In my line of work, smoking is by right considered one of the most vile habits a person could acquire. All through medical school you learn about the health hazards connected to the use of tobacco. While practicing medicine you see time and again how this is not empty propaganda, but translates into real life suffering and death. So, why would someone with this knowledge and experience ever want to come near a tobacco product? Well, the truth is that it´s not that simple.
There is no doubt whatsoever that tobacco can be very bad for you, but there are differences in what you use and how you do it. Most people who smoke cigarettes will inhale the smoke, exposing their lungs and bodies to a large number of potentially hazardous chemicals, many of which are strongly carcinogenic. The tobacco used in cigarettes is processed differently from that put into cigars. Cigarette smoke is acidic while cigar smoke is alkaline. This gives cigars and cigarettes different properties which in turn affects how they are smoked. Cigarette smoke needs to be inhaled to enable absorption of nicotine into the blood stream, which is not the case with cigars. The alkaline properties of cigar smoke actually makes it pretty uncomfortable to inhale, at least for persons who are not previous pipe- or cigarette smokers.
When you look at the studies that have been made on the health effects of cigar smoking, you quickly see that the study population is usually divided into different groups with different risk of developing smoke-related disease. The highest risk of adverse health effects is seen in those who has the highest consumption of tobacco, and also inhales the smoke. This is more common in persons who smoke both cigarettes and cigars, or has shifted from the former to the latter. The lowest risk is in the group who only smoke cigars and doesn´t inhale. This last group still has a higher risk for health problems than non-smokers, at least if they consume five or more cigars a day. If you don´t inhale the smoke at all, the risk for some tobacco-related diseases like lung cancer goes down significantly, but the risk for cancer of the mouth and larynx is still there. However, very little is known about health hazards for people who are occasional smokers, meaning less than one cigar a day. It seems reasonable to assume a connection between the risk of many of these diseases and the level of exposure, i e more smoking higher risk, less smoking lower risk. So, if you´re consuming 1 – 2 cigars a week, will that translate into a risk that needs to be taken into account? Nobody knows. Is such a risk greater than what you get from for example eating a lot of smoked food? Nobody really knows that either. So, my interpretation of the existing data is that we don´t know if there in fact is an increase in the risk of smoke-related disease for a person smoking less than one cigar a day (without inhaling). If there indeed is such an increased risk, I find it reasonable to believe that it is not very big.
It could be argued that it´s still stupid doing something like this if there is even a remote chance that it could be dangerous for you. Well, the same argument could be used against driving a car, eating a number of common foodstuffs or taking part in many a popular leisure activity. Sometimes we choose to do something that we like, in spite of it potentially not being 100% safe. This is just a part of being alive.
For my part, coming into contact with cigar smoking and actually finding it pleasant was rather surprising and not something I would have ever expected. To me it´s very similar to other areas of tasting – wine, whisky, fine food and so on – something that I´ve been enjoying for many years. Cigars are just another facet of this type of activity. As in other sorts of tastings, the nerd factor can´t entirely be disregarded. There is something appealing (at least to the male mind) in discovering an esoteric small batch bourbon and enjoying it´s finer points, and the same goes for the world of cigars.
So, if ever asked by friends or colleagues if I really think it´s ok to be smoking I would answer by paraphrasing former US President Bill Clinton. “Yes I´m smoking cigars, but I don´t inhale”. I´m 100% sure that one day something is going to kill me, but I don´t think it will be this.