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LATEST FLAME : A new generation is getting fired up over cigars. But when the smoke clears, will health concerns win out over fashion? : This hobby increases the risk of potentially fatal lip and oral cancers, not to mention cavities and bad breath.

November 10, 1995|MARK CHALON SMITH

Thinking of trying cigars? Don't take lighting up lightly. People who smoke cigars are at greater risk for oral and lip cancer and, if they inhale, cancer of the posterior pharynx (the back of the throat) as well as other areas along the respiratory tract, says Nicholas Salvati, a San Clemente dentist and a member of the American Cancer Society's Tobacco Activities Task Force.

Although most cigar smokers do not inhale, the hydrocarbons and heat of the cigar, plus the carcinogens in them, can cause precancerous white patch lesions--leukoplakia--and red ulcerated lesions--erythoplakia, he says.

Dentists often see nicotinic stomatitis, little red dots that are inflamed salivary glands that can lead to cancer lesions. "Smokers look as if they have burned the roof of their mouths," Salvati says.

The most common areas dentists search for oral cancers are the gums, floor of the mouth, cheeks and tongue. The No. 1 cancer of the mouth, about 95% of all cases, is squamous cell carcinoma; the vast majority occur on the lateral border of the tongue, according to Salvati.

Cancer of the lip is often caused by chronic irritation--sun exposure, smoking or trauma to the lips. Basal cell carcinoma is the most common cancerous lesion on the lips caused from sun exposure or, in some cases, from continually holding something hot between the lips, he says. With cigars, there is more risk for basal and squamous cell carcinoma because cigars have a greater surface area, and they burn longer on the lips.

Salvati also warns that, because of the way tobacco is grown and treated, "all the carcinogens and nitrosamines found in fertilizers and pesticides in the the ground end up on the tobacco leaf and most often gets processed into the tobacco," he says. Other risks with smoking, especially with cigars, are gum disease, gum recession, abrasions, bad breath and teeth stains. Also, sweeteners and flavor enhancers in the tobacco can exacerbate cavities and result in a higher accumulation of plaque and tartar, Salvati says.

About 35,000 to 40,000 oral cancers will be detected this year in the United States, which represents about 3% to 5% of all cancers, Salvati says. Unfortunately, oral cancer is one of the most lethal, with a 65% mortality rate.

"This is because the mouth has so many blood vessels that, if left unchecked, it spreads rapidly. It's a brutal and aggressive cancer," Salvati says. "If I can stop one person from getting oral cancer, I'd be happy."

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