Cigar smoking can increase the risk of certain cancers, even if people do not inhale. Smoking cigars can increase the likelihood of developing cancers such as lung, esophageal, and oral cancers. It can also lead to other adverse health effects.

Cigar smoke contains many harmful substances, which may increase the risk of cancer, lung disease, and heart disease.

This article looks at the risk of cigar smoking, how they compare to cigarettes, and tips for quitting.

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According to the Centers for Disease Control and Prevention (CDC), regular cigar smoking may increase the risk of several cancers, including:

  • lung
  • esophagus
  • larynx
  • mouth
  • throat
  • tongue
  • lip

Can cigars cause cancer if a person does not inhale the smoke?

Unlike cigarette smoke, people do not usually inhale cigar smoke.

The National Cancer Institute (NCI) notes that those who smoke cigars have lower rates of lung cancer, lung disease, and coronary heart disease compared with those who smoke cigarettes. However, they still have an increased risk of developing these conditions.

A person is still exposing their lungs, larynx, esophagus, and oral cavity, which includes the throat, mouth, lips, and tongue, to toxic and cancer-causing chemicals. In addition, swallowing tobacco smoke in saliva can increase the risk of oral and esophageal cancer.

Cigars cause cancer through the harmful substances in tobacco. Cigars, cigarettes, and pipes all use dried tobacco leaves.

According to the American Cancer Society, tobacco smoke contains at least 70 cancer-causing substances. Harmful substances in cigars include:

  • lead
  • arsenic
  • carbon monoxide
  • hydrogen cyanide
  • formaldehyde
  • ammonia
  • radioactive elements, such as polonium-210, which may contribute to lung cancer
  • benzene
  • tobacco-specific nitrosamines (TSNAs)
  • polycyclic aromatic hydrocarbons
  • nicotine, which creates an addictive effect

Cigar smoke contains many of the same harmful substances as cigarette smoke, although they may have varying levels.

Cigars use fermented and air-cured tobacco. The manufacturing process means cigar tobacco contains higher levels of nitrates and nitrites, releasing TSNAs — which are highly carcinogenic substances — when people smoke it.

Cigar wrappers also mean cigar smoke contains higher levels of the following harmful substances:

  • nitrogen oxides
  • ammonia
  • carbon monoxide
  • tar

A 2019 analysis found that almost 200,000 cases of cancer and cardiovascular conditions occurred in adults aged 35 or over in the United States in 2015 due to cigar smoking only.

Rates of lung cancer are lower in cigar smokers than in cigarette smokers but higher than in people who do not smoke cigars.

Cigars are usually a different size than cigarettes and use different types of tobacco.

The main differences between cigars and cigarettes include:

  • Type of tobacco: Cigarettes contain a blend of nonfermented tobacco. Most cigars contain one type of air-cured and fermented tobacco.
  • Amount of tobacco: A cigarette usually contains less than 1 gram (g) of tobacco. The amount of tobacco in cigars may vary from 1 to 20 g.
  • Wrapper: Cigarettes have a paper wrapper, while cigars have a tobacco wrapper.
  • Size: Cigarettes are usually a standard size and often take under 10 minutes to smoke. Cigars can come in different shapes and sizes and may take up to 2 hours to smoke.

There are three different-sized cigars available in the U.S.:

  • Large cigars: Large cigars may contain 5–20g of tobacco, measure over 7 inches in length, and take 1–2 hours to smoke. Premium cigars may contain the same amount of tobacco as a whole pack of cigarettes contains.
  • Cigarillos: Cigarillos are smaller types of cigars with around 3 g of tobacco but do not usually have a filter.
  • Little cigars: Little cigars appear similar to cigarettes and contain around 1 g of tobacco. Some little cigars contain a filter, similar to cigarettes.

Are they worse than cigarettes?

According to the NCI, cigar smoke may be more toxic than cigarette smoke due to:

  • An increased level of cancer-causing substances: The fermenting process for cigar tobacco produces high levels of nitrosamines, a cancer-causing chemical. Therefore, smoking cigars releases nitrosamines. Cigar smoke has higher concentrations of nitrosamines than cigarette smoke.
  • Higher levels of tar: Cigars contain more tar, a cancer-causing substance, per every gram of tobacco people smoke, compared with cigarettes.
  • Increased toxin levels: Cigars have a less porous wrapper than cigarettes, resulting in a reduced burning of tobacco than with cigarette smoking. This means cigar smoke contains a higher level of toxins than cigarette smoke.
  • Increased size: Most cigars are larger than cigarettes, meaning they contain more tobacco and have longer smoking times. This increases the exposure people have to toxic substances, such as carbon monoxide. One large cigar may contain the same amount of tobacco as a whole pack of cigarettes.

Smoking cigars may also increase the risk of other health problems, including:

If people want to quit smoking cigars, the following may help:

  • get clear on the reason for quitting, such as health, family, or finances
  • focus on the benefits of quitting, such as the body starting to repair damage from smoking as soon as people quit
  • speak with a doctor or counselor for advice and support
  • avoid switching to another tobacco product, such as e-cigarettes
  • use quitting medications instead, such as nicotine gums, patches, lozenges, nasal sprays, or inhalers
  • use non-nicotine medications, such as bupropion (Zyban) and varenicline (Chantix), to help ease withdrawal symptoms
  • decide in advance how to deal with challenges, such as avoiding situations that trigger an urge to smoke or calling a friend as a distraction from a craving

Helpful resources include:

For those based in the United Kingdom, the National Health Service (NHS) provides tips and resources to help quit smoking.

Learn more about 7 of the best apps for quitting smoking.

Cigars contain the same cancer-causing substances as cigarettes. Cigars may increase the risk of certain cancers, even if a person does not inhale the smoke.

If people want to quit smoking cigars, there are many support programs and resources available to help people quit.