One of the most common complaints you’ll hear from cigar smokers in Australia is the increasing heavy-handedness of State legislation. It’s one things to ban smoking of any kind from places likely to be frequented by non-smokers, such as restaurants, sporting facilities, and offices. It’s entirely another thing to ban smoking cigars in a dedicated cigar club. If I may be permitted a loose analogy, it is like banning street prostitution and then also lumping into the legislation banning sex between consulting adults in a brothel. Brothels are legal in most Australian states but smoking cigars in a cigar club is not? That doesn’t make much sense to me.

Like many cigar smokers I know, I have never been a cigarette smoker. Therefore, I am quite conscious that many people (myself included) do not like secondhand smoke. I don’t like to smoke cigars in public places where it might offend. Only an asshole would want to stick their cigar smoke in other people’s faces. As much as I don’t understand why people don’t appreciate the aroma of a premium cigar, I would never wish to force it upon them, any more than I would try to force a tee-totaller to drink a finger of Talisker.

Which is all the more reason to have dedicated venues for cigar smokers.

As I understand it, the main reasons for the introduction of heavier smoking restrictions are as follows:

1. Protecting non-smokers from secondhand smoke.
2. Protecting smokers from themselves.

The first point is obvious and I doubt many of us would disagree.

The second point is more troubling.

In a free society, it seems that people should have the right to eat, drink and smoke whatever they choose, as long as they aren’t hurting others in the process. The excuse used by governments to curb smoking is the burden on the public health system, which is reasonable, but does this apply to cigars?

The science conclusively says NO. The most comprehensive report on the subject (which I’ve blogged about before), a 1998 report called “Cigar Smoking: Overview and Current State of the Science” by David M. Burns that is published on the U.S. National Cancer Institute’s site, is very clear on the subject:

The pattern of excess disease risk among cigar smokers is not identical to that observed in cigarette smokers. Mortality ratios among cigarette smokers are much higher than those among cigar smokers for coronary heart disease, COPD (Chronic obstructive pulmonary disease) and lung cancer.

An explanation for the difference in mortality pattern between cigarette smokers and cigar smokers lies in differences in the depth and likelihood of inhalation of tobacco smoke between these two groups of smokers. Most cigarette smokers report inhaling the smoke into their lungs, while over three-quarters of the males who have only smoked cigars report that they never inhale.

The fraction of adult cigar smokers who smoke cigars every day is much smaller than the fraction of cigarette or smokeless tobacco users who use every day. This suggests that cigar smoking among adults, while probably able to cause addiction to nicotine, is less likely to do so than cigarette smoking or smokeless tobacco use. Data from California, which show that the recent change in cigar use among adults is largely an increase in occasional use, also suggests that the addictive potential of cigars is lower than that for cigarettes.

When cigar smokers don’t inhale or smoke few cigars per day, the risks are only slightly above those of never smokers.

So it seems clear that suggesting the risks associated with smoking cigars is the same as smoking cigarettes is not based on science. It’s like saying that the risk of riding a motor bike is the same as flying in a commercial plane. It just doesn’t work that way.

I’m a big fan of science. As XKCD likes to say – “Science. It Works, Bitches”.

Unfortunately, cigars are regularly being subjected to bad science and bad journalism.

A few months ago, Parade magazine ran an article called “The Dangers of Pipes and Cigars”. In the article, they reference a report done recently by Columbia University which, the article claims, showed that “smoking pipes or cigars doubled the odds of having an airflow obstruction.”

If this were indeed true, many of us would have to seriously reconsider our cigar habits.

The problem many cigar smokers have with this report, however, is that it is based on fluffy science.

As Smoke Magazine pointed out recently:

The Columbia study contained no new research, but an examination of a previous study that included just 56 individuals who smoked either cigars or pipes and did not smoke cigarettes.

Moreover, the study itself says “few participants smoked pipes or cigars…Effect estimates in this group were therefore relatively imprecise…” No kidding; what the survey actually showed was that among cigar-only smokers, the odds for decreased airflow to the lungs increased a trivial 1 percent when adjusted for age, race, sex, and height, and were 37 percent less than non-smokers when more carefully adjusted for 13 factors also including body mass, education, family history, and so on.

Additionally, the study report states “no U.S. studies have reported on the possible effects of cumulative pipe and cigar smoking on lung function.” This is wrong. In fact, the impact of cigar smoking was exhaustively reviewed by the National Cancer Institute in its monograph on cigars published in 1998.

Incidence of Chronic Obstructive Pulmonary Disease (COPD) was examined using the American Cancer Society’s massive CPS-I study, which included 15,072 cigar smokers. The result? For those who smoked an average of 1–2 cigars per day, there was no impact at all vs. non-smokers up through age 64, and for those who do not inhale, no impact through age 79!

Now consider that in the U.S. in 2009, smokers of all types of cigars averaged just 2.93 per week and smokers of handmade, premium cigars averaged a grand total of 1.59 per week!

But the CPS-I results are nowhere mentioned in the Columbia “study.”

