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Effects of Smoking Pipes and Cigars

Medically Reviewed by Sabrina Felson, MD on October 19, 2020

Pipe and cigar smokers often wave off worries that smoking is bad for their health. They claim their habit is harmless and perpetuate the common misperception that pipes and cigars are somehow safer than cigarettes. In reality, these tobacco products carry the same health risks as cigarettes.

Cigars and pipes differ in design from cigarettes, which are made from tobacco wrapped in thin paper. Cigars are wrapped in tobacco leaves, and unlike cigarettes, they don't typically have filters. In pipes, the tobacco sits in a bowl at the end, and a stem connects the bowl to the mouthpiece. But pipes can be equipped with filters.

Another type of pipe, the water pipe, consists of a body filled with water, a bowl in which the tobacco is placed, and an attached tube and mouthpiece through which the pipe is smoked. Water pipes, or hookahs, originated in ancient Persia and India about 400 years ago and are still popular today. Hookahs are filled with fragrant tobaccos in a variety of flavors, such as cherry, apple, or mint.

Cigar and Pipe Smoking vs. Cigarettes

Cigar and pipe smokers often argue that their health isn't at risk because they only smoke one or two a day and they don't inhale. There is also the claim that pipes and cigars aren't addictive. Yet research shows that cigar and pipe smoking still increase your risk for cancer more than nonsmokers' risk.

A single large cigar can contain more than a half-ounce of tobacco -- as much tobacco as an entire pack of cigarettes. One cigar also contains 100 to 200 milligrams of nicotine, while a cigarette averages only about 8 milligrams. That extra nicotine may be why smoking just a few cigars a week is enough to trigger nicotine cravings. Cigar smokers are at greater risk for oral cancers.

Tobacco used in pipes is cured and contains nicotine and the same carcinogens as cigarettes. Pipe smokers are more likely to get cancer of the lungs, liver, head, and neck than nonsmokers.

Health Effects of Smoking Pipes and Cigars

Here are just a few of the harmful health effects of smoking pipes and cigars:

Cancer. Even if you don't inhale, you can get cancer from smoking pipes and cigars. People who smoke cigars regularly are 4 to 10 times more likely than nonsmokers to die from cancers of the mouth, larynx, and esophagus. Oral cancer can develop anywhere the smoke touches, including the lips, mouth, throat, and tongue. People who inhale also increase their risk for cancers of the lung, pancreas, and bladder.

Lung disease. Cigar and pipe smoking double the risk for the airway damage that leads to chronic obstructive pulmonary disease (COPD), a lung disease that includes chronic bronchitis and emphysema. Smoking can also worsen asthma.

Heart disease. Smoking cigars or pipes increases the likelihood of having heart disease or a stroke. Cigars boost the risk of early death from coronary heart disease by 30%. Cigar smoke contains many of the same toxic and carcinogenic compounds that are found in cigarette smoke, and people who smoke four or more cigars per day are exposed to an amount of smoke equivalent to 10 cigarettes; even those who do not inhale are exposed to their own environmental smoke.

Tooth problems. Smoking pipes or cigars wreaks havoc on your mouth, contributing to gum disease, stained teeth, bad breath, and tooth loss. One study showed that pipe and cigar smokers had an average of four missing teeth.

Erectile dysfunction. Smokers are twice as likely to have erectile dysfunction as nonsmokers.

Cigars and pipes aren't just dangerous to the people who smoke them. They also give off secondhand smoke filled with toxic chemicals like carbon monoxide and hydrocarbons. Because a cigar wrapper (which is made from a tobacco leaf) is less porous than a cigarette wrapper, it doesn't burn as thoroughly as a cigarette wrapper. This increases the concentration of cancer-causing substances like ammonia, tar, and carbon monoxide released into the air.

Despite their sweet aroma, water pipes are also dangerous to your health. During a typical hookah smoking session, you'll inhale 100 to 200 times the volume of smoke that you'd get from a cigarette. Water pipes deliver at least as much nicotine and toxins as cigarettes, and they put users at a similar risk for cancer and other smoking-related diseases.

The same advice is true for pipe and cigar smokers as for cigarette smokers: Quit. If you can't kick the habit on your own, get help from your doctor, another health professional, or a smoking cessation service (800-QUIT-NOW, or 800-784-8669). Also, make sure to get regular checkups -- including mouth exams to look for signs of oral cancer. 

WebMD Medical Reference

Sources

SOURCES:

American Cancer Society web site: "Cigar Smoking."

Archives of Internal Medicine: "Cigar smoking and death from coronary heart disease in a prospective study of US men."

Health Services at Columbia: "Go Ask Alice! Cigar and pipe smoking: Safer than cigarettes?"

Annals of Internal Medicine: “The Association of Pipe and Cigar Use With Cotinine Levels, Lung Function, and Airflow Obstruction: A Cross-sectional Study.”

Journal of the National Cancer Institute: "Association Between Exclusive Pipe Smoking and Mortality From Cancer and Other Diseases."

Journal of  Periodontology: "Cigar, pipe, and cigarette smoking as risk factors for periodontal disease and tooth loss."

Ohio State University Medical Center.

CDC.

Rakel, Robert E. Textbook of Family Medicine, Saunders Elsevier, 2007.

American journal of epidemiology: "Cigarette, cigar, and pipe smoking and the risk of head and neck cancers: pooled analysis in the International Head and Neck Cancer Epidemiology Consortium."

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