Another dream of cigarette addicts is in the process of going up in smoke. This time, it's the delusion that a cigarette user can switch to smoking cigars or a pipe to cut down on the health dangers of tobacco.
And for nonsmokers who have found the odor of cigarette smoke repulsive but the sweet aroma of certain blends of pipe tobacco smoke attractive, there is another jolt into reality: So-called side-stream smoke--that which is exhaled or not inhaled by the smoker, in the first place--is more noxious when it comes from pipe tobaccos than when the origin is cigarettes.
Ironically, though the absence of any safety advantage for cigar and pipe smokers as opposed to cigarette users has been the subject of a growing body of evidence for nearly a decade, it has apparently taken a new study published by researchers in Minnesota last week to attract widespread public attention to the scientific reality.
"We got all the press, but it's the kind of thing that confirms evidence gathered by a lot of other people," said Terry Pechacek of the division of epidemiology of the University of Minnesota School of Public Health.
The new study comes on the heels of persistent attempts of pipe and cigar promoters to convince the public that even some physicians believe switching provides a safer alternative to cigarettes for smokers who believe they can't quit.
306 Smokers Studied
What Pechacek's group found, in a study of the smoking habits of 306 male smokers in seven cities in the upper Midwest, was that smokers who have switched from cigarettes to pipes or cigars find ways to continue to inhale the smoke, no matter what. The kinds of tobacco used in cigars and pipes are cured differently than those used in cigarettes, he said, with pipe-cigar tobaccos producing greater concentrations of cancerous tars and dangerous carbon monoxide gas than those used in cigarettes.
Even for a pipe or cigar smoker who has never used cigarettes, smoking four cigars or four pipefuls a day or more inflicts the equivalent damage to the heart and lungs of at least a half pack of cigarettes, Pechacek said.
"Heavy (cigar and pipe) smokers should be advised to reduce consumption or quit smoking," the Minnesota team warned in a report published in last week's issue of the Journal of the American Medical Assn. "Cigarette smokers contemplating switching to (cigars or pipes) should be advised that they are likely to inhale . . . and may not reduce their risk.
"Hence, quitting completely is the best and safest strategy."
The new report came as essentially the latest installment in a series of studies that have raised doubts about the comparative safety of pipes and cigars as opposed to cigarettes. In a paper published earlier this year, researchers at the National Cancer Institute found, for instance, that cigar and pipe smokers have an elevated risk of contracting bladder cancer.
In the past, the only significant controversy in the field has been over the question of the extent to which pipe and cigar smokers actually inhale, with some studies finding the amounts minimal and others finding them high.
The Minnesota research, Pechacek said, tried to ascertain smoke absorption by a new method--the measurement of levels in the blood of a chemical called serum thiocyanate, which occurs in the body as a byproduct of tobacco exposure. The researchers monitored serum thiocyanate levels in the bloodstreams of pipe and cigar smokers who had used cigarettes previously and those who had not.
Other Ways to Inhale
The former cigarette smokers recorded significantly higher measurements of the chemical marker, the Minnesota team found. The values recorded in the 306 smokers were compared with more than 2,200 others who were either exclusively nonsmokers or exclusively cigarette users.
What the findings indicate, Pechacek said, is that former cigarette smokers who have switched to pipes and cigars continue to find ways--perhaps unconsciously--to inhale large amounts of smoke. In a telephone interview, Pechacek said the former cigarette smokers apparently accomplish this by taking in a puff of smoke and then exhaling almost all of it immediately.
But they retain a small amount of smoke in their mouths and then inhale a fresh puff, with the fresh smoke mixing with the more noxious smoke that has remained from the previous puff. Some of that continuous series of mixings of old and new smoke is drawn back into the lungs, Pechacek said.
"Pipe and cigar smoke actually has higher levels or carcinogens and is actually more dangerous (than cigarette smoke) because it is more irritating to the mucous lining" of the throat and respiratory system, he said. "Cigarette smoke is easier to inhale."