As I’ve said on the blog before when I covered the CPS-I study, I take my health very seriously and so I’m always keeping an eye out on the latest science on cigars and health. It is unfortunate that a lot of the media coverage on the subject is pretty fluffy and either out-right biased or based on bad science.

In this episode, we’re joined again by Perdomo’s Head of Pre-Production, 77 year-old Aristides Garcia, to talk about his secrets for living a long and healthy life! Aristides has smoked about 20 cigars a day since the age of 14 but has never been sick in his life.

The crew here at Perdomo Cigars Australia would like to acknowledge the passing today of Don Alejandro Robaina, aged 91.

According to the BBC:

Mr Robaina, the only person to have a brand of Cuban cigars named after him, had been a roving ambassador for the country’s state-run cigar industry.
But more typically, he could be found on his small farm in the Vuelta Abajo region of western Cuba, tending his beloved tobacco plants.

As Jason tweeted:
They were right!! Cigars must be bad for your health. Don Alejandro Robaina dies at the young age of 91. May he RIP.

Are cigars bad for your health?

Well of course the answer is ‘yes’. The right questions to ask are “to what degree?” and “what are the risks?”

The simple answer is “there is some debate on the subject”. Not debate as to whether or not cigars are bad for you – it’s a well established fact that smoking tobacco of any kind isn’t good for you. However there seems to be very little research done on the long-term health impacts of being a premium cigar-only smoker (i.e. someone who smokes cigars but not cigarettes or cigarillos), who doesn’t inhale, and who doesn’t smoke more than three a day. This description, by the way, seems to include the majority of cigar smokers. They are too expensive for many of us to smoke more than one or two a day at most. The only people I’ve met who smoke more than one or two a day are people in the industry, and most of those only smoke two or three a day (except the people working at the Perdomo factory in Nicaragua, we met a few who smoke between 10 and 20 a day, every day!). So when you read something about the effects of cigar smoking on your health, it’s important to make sure the data breaks down for the person I mentioned above (a premium cigar-only smoker, who doesn’t inhale, and who doesn’t smoke more than three a day) and doesn’t just lump all cigar smokers into the same camp.

I’ve been looking online for research on the subject of cigars and your health and there is conflicting data but we want our customers to be educated about the risks, and so I’m going to regularly present our findings here.

Now I’m someone who cares a lot about my health. I exercise regularly and eat pretty well. My partner (who also loves cigars) is a health nut, she’s at the gym every day and likes to prepare lots of fresh fruit and vegetables for our meals. We both eat very little meat and dairy (except for some skim milk in our latte and a nice brie every now and again). We are what you might call ‘health conscious’.

So how do we justify smoking cigars to ourselves?

The same way we justify the other ways we indulge ourselves that are also not good for our health – cheese, rum, beer, scotch, wine, coffee, salami, chocolate, etc. If we wanted to be obsessively hard core about our health, we would abstain from all of those things, all of the time. But our approach is one of moderation. We sometimes eat and drink things that we know aren’t good for us, but we do it in moderation and balance it out with lots of healthy stuff. And we feel the same way about cigars. We limit ourselves to a few a week (and we tend to share a cigar as well, smoking half each – it’s romantic!). We don’t inhale. And, of course, we only smoke the best premium cigars – Perdomo. This is important because the best premium cigars are fermented, cured and aged long enough to allow a lot of the inherent toxins to be removed. The manufacturers of lower quality cigars, cigarillos and cigarettes don’t bother with this process, hence they are filled with many more toxins and are much worse for your health. Cigarettes, of course, rate the worst – they are filled with thousands of chemicals which you inhale into your lungs along with the nicotine. Premium cigars such as Perdomo contain NO additives or chemicals – it’s pure tobacco – fermented, cured and aged for a long time.

One of the major differences between cigarette smokers and cigar smokers, in my experience, is the reason they smoke. Cigarette smokers seem to be after the nicotine hit. That’s not what cigars smokers are looking for. They are looking for taste and aroma. It’s similar to people who drink a slab of VB on the weekend versus people who like to savour a $100 bottle of wine. One is looking to get drunk, the other is appreciating a fine product and it’s complex flavours. Consequently, cigar smokers tend to appreciate a fine cigar after a nice meal with friends. It’s a completely different paradigm to cigarettes and, as a result, the health effects are also different.

Okay, let’s look at what the scientists have to say.

The following is from a 1998 report called “Cigar Smoking: Overview and Current State of the Science” by David M. Burns that I found on the U.S. National Cancer Institute’s site.

Let’s cut right to the chase.

“There is little evidence from what is known about the tobacco content and manufacture of premium cigars to suggest that they are less hazardous than other cigars. Clearly, cigar smoke is as, or more, toxic and carcinogenic than cigarette smoke; and differences in disease risks produced by using cigarettes and cigars relate more to differences in patterns of use, and differences in inhalation, deposition and retention of cigarette and cigar smoke than to the differences in smoke composition. Demonstration of a close association between the intensity of cigar smoke exposure and rates of excess disease provide compelling evidence for a causal association between cigar smoking and disease occurrence. Most of the cancers caused by cigarette smoking occur at increased rates among regular cigar smokers. Cigar smokers who inhale deeply, particularly those who smoke several cigars per day, have higher rates of coronary heart disease and chronic obstructive pulmonary disease (COPD).” (The bold is mine).

