tobacco, differentiating it from a cigarette wrapped in non-tobacco paper. Cigars contain the same toxic, addictive, and carcinogenic compounds found in cigarettes, despite the misconception that they are a safer alternative. Regular cigar use significantly increases the risk for various cancers and other serious health conditions.
The Direct Answer: Cancer Sites Linked to Cigar Use
Cigar smoke contains cancer-causing agents that directly expose the entire upper aerodigestive tract to high concentrations of toxins. Even without intentional inhalation, the risk for cancers of the mouth, throat, and esophagus remains significantly elevated. Regular cigar smokers face a risk of death from oral, laryngeal, and esophageal cancers that is many times higher than that of non-smokers.
Cancers of the oral cavity are a primary concern, affecting the lips, tongue, gums, and the lining of the mouth. The carcinogens in the smoke dissolve in saliva, which the smoker swallows, exposing the pharynx, larynx, and esophagus to these toxins. The larynx, or voice box, is also directly exposed as the smoke passes through the mouth.
While the risk for lung cancer is lower in non-inhaling cigar smokers than in cigarette smokers, it is still much higher than in non-tobacco users. If a smoker inhales deeply or frequently, their risk for lung cancer rises to levels comparable to those of a daily cigarette smoker. Cigar smoking is also linked to an increased risk of pancreatic cancer.
How Cigar Smoke Differs from Cigarette Smoke
The physical and chemical properties of cigar smoke contribute to its risk profile for the upper body. A single large cigar can contain up to 20 grams of cured tobacco, equivalent to an entire pack of cigarettes, leading to higher total exposure to harmful substances. Most cigars also lack a filter, meaning the smoker receives a higher concentration of tar and toxins directly into the mouth and throat.
The tobacco used in cigars is typically fermented and aged, resulting in higher concentrations of carcinogenic tobacco-specific nitrosamines (TSNAs) compared to cigarette tobacco. Furthermore, cigar smoke is notably more alkaline, possessing a higher pH value than the more acidic smoke produced by cigarettes. This alkalinity is a key factor in nicotine absorption.
The higher pH allows nicotine to become “freebase,” enabling it to be readily absorbed directly through the mucous membranes of the mouth and gums. This absorption provides the user with a psychoactive dose of nicotine even without inhaling the smoke into the lungs. This mechanism explains why cigar smokers can maintain nicotine dependence while facing an extremely high risk for cancers of the mouth and throat.
Behavioral Factors Determining Individual Risk
The risk of cancer from cigar smoking is directly tied to the dose and how the product is used, following a clear dose-response relationship. Individuals who smoke cigars daily or on a regular basis accumulate a much higher lifetime exposure to carcinogens than those who use them only occasionally. Longer smoking sessions, which are typical with larger cigars, also increase the total volume of smoke and time of exposure.
The decision to inhale is the most significant behavioral factor modifying an individual’s specific cancer risk profile. While non-inhalers primarily risk oral, pharyngeal, and esophageal cancers, inhaling the smoke drastically increases the risk for lung cancer, chronic obstructive pulmonary disease (COPD), and heart disease. When cigar smoke is inhaled, the risk of lung cancer can become nearly equivalent to that of a cigarette smoker, especially if the user smokes five or more cigars per day.
The size of the cigar impacts exposure, with larger formats containing significantly more tobacco and burning for a longer duration. The longer a person uses any tobacco product, starting from a younger age, the greater the cumulative damage to their cells and tissues. This long-term exposure heightens the probability of cancerous mutations forming over time.
Cigar Smoking Versus Cigarette Smoking: A Risk Comparison
A common perception is that cigar smoking is a less harmful habit than cigarette smoking, a belief often fueled by the fact that many cigar smokers do not inhale. However, this comparison is misleading because the primary site of risk simply shifts rather than disappears. Although the rate of lung cancer may be lower for non-inhaling cigar smokers, their risk for oral, laryngeal, and esophageal cancers is substantially higher than for non-smokers.
The risk of death from all causes is still elevated for regular cigar smokers compared to non-tobacco users. The large amount of tobacco and the alkaline nature of the smoke ensure that the user is exposed to high levels of carcinogens and nicotine regardless of inhalation depth. Ultimately, there is no safe form of tobacco use, and both cigars and cigarettes carry significant health risks.