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Reducing Risks of Pipe and Cigar Smoking

 Summary Notes from the lecture of Henri P. Gaboriau M.D.

(425) 898-1228

 

March 2002

 

1) The highest to lowest risks from tobacco products are as follows:

Risk                                                                 Primary Risk

#1)       Cigarettes                                           Lungs, throat (Erytroplaleia)

#2)       Cigars                                                 Lip, tongue

#3)       Smokeless – snuff, chew etc.           Gum line (Leukoplakia)

#4)       Pipes                                                   Tongue

 

2) Lung cancer risk index study*:    

                                       

Risk

·       Non-smoker                                               1.0       (base number)

·        Cigarette – 20 grams / day                    16.0     (i.e. 16 x the risk of  non-

smokers)

·       Cigar – 20 grams / day                             3.2

·       Pipe – if > 10 bowls per day                     6.7      

·       Pipe – if 5 bowls per day                          3.2      

·       Pipe – if 3 bowls per day                          1.5

·       Pipe – if 2 bowls per day                          1.26

·       typical - 2 bowls every 2-3 days             ~1.05 (almost  same as non-smoker)

 

(*Source Webline – reviewed 22 articles. 21,520 smokers studied between 1969 – 93)

 

3) Bladder cancer risk index (although more rare in smokers than is lung and throat cancer)

 

                                                Risk

·       Non-smoker           1.0

·       Cigarette                3.5

·       Cigar                       2.3

·       Pipe                        1.9

 

4) Do Pipe and Cigar smokers inhale?

 

Most Cigar and Pipe smokers do not inhale - unless they were former cigarette smokers. To test the theory, a study* was conducted with an endoscope camera down the nose and throat to observe breathing patterns in smokers. Here were the results:

·       Former cigarette smokers inhaled pipes like cigarettes

·       Cigar and pipe smokers – breathed normally first, then inhaled into mouth only, smoke was mostly blocked from throat by tongue, then exhaled the smoke w/o going into the lungs.

·       You can test this on yourself. Take a toke on a pipe or cigar as you normally would. Now breathe in and out through your nose two or three times. Do you see smoke when you in exhale? If yes, you are inhaling. If no, now exhale the smoke from your mouth. Did smoke come out of your mouth? If yes, you are not inhaling and are tremendously decreasing your risk of lung cancer.

 

*"Pattern of inhalation of Tobacco Smoke in Pipe, Cigarette and Never Smokers” AM Rev Respir Dis 1985

 

5) Reducing the risk of tongue burn and/or tongue and mouth cancer.

 

·       A burn or scar from hot smoke is what you are trying to avoid. This can lead to cancer.

·       Don’t leave the pipe clenched in your teeth in one position touching your tongue for a long time. Move the pipe around your mouth as you smoke.

·       Sip your pipe like a fine wine, don’t draw heavily.

·       Find a cool burning tobacco that you enjoy. Aromatic tobaccos tend to burn hotter than do English.

·       Always drink while you smoke. This helps cool the mouth, quench the thirst from dry smoke, coat the mouth from hot smoke, and wash away any hot debris. Water, sodas, coffee, tea are fine. Don’t drink anything very hot though.

·       However, sorry everyone, do not drink alcohol while you smoke. The combination of alcohol and smoke is not just a linear risk, but exponential. This is a huge mistake most smokers make. The alcohol destroys the flora and protective lining of mucus in the mouth. Then the hot smoke will directly come in contact with the unprotected mouth lining. Drink alcohol only after you smoke.

·       Smoking depletes the body of vitamins A and C. Take up to 3000 mg of VC a day. Also take selenium and other antioxidants that will help buffer your body from free radicals, cancer and anti-aging.

 

6) Medical examination:

 

At least once a year, tell your physician you are a pipe smoker and would like to have your mouth and tongue examined. Schedule your teeth exams ~ 6 months after your physician’s and have your dentist give another exam. You now have two exams a year, by two different medical specialists.

 

7) Life expectancy for Pipe Smokers:

 

Okay, sit down for this…. A US Surgeon General report “Smoking and Health” (No. 1103, page 112) noted, “Death rates for current pipe smokers were little if at all higher than for non-smokers, even with men smoking 10 pipefuls per day and with men who had smoked pipes for more than 30 years.” On page 92 the report also stated, “Pipe smokers who inhale live as long as nonsmokers and pipe smokers that don’t inhale live longer than non-smokers.

 

What? Life expectancy for pipe smokers is three years longer than… Non-Smokers! Just try to use that argument with an anti-smoking activist! Of course this is not to encourage people to smoke, but has more to do with the personality of a typical pipe smoker. Most are type “B” where most cigarette smokers are type “A”. So a pipe smoker, on average, is a more laid back person. Second, smoking a pipe is very relaxing. You just can’t be angry when you are smoking a pipe.

 

Cigars are also relaxing but it seems, not as much as pipes. Most cigarette smoking is not so much a relaxing experience as it is a need for nicotine.

 

8) Other interesting facts and some to keep in mind:

 

1)     Pipe smoking is the lowest tobacco risk - but the risk is not zero.

2)     Pipe smoking risk is much like a second hand smoke risk

3)     Pipe tobacco has less nicotine per gram than cigarettes and contains very little of the additives.

4)     Wet smoking is the worst risk so be sure and clean pipe thoroughly.

5)     If you have any sores in your mouth or a sore throat, wait to let the mouth heal first.

6)     The main risks from cigars is chewing the cigar and the direct contact with the lips.

7)     27% of all smokers are pipe smokers in Sweden. In US only 2%

 

I hope you follow the tips above. If you do, you should significantly lower your health risks from pipe and cigar smoking. Wishing you a wonderfully aromatic, relaxing and healthy enjoyment of your favorite pipe and cigar for a long lifetime.


Disclaimer: Note that the information provided in this lecture summary report are the opinions of Dr. Gaboriau. The Seattle Pipe Club has documented the lecture for informational purposes only and claims no responsibility for the accuracy of its content.