Dear Reader,

Cigar smokers may think they have a free pass when it comes to the negative health effects of tobacco use, but the sad reality is that cigar, pipe, and cigarette smoking all cause cancer. Even the deceptively labeled "natural cigarette" poses serious health risks. They all contain tobacco, the cancer causing agent, and they all have nicotine, which causes addiction and dependency. The difference between a cigar and cigarette is that a cigar is a roll of cut tobacco wrapped in leaf tobacco or a tobacco product. Cigarettes are rolls of tobacco wrapped in paper or any other non-tobacco product. Natural cigarettes are made without chemical additives or flavorings, using full tobacco leaves rather than reconstituted sheet or scrap tobacco. The only possible advantage to natural cigarettes seems to be an earth-friendly one, since fewer chemical by-products result from their manufacture, and some natural cigarette companies produce their tobacco organically.

Cigar smoking may have the reputation of being less harmful because most cigar smokers are only "occasional" users, and most do not inhale the smoke into their lungs when puffing. However, with frequent use, cigar smoking can be just as, if not more, harmful than cigarette smoking. Consider the following:

• Smoking five cigars a day and inhaling moderately produces the same lung cancer risk as smoking a pack of cigarettes a day.
  
• Since cigars are much larger than cigarettes, each one packs more punch. Some large cigars contain as much tobacco (and nicotine) as an entire pack of cigarettes.
  
• Cigar smoking can be a gateway to cigarette smoking. One study has shown that cigar smokers are more than twice as likely to take up cigarette smoking as people who have never smoked cigars.
  
• Cigars produce even more environmental tobacco smoke (ETS) than cigarettes, due to their size, long aging and fermentation, and long burning time. The wrapper of a cigar (made of tobacco leaf) is not very porous and burns less completely than cigarettes, meaning the air surrounding a cigar smoker has higher concentrations of nitrogen oxides, ammonia, carbon monoxide, and tar than the air around a cigarette smoker.
  
• The relapse rate of former cigarette smokers who smoke cigars is twice as great as the relapse rate of former cigarette smokers who do not smoke cigars.

Even if the cigar smoker doesn't inhale, the carcinogens in the smoke touch the lips, mouth, tongue, throat, and larynx. Lung cancer risk for non-inhaling, daily cigar smokers is still double that of nonsmokers. In fact, cigar smokers place themselves at risk for:

• Lung cancer as well as cancers of the mouth, lip, tongue, throat, pharynx, larynx, esophagus, stomach, and pancreas
• Chronic bronchitis, emphysema, chronic obstructive pulmonary disease (a lung disease) and the exacerbation of asthma
• Coronary heart disease, including stroke and heart attack
• Vascular diseases, including aneurysm
• Oral diseases, tooth erosion, tooth loss, stained teeth, and chronic bad breath

The possibility of becoming addicted is also a concern — in terms of increased health risks with long-term use, dependency, and the financial impact of smoking. Each cigar contains a lot of nicotine — between 100 and 200 milligrams, or as many as 444 milligrams, where as one cigarette has about 8.4 milligrams. Since nicotine is absorbed very easily through the tissues of the mouth a cigar smoker can become addicted even without inhaling.

According to the National Institute on Drug Abuse, tobacco use kills more than 430,000 people a year in the United States — more than alcohol, cocaine, heroin, homicide, suicide, car crashes, fire, and AIDS — combined. The National Cancer Institute reports that tobacco use is also the single greatest cause of excess cancer deaths and the leading preventable cause of death in the U.S. And don't forget about the second-hand smoke repercussions! The Environmental Protection Agency states that second-hand smoke causes about 3,000 cases of lung cancer a year in non-smoking adults, 40,000 cases a year of cardiovascular disease, and contributes to respiratory illness and Sudden Infant Death Syndrome (SIDS) in children.

So, although we may not hear much about Native Americans dying as a result of tobacco use in the 'old days', the likelihood is that it did affect their health, and maybe even their mortality rate. However, Native Americans mainly used tobacco for religious and celebratory purposes; their use was generally not as heavy or chronic as it is for people today, so it is difficult to understand the impact of tobacco on disease and health in that time.

If you are a Columbia student and are looking to quit smoking, Primary Care Medical Services (PCMS) sponsors a Tobacco Cessation Program for those students who want to quit or support someone who is quitting. PCMS can connect you with a variety of resources such as support groups, relaxation techniques, acupuncture, nicotine replacement and other medication options as well.

Alice

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