Effect of Cigar Smoking on the Risk of Cardiovascular Disease, Chronic Obstructive Pulmonary Disease, and Cancer in Men

C igar consumption has been increasing in the United States since 1993. There are several likely reasons for this increase, including promotion by the mass media and the belief that cigar smoking is generally thought to be safer than cigarette smoking. The association of cigar smoking with cancer of the oropharynx and the upper aerodigestive tract and chronic obstructive pulmonary disease (COPD) has been well documented by a number of studies. However, the association of cigar smoking with cardiovascular heart disease (CHD) has not been determined definitively. This article reported a retrospective study that evaluated the association of cigar smoking with several disorders. Although the study has some limitations that are common with retrospective studies, it is well thought out and well designed. It offers substantial evidence that cigar smoking is associated with an increased risk of COPD and related conditions and CHD and that cigar smoking is associated with an increased risk of cancer of the oropharynx and lung cancer. It also offers support for an apparent dose-response (number of cigars smoked daily) association with multiple disorders. The study cohort was a subpopulation of 17,774 men aged 30 to 85 years enrolled in the Kaiser Permanente Medical Care Program of Northern California. They were selected from a larger population of 207,165 members (46% male, 54% female) aged 14 and up that had had voluntary health examinations at the time of their enrollment from 1964 through