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Commentary: The Truth About Cigar Studies

18 Nov 2014

FDA-cigars-large

By now, you’ve probably heard or read about the findings of a new long-term study of cigar smoking that generated headlines like this one from Fox News: “Cigars just as harmful to health as cigarettes, study says.” Well, don’t toss your Davidoffs in the dustbin just yet.

A closer look inside the numbers, along with some helpful responses from the study’s lead researcher, show that the results aren’t nearly that clear for those of us who enjoy premium, hand-rolled, all-tobacco cigars.

First, and perhaps most importantly, the study made no distinction between those who smoke machine-made cigars and those who smoke premium cigars. In fact, that information wasn’t even collected in the survey of 25,522 subjects for the 1999-2012 National Health Nutrition and Examination Survey, Dr. Jiping Chen, an epidemiologist in the Food and Drug Administration’s Center for Tobacco Products, told me in an email.

Consequently, there was also no consideration of differences in smoking, such as inhaling/not inhaling or the frequency of consumption, Dr. Chen said. “No information was collected in the study on the types of cigars smoked or reasons why cigars were smoked.”

So, someone who sucks down a half-dozen White Owls a day is a “cigar smoker,” the same as someone who lights up an Arturo Fuente Hemingway once a week. “All cigar smokers were treated as a single group,” Dr. Chen said of the survey that was the basis for the cigar study.

This is important because, without getting overly technical, the study compared levels of five “biomarkers”—substances scientists use to measure things like disease or environmental exposure—found in cigar smokers and non-smokers. To get the measurements for cigar smokers, she said, researchers took “the average levels of biomarkers of all cigar smokers.”

Now, to put that in perspective, bear in mind there are roughly 350 million premium cigars sold annually in the United States. Machine-made cigars are sold in the billions. In other words, the premium cigar market is just a tiny fraction of the cigar market.

So it stands to reason that the cigar-smoking group in the study would be vastly tilted toward those who smoke machine-made cigars, and it’s also as likely that an overwhelming percentage of them utilize cigars as do those who smoke cigarettes—as a nicotine delivery system, not for enjoyment, as do most premium-cigar smokers.

Averaging things like this can be dangerous. If, for example, you take the average of Bill Gates’ assets and my assets, we both appear to be very wealthy men.

One other point from the research that I find worth noting is the fact that there was no assessment of the impact of the 2009 SCHIP tax increases. Those undoubtedly led an unknown number of cigarette smokers to turn to machine-made “cigars” because they were taxed at a lower rate and offered a cheaper alternative. To my mind, while these people may now be classified as cigar smokers, they’re really cigarette smokers under a different name.

This contention was at least partly supported, I think, by findings that cigar smokers who were former cigarette smokers had higher levels of the two biomarkers found only in tobacco than did those who hadn’t smoked cigarettes before.

Now, let’s be honest. I don’t think anyone could reasonably dispute the notion that if you smoke cigars like cigarettes you’re almost certainly engaging in the same highly risky behavior as a cigarette smoker. And I can’t imagine that, in this day and age, that would surprise anybody. But that isn’t even remotely the way nearly all of us who smoke premium cigars actually smoke them. We don’t inhale, we don’t smoke all day long, and we aren’t addicted to nicotine.

We do recognize that there is some added danger to smoking premium cigars, but we also know that it is relatively small, and it’s a risk we’re willing to take. Just as we willingly take many other risks in our lives to do things we enjoy.

And as the FDA continues to consider its position on regulating cigars—and whether to grant an exemption for premium cigars—the distinctions I’ve pointed out could make a world of difference. It would be more than a shame for this research to help derail the efforts to secure that exemption because I believe it clearly isn’t applicable.

One bright spot in all this is that the very helpful FDA press officer who helped arrange my email exchange with Dr. Chen told me she will forward this to those involved in the consideration of cigar regulations.

Hopefully, they’ll read it and reach the right conclusion.

George E

photo credit: Stogie Guys

Drew Estate

11 Responses to “Commentary: The Truth About Cigar Studies”

  1. thecigarauthority Tuesday, November 18, 2014 at 9:17 am #

    Awesome article and insight!