As I mentioned earlier, most cigar smokers do NOT fit into this category. They don’t inhale and they smoke WAY less that several cigars a day.

Burns continues:

“However, the pattern of excess disease risk among cigar smokers is not identical to that observed in cigarette smokers. Mortality ratios among cigarette smokers are much higher than those among cigar smokers for coronary heart disease, COPD and lung cancer.”

This is one point we think needs to be made clearly – cigarettes are MUCH worse for you than cigars, especially if you don’t inhale and smoke less than a several cigars a day.

“An explanation for the difference in mortality pattern between cigarette smokers and cigar smokers lies in differences in the depth and likelihood of inhalation of tobacco smoke between these two groups of smokers. Most cigarette smokers report inhaling the smoke into their lungs, while over three-quarters of the males in CPS-I who have only smoked cigars report that they never inhale.”

The following table taken from page 6 of Burns report suggests that people who smoke 1 – 2 cigars a day (which is a lot more than most cigar smokers I know who tend to smoke 1 – 2 a week), have an increased risk of most types of cancer (although, interestingly, they have a LOWER risk of coronary heart disease and lung cancer?) but only a 2% increased risk for “All Causes Of Death”. Compare this to people who smoke a pack a day of cigarettes who have a 69% increased risk of “All Causes”. Burns writes “When cigar smokers don’t inhale or smoke few cigars per day, the risks are only slightly above those of never smokers.”

cigars and your health

I mentioned earlier that cigar smokers have a different objective (flavour, aroma) than cigarette smokers. According to Burns:

“The fraction of adult cigar smokers who smoke cigars every day is much smaller than the fraction of cigarette or smokeless tobacco users who use every day. This suggests that cigar smoking among adults, while probably able to cause addiction to nicotine, is less likely to do so than cigarette smoking or smokeless tobacco use. Data from California, which show that the recent change in cigar use among adults is largely an increase in occasional use, also suggests that the addictive potential of cigars is lower than that for cigarettes (Gerlach et al., 1998).”

Environmental Tobacco Smoke (ETS)

Burns makes the point that you want to avoid breathing in cigar smoke as much as possible and we completely agree. For that reason, we recommend that you only smoke cigars in places with excellent ventilation – outside or, if you intend smoking inside your home, make sure you have open windows and doors or have extraction fans installed.

Burns: “Tobacco smoke produced by cigars contains most of the same toxic and carcinogenic constituents found in cigarette smoke. In general however, large cigars produce more carbon monoxide, as well as higher amounts of nitrogen oxides and carcinogenic N-nitrosamines, per gram of tobacco burned, and the free ammonia in tobacco smoke is higher due to the more alkaline pH of the smoke. It is likely this difference in free ammonia that results in the more pungent smell of cigar smoke. The major difference between cigarettes and cigars is the amount of tobacco contained in each product. Cigarettes generally contain less than one gram of tobacco and are smoked for about 7-8 minutes, with a substantial interval between cigarettes. Large cigars commonly contain 5-17 grams of tobacco, and are smoked over intervals as long as 60-90 minutes. Thus cigars, while generating similar amounts of ETS per minute compared to cigarettes, continue generating smoke for a much longer period of time; and therefore, the total amount of ETS generated by a single large cigar is much greater than that by a single cigarette.”

So, as I said earlier, make sure you take precautions to avoid inhaling as much tobacco smoke as possible.

The Other Side Of The Debate.

When we were in Nicaragua recently, we met a couple of old Cuban men in their late 70s who had been smoking cigars every day all their lives and they are as fit as a bull. These gentlemen spent most of their lives in the cigar business and certainly don’t think cigars are bad for your health.

A 2006 report on centenarians by Dr Nancy Nepomuceno in Cuba claimed that

Cuba’s high number of centenarians say their longevity is down to laying off alcohol, but indulging in coffee, cigars and sex.

So, as I said in the beginning – there is some debate.

77 year-old Aristides Garcia, Perdomo's Head of Pre-Production

Let me end this post by repeating what I think are the main points you need to know regarding cigars and health.

1. Cigars are made of tobacco. Tobacco isn’t good for you. So if you are going to smoke cigars, do it in moderation, the same way you might eat pizza, cheese and chocolate. Or the same way a sensible person drinks alcohol or coffee. Be sensible.

2. According to Burns’ report, “When cigar smokers don’t inhale or smoke few cigars per day, the risks are only slightly above those of never smokers.”

3. Avoid environmental smoke by smoking cigars outdoors or by making sure you smoke in a very well ventilated room.

I’ll report back when more evidence comes out about moderate cigar smoking. Until then, enjoy your cigars in moderation, folks!