ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Tuesday, June 4, 1996 TAG: 9606040026
SECTION: EXTRA PAGE: 6 EDITION: METRO
COLUMN: personal health
SOURCE: JANE BRODY
It is almost as if many people cannot live without an in-your-face vice that flouts admonitions to lead a healthier life.
The latest to achieve celebrity status is cigar smoking.
In clubs and restaurants, at special parties and on city streets, the air is being filled with cigar smoke by people with money to burn, from stars like Demi Moore, Whoopi Goldberg, Jack Nicholson and David Letterman to high-achievers in the corporate world.
These highly visible and influential image makers threaten to stymie the significant progress that has been made in curbing smoking, the nation's most costly health-damaging habit. These cigar aficionados are society's trend setters. Can the less affluent be far behind in taking up cigars?
Perhaps George Burns' survival to 100 despite the cigar as his constant companion, or the lack of a government health warning on cigar packages, has convinced millions of people that cigars are safe and has prompted many in their 20s and 30s to take up the habit.
But studies have shown otherwise.
While smoking cigars may not be quite as deadly as cigarettes, which are inhaled more often, there is no question that cigars can cause cancer and other deadly diseases, even if the smoke is not inhaled. And the sidestream smoke emanating from cigars that bystanders cannot help but inhale is at least as carcinogenic as the smoke from cigarettes.
The resurgence
When cigarette smoking took a nose-dive after the first surgeon general's report on smoking and health in January 1964, millions of Americans switched to cigars, producing a consumption peak that year of 9.1 billion. Then, as cigarette smokers backslid or found cigars an unacceptable substitute, the stogie suffered a gradual decadeslong decline, falling to an all-time low of 2.1 billion in 1993.
It has been a growth market ever since, especially for the sellers of premium cigars - the kind that cost about $2.50 a piece or more. Retailers report annual sales increases of 50 percent or more in premium cigars for the last two years, with no slackening in sight. A glossy magazine, Cigar Aficionado, with half a million readers, is further evidence of the smoking frenzy. Private cigar clubs, cigar cruises, cigar nights for sampling brands while sipping cognac and high-end dinner parties for cigar smokers only are helping to glamorize the habit.
The cigar industry estimates that more than 10 million Americans - 99.9 percent of them men - now regularly smoke cigars, an increase of about 2 million since 1993. And, with industry advertising now targeting women the way cigarette companies did two decades ago, the men are being joined by a growing number of women who, by taking up cigars, may be putting their lives on the line in the name of equal opportunity.
The health risks
The American Lung Association cites a number of myths about the ``safety'' of cigar smoking, among them that cigars are a safe alternative to cigarettes, that cigar smoking is not addictive and that smoking cigars does not cause lung cancer or chronic pulmonary disease.
These are the facts:
* Cancer. Cigar smoking causes cancer of the larynx, mouth, esophagus and lungs. Over all, men who smoke cigars have death rates from cancer that are 34 percent higher than those of nonsmokers. Studies that followed the fates of cigar smokers and nonsmokers over many years have shown that cigar smoking raises the risk of dying from cancers of the larynx, mouth and esophagus by 4 to 10 times. These rates are similar to those associated with cigarette smoking and are believed to reflect the fact that when cigars are puffed the smoke is held in the mouth and upper airways.
Researchers who examined cells from the larynx, the body's voice box, found that 99 percent of cigar smokers had ``atypical cells,'' the first step toward malignancy, whereas only 25 percent of nonsmokers had such cellular abnormalities.
The chances of developing lung cancer are indeed lower for cigar smokers than for cigarette smokers, largely because most cigar smokers do not inhale. But lung-cancer death rates among cigar smokers are about three times as high as they are among nonsmokers. The risk rises with the number of cigars smoked each day, and studies in other countries indicate that for those who inhale cigar smoke, the lung cancer risk is comparable to that of cigarette smoking
Dr. I.T.T. Higgins and colleagues at the American Health Foundation, a nonprofit research organization in New York City, have pointed out that ``when cigarette smokers switch to cigars or pipes, they usually have been found to continue to inhale in the way they were accustomed to when they smoked cigarettes.'' For this reason, they say, ``no health benefit should be anticipated from switching.'' These researchers found in a study of more than 6,000 people that even 30 years after quitting cigarettes, those who took up cigars faced almost five times the nonsmoker's risk of developing lung cancer.
* Chronic lung disease. Cigar smokers are more likely than nonsmokers to develop chronic obstructive lung disease, although again the risk is lower than that of cigarette smokers. Several studies that followed smokers and nonsmokers over a period of years showed that cigar smokers face an increased risk of dying of lung disease that may be as much as 360 percent as high as the risk for nonsmokers. An autopsy study of the lungs of 1,443 men who died in six New York and New Jersey hospitals found that the rate of emphysema among cigar smokers was five times that of nonsmokers.
* Heart and blood vessel disease. Nicotine, the addictive drug released when any tobacco product is used, does not have to be inhaled to damage the heart and blood vessels. Nicotine can be absorbed into the blood stream through the mouth. This drug speeds up the heart and constricts blood vessels, which reduces blood flow to the heart. Two European studies showed an increased risk of heart attacks in cigar smokers, and a study of 25,000 men in Sweden found that cigar smokers were five times as likely as nonsmokers to die from a ruptured aorta, the body's main artery. And a study of 7,700 men showed a threefold increased risk of stroke among cigarette smokers who switched to cigars.
* Passive cigar smoke. According to the Environmental Protection Agency, the sidestream smoke from cigars is a more insidious poison than that from cigarettes. Particle emissions, which include carcinogens, from one cigar exceeded those from three cigarettes, and carbon monoxide emissions were 30 times as high.
When a cigar is smoked in an office, the agency's standard of 9 parts carbon monoxide per million parts of air can be exceeded in 20 minutes. | New York Times Syndicate
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