Cigar and pipe smoking are often seen as less harmful alternatives to cigarettes, but the truth is that they can still be dangerous. While smoking a pipe or cigar from time to time may be less harmful than smoking cigarettes regularly, no form of smoking is completely safe, and even occasional smoking carries health risks. Our analysis showed that cigarette smokers who switch to cigars or pipes reduce the risk of lung cancer, supporting Wald and Watt's conclusion. We also found that mixed smokers who stop smoking cigarettes but continue to smoke cigars or pipes also reduce their risk of lung cancer, although they still have a five times greater risk than that of non-smokers. Cigar smokers have a higher risk of oral cancer, and pipe smokers are more likely to have lung, liver, head and neck cancers than non-smokers.
Cigarette smokers generally reported deeper inhalation and had higher blood levels of carboxyhemoglobin than primary pipe or cigar smokers or those who changed habits. Pipe and cigar smokers (and those who have smoked cigarettes for a long time) are also likely to have a higher relative risk of lung cancer than non-smokers than the authors' study suggests. Editors Wald and Watt reported that switching from smoking cigarettes to pipes or cigars would reduce smokers' risk of dying from smoking-related diseases by approximately half. The findings showed no significant difference in the number of deaths between pipe and cigarette smokers who smoked comparable amounts of tobacco. Pipe smokers are also at greater risk of dying from heart disease, strokes and chronic lung diseases. People who quit smoking cigarettes for cigars or pipes had similar risks as smokers who only smoke cigars and only pipes. It would be regrettable if this report encouraged cigarette smokers to switch to pipes or cigars.
More research is needed to demonstrate the relationship between smoking cigars and pipes and cancers of the stomach, pancreas, colon and rectum.