Roll-ups, Cigars and Pipes


25 g = approx. 50 cigarettes

25 g per week = approx. 7 cigarettes per day

50 g per week = approx. 14 cigarettes per day

  • Despite common misconception, roll-ups are ‘at least as hazardous as any other type of cigarette’,” reports The Independent.
  • Tend to contain less tobacco than cigarettes
  • Cheaper than cigarettes
  • The tobacco is less tightly packed which means less carbon monoxide is produced
  • Can be smoked with or without a filter
  • Tend to be smoked right down to the end where a lot of tar gathers
  • More heavily treated with additives to allow moisture retention
  • Cheaper than regular cigarettes so more likely to be smoked by people on low income
  • Currently there is no published data on tar, nicotine or carbon monoxide levels of roll-ups

Cigars / CigarillosCigar

1 cigar = approx. 4 cigarettes

1 cigarillo = approx. 2 cigarettes

Risks of cigar smoking:

  • Coronary heart disease, stroke, cancers similar to levels found in light cigarette smokers.
  • Lung cancer risk the same as those in light cigarette smokers – twice the risk as a nonsmoker.
  • Higher risks of other cancers including colon, pancreatic, larynx.
  • If a cigar smoker used to smoke cigarettes they may have transferred inhalation technique, putting them at higher risk of disease.
  • Capable of providing high levels of nicotine to produce clear dependence, even if the smoke is not inhaled.

Pipe Smoking

1 pipe = approx. 2.5 cigarettes

Risks of pipe smoking:

  • Coronary heart disease, stroke, cancers similar to levels found in light cigarette smokers.
  • Compared with non-smokers, eight times the risk of lung cancer, four times the risk of throat cancer, more than double the risk of oesophageal cancer, three times the risk of chronic obstructive pulmonary disease.
  • Higher risk of other cancers including colon, pancreatic, larynx.

Risk to the pipe or cigar smoker’s health

In 2007 just 2% of men smoked at least one cigar per month. Very pexels-photo-192473few women have ever smoked cigars and since 1978 the numbers have scarcely been measurable. In 2007, only one percent of men said they smoked a pipe, and they were almost all over 50 years old. With most pipe and cigar smokers now being ex-smokers of cigarettes, they may also have transferred their inhalation techniques, despite the irritancy of the smoke: in this case, they will be at significantly greater risk of disease than pipe or cigar smokers who have never smoked cigarettes. Pipe and cigar smoking carries a major risk of smoking-related ill health, including coronary heart disease (CHD), stroke, cardiovascular, non-cardiovascular, cancers and total mortality, similar to levels for light cigarette smokers. Compared to non-tobacco users, pipe smokers have five times the risk of lung cancer; nearly four times the risk of throat cancer and more than double the risk of esophageal cancer. Colon cancer risk increased by forty percent, pancreatic cancer by sixty percent and cancer of the larynx by thirteen percent. Pipe smokers have a greater risk of other tobacco-related diseases. They had a thirty percent risk of heart disease and nearly three times the risk of chronic obstructive pulmonary disease.

Lung cancer

Mortality rates for lung cancer in those who have always smoked only cigars and pipes are significantly higher than in non-smokers but are lower than for cigarette only smokers. The risk of lung cancer increases in relation to the number of cigars or pipes of tobacco smoked each day and the degree of inhalation. The lower risk of lung cancer among pipe and cigar smokers when compared to cigarette smokers is due to the lesser amount smoked and the lower degree of inhalation.

Other cancers

Cigar smokers who do not inhale receive a high smoke exposure to the mouth and tongue causing an increased risk of oral cancers. Also, tobacco constituents dissolved in their saliva are swallowed down their oesophagus producing an increase in oesophageal cancers. Cancer of the larynx is also developed by pipe and cigar smokers at rates comparable to those of cigarette smokers (i.e. several times that of non-smokers). A US study found that cigar smokers face more than twice the risk of cancers of the mouth, throat and oesophagus in comparison to non-smokers.

Respiratory disorders

Pipe and cigar smokers experience higher mortality from bronchitis and emphysema as compared with non-smokers although not as high as that of current cigarette smokers. A US study found that cigar smokers face a 45% greater risk of developing bronchitis and emphysema compared to non-smokers.

Heart disease

In one study, cigar smokers who had taken up cigars after stopping cigarettes and smoked at least five cigars a day had a risk of non-fatal myocardial infarction about four times as high as that among ex-cigarette smokers who did not smoke cigars. Among those who had never smoked cigarettes, there was very little increased risk.

Secondhand Smoke

Non-smokers are at risk of contracting lung cancer from exposure to other people’s smoke, whether that smoke is from pipes, cigars or cigarettes. Sidestream smoke from cigars contributes more to tobacco smoke pollution than sidestream smoke from cigarettes when equal amounts of tobacco are burned.

Nicotine dependency

The smoke of cigars is more alkaline than cigarette smoke and dissolves more easily in saliva. Therefore the desired dose of nicotine is achieved without the need to inhale the smoke into the lungs. Cigars are capable of providing high levels of nicotine at a rate fast enough to produce clear dependence, even if the smoke is not inhaled.

Source: ASH Essential Information No.13—

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