Cigar smoking is associated with many of the same fatal conditions as cigarette smoking, according to research published in open access journal BMC Public Health. This underscores the fact that cigar smoking is not a safe alternative to cigarette smoking.

Consumption of cigars in the USA doubled from 6.2 billion cigars in 2000 to more than 13.7 billion in 2011. This contrasts with a 33% reduction in cigarette consumption over the same period. There is particular concern about cigar use in youth and young adults. Among young adults aged 18-24, 16% reported smoking cigars at least one day in the past 30 days during 2009-2010. A recent report suggests during 2012, 12.6% of high school students smoked cigars, cigarillos or little cigars, at least one day in the past 30 days.

Researchers from the US Food and Drug Administration (FDA) carried out a systematic review of studies about cigar smoking and all-cause and smoking-related mortality to gain more comprehensive information about the long-term public health implications of cigar use. The team wanted to examine the health risks to current cigar smokers compared to those who never smoked cigarettes or never used any tobacco, so they excluded any study that involved current cigarette smokers. Separate results were reported for current cigar smokers with no prior history of cigarette smoking vs. those who had previously smoked cigarettes. As such, 22 studies were analyzed that were primarily conducted in the USA, the UK, Canada, Denmark, Sweden and Finland.

Lead researcher, Cindy Chang from the FDA, says: "The results reinforce the fact that cigar smoking carries many of the same health risks as cigarette smoking. Cigar smoking is linked to fatal oral, esophageal, pancreatic, laryngeal, and lung cancers, as well as heart disease and aortic aneurysm."

The authors also report that those who exclusively smoked cigars and had never smoked other tobacco products also had an increased risk of all-cause mortality. The risk of death from oral, esophageal and lung cancers was found to increase with inhalation of cigar smoke. Even in those who reported not inhaling cigar smoke, there was an increased risk of death caused by oral, laryngeal and esophageal cancer.

Those who smoked cigars and had previously smoked cigarettes had a much higher risk of lung cancer and chronic obstructive pulmonary disease compared to cigar smokers who had not previously smoked cigarettes. The researchers believe this could be due in part to the inhalation patterns of these different types of cigar smokers.

The studies included in this analysis focused primarily on white men in North America and Europe that smoked cigars in the 1960s or earlier. In addition, since the time of these studies, the US cigar market has expanded from predominantly large traditional cigars to a wide variety of cigar sizes, flavors and packaging. To strengthen our knowledge on this area the researchers say that future studies should focus on different populations, cigar type (e.g., cigarillos, little cigars), and the level of exposure.