Is smoking cigars safe? Like anything it probably has more to do with moderation than fear, uncertainty and doubt. In this section we provide links to information that can be found around the World Wide Web regarding cigars and health to help you decide if you want to continue enjoying the leaf. If you come across other articles that you think should be on this page or discover that one of the links herein is broken please contact webmaster@cigarweekly.com. Special thanks to CW member Alec Grandon (goldberg) for compiling the initial list of links.
HPV Causes Lung Cancer
Since the 1980s, a small but steady trickle of research (mostly foreign) has implicated human papillomaviruses as a cause of lung cancer. HPV DNA has been detected in over 21.7% of non-small cell lung cancers. It was not established that HPV causes 100% of cervical cancers until 1999, so the prevalence of HPV is probably underestimated in these early studies. If HPV is the true cause of only 20% of lung cancers, this would equal over 30,000 US cases, or ten times the number of pretended secondhand smoke deaths, annually. This is also nearly three times more than the approximately 12,000 (CDC) new cervical cancers in the U.S.! Because smokers and passive smokers are more likely to have been exposed to this virus, the anti-smokers' studies, which are based on nothing but lifestyle questionnaires, automatically falsely blame the extra lung cancers cancers caused by HPV on smoking and passive smoking. The health establishment has officially ignored the implications of this research, including the Surgeon General, the US Environmental Protection Agency, and the California EPA, in their ETS reports on smoking and secondhand smoke. Therefore, these officials are guilty of scientific fraud.
New Views About Asthma Causes
Since the anti-smoking movement began, the death rates from asthma in the United States have more than doubled in every age group above five years old. This is despite all the people who quit smoking, the smoking bans in public places, and people intimidated out of smoking in their own homes. And, anyone who looks at the death rates from asthma by age can see that they rose across all segments of the population, in the manner of an epidemic of infectious disease.
And, although the anti-smoking propagandists keep the public in the dark, the belief that things like smoking and pollution cause asthma has even lost credibility among experts. Not even the author of the EPA ETS report chapters on asthma, Dr. Fernando Martinez of the University of Arizona, believes in the garbage that he wrote any more. Quote: "Like most people, I assumed tobacco smoke and pollution were the problem -- this was the politically correct way to think. But these factors turned out not to play a major role. In high-pollution areas, in low-pollution areas, among all ethnic groups, there was asthma. Clearly, something else was involved." (Does Civilization Cause Asthma? By Ellen Ruppel Shell. The Atlantic Monthly, 2000 May;285(5):90-100, page 94.)
Leisurely Cigar Puffs Have Hidden Risks
July 2003: The Academy of General Dentistry
Viewed as a glamourous luxury by men and women, cigars are promoted by everyone from sport superstars to top movie stars to upscale clothing stores and clubs. U.S. consumers lit up 4.4 billion cigars last year and sales continue to rise. As cigar connoisseurs are leisurely puffing, they fail to realize that their habit not only hurts their health and smiles, but also is addictive and may be more dangerous than cigarettes, say dental experts meeting at the Academy of General Dentistry's 45th annual meeting.
Cigar Smoking: Growing Popularity Among Young Adults
November 2002: American Cancer Society
Cigar smoking is currently a popular trend in the United States, especially among young men and women. It is fueled in part by the efforts of the tobacco industry to glamorize cigars and the willingness of movie stars and athletes to be photographed smoking cigars.
Cigars and Cancer - Some Important Papers
June 2002: Internet Cigar Group
Read Dr. Schneiderman's response to the 1998 National Cancer Instutute's monograph Cigars: Health Effects and Trends...
Cigar smoking in men and risk of death from tobacco-related cancers.
December 2000: National Library of Medicine
Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341-3717, USA.
Don't Have a Cigar
November 2000: HeartInfo.org
Cigars are sexy? Cigars taste good? If you think so, think about the fact that they're just as bad for you as cigarettes -- and maybe worse.
Cigar Smoking is a Serious Risk to Public Health
August 2000: Center for the Advancement of Health
Smoking cigars instead of cigarettes does not decrease the risk of nicotine addiction and the health risks associated with tobacco
The Tobacco Reference Guide
June 2000: The Tobacco Reference Guide by David Moyer, MD
This book is an updated edition of the 1998 book The Tobacco Almanac. These data have been compiled from medical and media sources.
Background on Cigar Monograph: Cigars: Health Effects and Trends
April 1998: National Institutes of Health
The health risks associated with cigar smoking reported in this monograph are for daily cigar users (at least one cigar per day). The health risks associated with less than daily smoking (occasional smokers) are not known. About three-quarters of cigar smokers smoke only occasionally.
| Written By: Jerome Arnett, Jr., M.D. Published In: Environment & Climate News Publication Date: July 1, 2008 Publisher: The Heartland Institute |
Exposure to secondhand smoke (SHS) is an unpleasant experience for many nonsmokers, and for decades was considered a nuisance. But the idea that it might actually cause disease in nonsmokers has been around only since the 1970s.
Recent surveys show more than 80 percent of Americans now believe secondhand smoke is harmful to nonsmokers.
Federal Government Reports
A 1972 U.S. surgeon general's report first addressed passive smoking as a possible threat to nonsmokers and called for an anti-smoking movement. The issue was addressed again in surgeon generals' reports in 1979, 1982, and 1984.
A 1986 surgeon general's report concluded involuntary smoking caused lung cancer, but it offered only weak epidemiological evidence to support the claim. In 1989 the Environmental Protection Agency (EPA) was charged with further evaluating the evidence for health effects of SHS.
