Researchers say cigarette smoking has declined in recent years, and pipe and cigar smoking have increased, partly because of a misperception that pipes and cigars are safer than cigarettes.
But the study shows that pipe and cigar smoking damages lung function in a manner similar to cigarettes and is associated with chronic obstructive pulmonary disease (COPD). COPD is a progressive disease that causes damage to the airways and makes it more difficult to breathe. It is the fourth leading cause of death in the U.S.
Although cigarette smoking is a well-known cause of COPD, experts say few studies have looked at whether alternative forms of smoking, such as pipes and cigars, cause the same changes in the lungs that lead to COPD. These results suggest that indeed is the case.
“Smoke, whether from cigarette, pipe, or cigar, will result in absorption of one of the most addictive chemicals known, nicotine, and will produce measurable lung damage,” Michael B. Steinberg, MD, MPH, of the Robert Wood Johnson Medical School, writes in an editorial that accompanies the study in the Annals of Internal Medicine.
“The results are especially important because the tobacco industry is challenged by decreasing cigarette sales and is actively promoting product substitution and concurrent use as an alternative to complete tobacco cessation.”
Pipes and Cigars Hurt Lung Function
In the study, researchers looked at the effects of cigar and pipe smoking on changes in lung function in 3,528 people aged 48 to 90 who were participants in a study about heart disease risk factors.
The participants answered a survey about their past and present smoking habits, and researchers evaluated their lung function and cotinine levels. Cotinine is a byproduct of nicotine and is detected in the urine.
The results showed those participants who did not smoke cigarettes but did smoke cigars or pipes were twice as likely as never smokers to have decreased lung function. Those who smoked cigars or pipes in addition to cigarettes also had a higher risk of lung function impairment consistent with the development of COPD.
Researchers found that pipe and cigar smoking was also associated with increased cotinine levels.
“Some pipe and cigar smokers say they do not inhale, or inhale less, than cigarette smokers. The elevated cotinine levels in the current study, however, belie this notion and provide a biological measure of nicotine exposure,” write researchers R. Graham Barr, MD, DrPH, assistant professor of medicine and epidemiology at Columbia University in New York City, and colleagues.