A cigar is a roll of fermented tobacco wrapped in a tobacco leaf or a substance containing tobacco, setting it apart from a paper-wrapped cigarette. A common but dangerous misunderstanding suggests that cigars are a safer alternative to cigarettes. However, cigar smoke contains the same toxic and cancer-causing chemicals found in cigarette smoke, often in higher concentrations. Using any tobacco product, including cigars, is unsafe and carries significant health risks.
Nicotine Content and Addiction
The sheer quantity of tobacco in a cigar results in a higher nicotine content compared to a cigarette. A single large cigar can contain anywhere from 100 to 200 milligrams of nicotine, comparable to the total nicotine found in an entire pack of cigarettes. This high nicotine load is the primary driver of dependence and addiction, even if the smoke is not fully inhaled.
Cigar tobacco smoke is more alkaline than cigarette smoke, which changes how the body absorbs the nicotine. This alkalinity allows nicotine to be absorbed directly through the mucous membranes lining the mouth and cheek, a process known as trans-buccal absorption. Consequently, a cigar smoker absorbs large amounts of nicotine into their bloodstream without drawing the smoke deeply into the lungs. The resulting nicotine dependence can be just as strong as with cigarettes.
Localized Cancer Risks from Direct Contact
Holding cigar smoke in the mouth exposes the upper digestive and respiratory tracts to a direct, concentrated stream of carcinogens. This prolonged exposure increases the risk of cancers in the areas that come into contact with the smoke. Regular cigar smoking raises the risk for cancers of the oral cavity, including the mouth, tongue, and lip.
The smoke’s toxic chemicals also affect the throat and surrounding structures. Cigar users face an elevated risk of developing cancer in the pharynx (throat) and larynx (voice box). When saliva contaminated with these chemicals is swallowed, the esophagus is also exposed, leading to an increased risk of esophageal cancer. For these localized cancers, the risk for cigar smokers can be comparable to that of cigarette smokers.
Systemic Cardiovascular and Respiratory Damage
Beyond local damage, the toxic chemicals absorbed from cigar smoke cause systemic problems throughout the body. Nicotine and carbon monoxide, a highly poisonous gas present in the smoke, are absorbed into the bloodstream, immediately affecting the cardiovascular system. This process damages the lining of the blood vessels, accelerates plaque buildup in the arteries, and increases the risk of life-threatening events.
Cigar smoking contributes to elevated heart rate and increased blood pressure, placing greater strain on the heart. Heavy cigar use, especially with inhalation, increases the likelihood of suffering a heart attack, stroke, and other coronary heart diseases. The absorbed toxins also negatively impact the lungs, even if the smoke is only partially inhaled. Regular cigar smoking raises the risk for chronic respiratory diseases such as emphysema and Chronic Obstructive Pulmonary Disease (COPD).
The Myth of Safe Puffing
The belief that cigars are safe because the smoke is only “puffed” and not inhaled is a misconception. Even without deep inhalation, the localized cancer risks to the mouth, throat, and esophagus remain high due to the direct contact with the smoke. The carcinogens and toxins in the smoke are still absorbed through the oral mucosa, leading to the increased risk of these upper airway cancers.
The systemic effects are also not avoided simply by not inhaling. Nicotine is absorbed directly through the mouth lining, feeding the addiction and contributing to cardiovascular strain. Cigar smoke produces higher amounts of secondhand smoke than cigarettes, because they contain more tobacco and burn longer. This toxic plume contains the same harmful chemicals, increasing the risk of heart disease and lung cancer for bystanders.