  2. David Tuesday, November 18, 2014 at 12:36 pm #

    Glad someone else saw through this government propaganda posing as a clinical study. If you read how the media has interpreted this data one would think the FDA conducted a prospective , well controlled clinical trial whose primary endpoint was to prove that cigar smoking is equally deleterious to cigarette smoking. This is nothing more than a chart review of exiting data that was not collected to prove that point. It is amazing to me that since the FDA has extended the comment period regarding this proposed legislation they have launched 2-3 data sets to prove their own pre-drawn conclusion that cigars should indeed be regulated by them.

  3. Swede214 Tuesday, November 18, 2014 at 12:36 pm #

    Thanks George for this article, and hopefully the Doctor will do what she said.

  4. Timothy Black Tuesday, November 18, 2014 at 1:59 pm #

    thank you for this

  5. Archie Tuesday, November 18, 2014 at 4:10 pm #

    So if this most recent study doesn't do it, are there any studies that have effectively proven cigars are not a safe alternative to smoking cigarettes?

    Is there any study showing poor health consequences for those who smoke 4-5 cigars a week and don't inhale?

    Thanks for the great article, by the way!

    • George e Tuesday, November 18, 2014 at 6:15 pm #

      Archie – I've been looking for years to find any legitimate, in-depth research into the effects of premium, all-tobacco cigar smoking. Haven't found one yet. I have asked numerous experts and none has pointed me to one. I think the pool may just too small to interest researchers and the results very difficult to measure. Also, I think two other factors come into play: 1) much of the tobacco research is driven by an interest in assessing the effect on youth and under-age smoking, and it is pretty obvious that really isn't a problem with premium cigar smoking and 2) I'm not sure, quite frankly, that many of the researchers really understand the differences in machine-made cigars and premium cigars, and those that smoke them. If anyone out there is aware of such a study, please let me know.

  6. Frank Daddario Wednesday, November 19, 2014 at 2:24 pm #

    .

    ,,,,,,,,,,,,so lets say CIGARs are as UNhealthy as CIGARETTEs is FACTUAL

    got it ?

    okay ?

    ………………now pass me the lighter !

    puff

    puff

  7. Jake Wednesday, November 19, 2014 at 7:47 pm #

    Great article. Hopefully someone with some decision-making prowess at the FDA will indeed read it, and understand it for what it is and the flaws that it reveals.

  8. khalid Al Lawati Friday, November 21, 2014 at 6:08 am #

    Very nice articel and informative ….

    THANK YOU

    And lets continue smoking premium cigars

  9. Bart Monday, November 24, 2014 at 2:06 am #

    If you want a legitimate study check out what the National Institute of Health said about their study correlating cigars with cancer. i found it on the internet and I would guess anyone could do the same.
    1. Correlation with cancers of any type—one to tow cigars per day practically nil. In fact one study showed a negative correlation with cancer and smoking one cigar per day.

    2. Three cigars per day and up there is an extremely small but existent correlation with cancer that increase with the number of cigars per day smoked. But it is still very small.

    3. Largest correlation exists with smoking and consuming alcohol at the same time. The alcohol seems to be some kind of activator of compounds in the smoke. Correlations are still small, but I take them to heart and do not smoke and drink.

    The studies were seeking any cancers, but found them, when they existed, mostly in the oral cavity, not in the lungs or other organs. I would imagine these were people smoking real cigars, not Winchesters.

    I am registered in a number of cigar forums. A question I always pose is, "Do you know any cigar smoke who acquired oral cancers. I have yet to receive a positive reply. Nevertheless, my personal choice is keep a glass of water around when I am smoking and rinse my mouth occasionally, and I do not like to swallow a lot of saliva when I smoke. So I tend to spit on the sidewalk quite a bit. Guess I can't smoke in Singapore. As I am a daily smoker, I feel the precautions make sense, at least to me.

    • George E. Monday, November 24, 2014 at 8:27 am #

      Bart – Can you be more specific about the study to which you refer? There are any number of them and I'd like to make sure I'm looking at the right one. I think I know, but I don't want to guess.