In 1992 EPA published its report, "Respiratory Health Effects of Passive Smoking," claiming SHS is a serious public health problem, that it kills approximately 3,000 nonsmoking Americans each year from lung cancer, and that it is a Group A carcinogen (like benzene, asbestos, and radon).
The report has been used by the tobacco-control movement and government agencies, including public health departments, to justify the imposition of thousands of indoor smoking bans in public places.
Flawed Assumptions
EPA's 1992 conclusions are not supported by reliable scientific evidence. The report has been largely discredited and, in 1998, was legally vacated by a federal judge.
Even so, the EPA report was cited in the surgeon general's 2006 report on SHS, where then-Surgeon General Richard Carmona made the absurd claim that there is no risk-free level of exposure to SHS.
For its 1992 report, EPA arbitrarily chose to equate SHS with mainstream (or firsthand) smoke. One of the agency's stated assumptions was that because there is an association between active smoking and lung cancer, there also must be a similar association between SHS and lung cancer.
But the problem posed by SHS is entirely different from that found with mainstream smoke. A well-recognized toxicological principle states, "The dose makes the poison."
Accordingly, we physicians record direct exposure to cigarette smoke by smokers in the medical record as "pack-years smoked" (packs smoked per day times the number of years smoked). A smoking history of around 10 pack-years alerts the physician to search for cigarette-caused illness. But even those nonsmokers with the greatest exposure to SHS probably inhale the equivalent of only a small fraction (around 0.03) of one cigarette per day, which is equivalent to smoking around 10 cigarettes per year.
Low Statistical Association
Another major problem is that the epidemiological studies on which the EPA report is based are statistical studies that can show only correlation and cannot prove causation.
One statistical method used to compare the rates of a disease in two populations is relative risk (RR). It is the rate of disease found in the exposed population divided by the rate found in the unexposed population. An RR of 1.0 represents zero increased risk. Because confounding and other factors can obscure a weak association, in order even to suggest causation a very strong association must be found, on the order of at least 300 percent to 400 percent, which is an RR of 3.0 to 4.0.
For example, the studies linking direct cigarette smoking with lung cancer found an incidence in smokers of 20 to around 40 times that in nonsmokers, an association of 2000 percent to 4000 percent, or an RR of 20.0 to 40.0.
Scientific Principles Ignored
An even greater problem is the agency's lowering of the confidence interval (CI) used in its report. Epidemiologists calculate confidence intervals to express the likelihood a result could happen just by chance. A CI of 95 percent allows a 5 percent possibility that the results occurred only by chance.
Before its 1992 report, EPA had always used epidemiology's gold standard CI of 95 percent to measure statistical significance. But because the U.S. studies chosen for the report were not statistically significant within a 95 percent CI, for the first time in its history EPA changed the rules and used a 90 percent CI, which doubled the chance of being wrong.
This allowed it to report a statistically significant 19 percent increase of lung cancer cases in the nonsmoking spouses of smokers over those cases found in nonsmoking spouses of nonsmokers. Even though the RR was only 1.19--an amount far short of what is normally required to demonstrate correlation or causality--the agency concluded this was proof SHS increased the risk of U.S. nonsmokers developing lung cancer by 19 percent.
EPA Study Soundly Rejected
In November 1995 after a 20-month study, the Congressional Research Service released a detailed analysis of the EPA report that was highly critical of EPA's methods and conclusions. In 1998, in a devastating 92-page opinion, Federal Judge William Osteen vacated the EPA study, declaring it null and void. He found a culture of arrogance, deception, and cover-up at the agency.
Osteen noted, "First, there is evidence in the record supporting the accusation that EPA 'cherry picked' its data. ... In order to confirm its hypothesis, EPA maintained its standard significance level but lowered the confidence interval to 90 percent. This allowed EPA to confirm its hypothesis by finding a relative risk of 1.19, albeit a very weak association. ... EPA cannot show a statistically significant association between [SHS] and lung cancer."
The judge added, "EPA publicly committed to a conclusion before the research had begun; adjusted established procedure and scientific norms to validate its conclusion; and aggressively utilized its authority to disseminate findings to establish a de facto regulatory scheme to influence public opinion."
In 2003 a definitive paper on SHS and lung cancer mortality was published in the British Medical Journal. It is the largest and most detailed study ever reported. The authors studied more than 35,000 California never-smokers over a 39-year period and found no statistically significant association between exposure to SHS and lung cancer mortality.
Propaganda Trumps Science
The 1992 EPA report is an example of the use of epidemiology to promote belief in an epidemic instead of to investigate one. It has damaged the credibility of EPA and has tainted the fields of epidemiology and public health.
In addition, influential anti-tobacco activists, including prominent academics, have unethically attacked the research of eminent scientists in order to further their ideological and political agendas.
The abuse of scientific integrity and the generation of faulty "scientific" outcomes (through the use of pseudoscience) have led to the deception of the American public on a grand scale and to draconian government overregulation and the squandering of public money.
Millions of dollars have been spent promoting belief in SHS as a killer, and more millions of dollars have been spent by businesses in order to comply with thousands of highly restrictive bans, while personal choice and freedom have been denied to millions of smokers. Finally, and perhaps most tragically, all this has diverted resources away from discovering the true cause(s) of lung cancer in nonsmokers.
Dr. Jerome Arnett Jr. (jerry.arnett@gmail.com) is a pulmonologist who lives in Helvetia, West Virginia.
For more information ...
James E. Enstrom and Geoffrey C. Kabat, "Environmental tobacco smoke and tobacco related mortality in a prospective study of Californians, 1960-98," British Medical Journal, May 2003: http://www.heartland.org/article.cfm?artId=23332.