A cigar is a roll of fermented, dried tobacco wrapped in a tobacco leaf or tobacco-containing material, unlike a cigarette, which uses paper. While cigars have a history dating back over a thousand years, their contemporary consumption carries significant health implications. The unique structure and processing of the tobacco profoundly influence how its chemical components interact with the body. Understanding the effects of cigar use requires examining its chemical delivery system and resulting physiological impact.
Chemical Composition and Nicotine Delivery
The distinct processing of cigar tobacco creates a chemical profile that differs significantly from cigarettes. Cigar tobacco is air-cured and often fermented, which concentrates tobacco-specific nitrosamines (TSNAs), known carcinogens. This fermentation also makes the smoke more alkaline, typically reaching a pH of 6.5 or higher. This higher pH is a crucial factor in nicotine absorption, converting nicotine into its “free” form. Free nicotine is readily absorbed directly through the mucous membranes of the mouth and nasal cavity, a process called buccal absorption. A single large cigar can contain as much tobacco as an entire pack of cigarettes, resulting in a higher overall nicotine content and a larger volume of smoke. The combination of high nicotine content and alkaline smoke ensures efficient delivery of the addictive compound into the bloodstream, even without deep inhalation.
Immediate Physiological Impact and Addiction
Immediate Physiological Impact
Nicotine absorbed from the cigar smoke travels rapidly to the brain, affecting the central nervous system. This triggers the adrenal glands to discharge epinephrine (adrenaline). This acute physiological response causes an immediate but temporary increase in heart rate, blood pressure, and respiration.
Addiction Mechanism
Nicotine also acts on the brain’s reward pathways by stimulating the release of dopamine, a neurotransmitter associated with pleasure and reinforcement. This dopamine surge creates the temporary feeling of relaxation or the “buzz” that users experience. This cycle of immediate reward followed by the drop in nicotine levels reinforces the compulsion to continue use.
Despite the perception that occasional cigar use is not addictive, the efficient buccal absorption mechanism ensures cigar smokers absorb enough nicotine to establish dependence. Users can develop nicotine dependence comparable to that of cigarette smokers, even with less frequent use or minimal inhalation. The pharmacological effects of nicotine make cigar smoking a dependence-producing behavior.
Long-Term Disease Risks
Sustained cigar use is directly associated with increased chronic morbidity and mortality across multiple organ systems.
Cancer Risks
The exposure of the oral cavity and upper aerodigestive tract to the toxic smoke places users at a significantly elevated risk for certain cancers. Regular cigar smokers have four to ten times the risk of dying from oral, laryngeal, and esophageal cancers compared to non-smokers. Even if the smoke is not inhaled, the high concentration of carcinogens in the smoke remains in contact with the tissues of the mouth, tongue, throat, and larynx. This local exposure is why non-inhalers are highly susceptible to cancers of the oral cavity. For those who do inhale, or for heavy users, the risk of lung and pancreatic cancer also increases substantially.
Cardiovascular Risks
Cigar smoking also poses significant cardiovascular risks due to nicotine’s effect on the circulatory system. Nicotine constricts blood vessels and increases the workload on the heart, leading to an increased risk for coronary heart disease, heart attack, and stroke. Studies have shown that regular cigar smokers have a 27% higher risk for coronary heart disease compared to individuals who have never smoked.
Pulmonary Risks
The pulmonary system is also compromised, with an increased risk for diseases like emphysema and Chronic Obstructive Pulmonary Disease (COPD). Regular cigar smokers face a 45% higher risk for COPD than non-smokers. While this risk may be lower for non-inhalers than for heavy cigarette smokers, it is still significantly higher than for non-users of tobacco products, illustrating the substantial burden on lung health.
Addressing Common Safety Misconceptions
A persistent misconception is that cigars are safe if the smoke is not inhaled. However, the chemical reality of buccal absorption disproves this idea. The high alkalinity of the smoke delivers nicotine through the mucous membranes of the mouth, meaning the user is still exposed to high levels of the addictive substance and carcinogens coating the mouth. The high incidence of oral and esophageal cancers among cigar smokers directly results from this localized exposure.
Another common belief is that infrequent or occasional cigar use eliminates health risks. There is no safe threshold for tobacco use, and even light cigar smoking has been shown to increase the risk of disease. The cumulative exposure to toxins, even if sporadic, contributes to long-term pathology.
The danger also extends beyond the user through secondhand smoke. Cigar smoke contains the same toxic and carcinogenic chemicals found in cigarette smoke, often in higher concentrations due to the volume of tobacco and longer smoking time. Exposure to secondhand cigar smoke increases the risk of lung cancer and heart disease in non-smokers, and it is particularly harmful to children, contributing to asthma and ear infections.