Secondhand cigar smoking,taking care of yourself

  Taking care of yourself, what about secondhand cigar smoke? Are there laws regulating cigars?

Any past or current cigar use is important information for your health care provider to know so he or she can be sure that you have appropriate preventive health care. It is well known that cigar use puts you at risk for certain health-related illnesses, so part of your health care should focus on related screening and preventive measures to help you stay as healthy as possible. For example, you will want to be certain that you regularly check the inside of your mouth for any changes and have an oral exam by your doctor or dentist if you have any changes or problems. The American Cancer Society recommends that periodic checkups should include oral cavity (mouth) exams. By doing this cigar users may be able to prevent, or detect early, oral changes, leukoplakia (white patches on the mouth membranes), and oral cancer.

You should also be aware of any change in cough, a new cough, coughing up blood, hoarseness, difficulty breathing, wheezing, headaches, chest pain, loss of appetite, weight loss, general fatigue, and repeated respiratory infections. Any of these could be signs of lung cancer or a number of other lung conditions and should be reported to your doctor. While these can be signs of a problem, many lung cancers do not cause any noticeable symptoms until they are advanced and have spread to other parts of the body.

If you have any health concerns that may be related to your cigar use, please see your health care provider as quickly as possible. Taking care of yourself and getting treatment for small problems will give you the best chance for successful treatment. The best way, though, to take care of yourself and decrease your risk for life-threatening lung problems is to quit using any form of tobacco.

What About Secondhand Cigar Smoke?

Because cigars have more tobacco than cigarettes, and because they often burn for much longer, they give off greater amounts of secondhand smoke, also known as environmental tobacco smoke (ETS) or passive smoke. Secondhand smoke includes both the smoke from the end of the cigar and the smoke exhaled by the smoker.

In general, secondhand smoke from cigars contains many of the same toxins (poisons) and carcinogens (cancer-causing agents) as cigarette smoke but in higher concentrations. Some of the toxins or irritants in cigar smoke include:

* carbon monoxide
* nicotine
* hydrogen cyanide
* ammonia
* volatile aldehydes

Carcinogens in cigar smoke include the following:

* benzene
* aromatic amines (especially carcinogens such as 2-naphthylamine and 4-minobiphenyl)
* vinyl chloride
* ethylene oxide
* arsenic
* chromium
* cadmium
* nitrosamines
* polynuclear aromatic hydrocarbons

There are some differences between cigar and cigarette smoke, though. These differences are due to the long aging and fermentation process used for cigar tobacco and to the fact that the cigar wrapper is not as porous as cigarette paper.

Cigar tobacco has a high concentration of nitrogen compounds (nitrates and nitrites). During fermentation and smoking, these compounds give off several tobacco-specific nitrosamines (TSNAs), some of the most potent human carcinogens known. Also, because the cigar wrapper is less porous than cigarette paper, the tobacco doesn’t burn as completely. The result is a higher concentration of nitrogen oxides, ammonia, carbon monoxide, and tar -- all very harmful substances.

In a recent study, researchers found that the concentrations of carbon monoxide at 2 cigar social events in San Francisco were higher than the levels found on a busy California freeway. Had these indoor exposures lasted 8 hours, they would have exceeded the National Ambient Air Quality Standards for outdoor air established by the Environmental Protection Agency. While the health effects on nonsmokers at cigar social events have not been studied, there is clearly an increased risk of lung cancer from long-term exposure to secondhand smoke.

Are There Laws Regulating Cigars?

Cigars have fewer federal regulations than cigarettes and smokeless tobacco. Until recently, health warnings required on other tobacco products were absent on cigars. However, warnings of proven health risks similar to those required for cigarettes have been added to cigar packaging and advertisements. This is a result of a legal settlement in June of 2000 between the Federal Trade Commission and the 7 largest US cigar companies (representing 95% of the US market). The labels carry 1 of the following 5 surgeon general warnings, on a rotating basis:

* Cigar smoking can cause cancers of the mouth and throat, even if you do not inhale.
* Cigar smoking can cause lung cancer and heart disease.
* Tobacco use increases the risk of infertility, stillbirth, and low birth weight.
* Cigars are not a safe alternative to cigarettes.
* Tobacco smoke increases the risk of lung cancer and heart disease, even in nonsmokers.

Cigars at present are exempt from federal tobacco regulations that restrict youth access and limit advertising. However, all 50 states and the District of Columbia have laws that either specifically address youth access to cigars or limit youth access to all tobacco products.

Since the mid-1960s the Federal Trade Commission has overseen a testing program to report yield of tar, nicotine, and carbon monoxide for most brands of cigarettes. Cigars, however, are not included, and makers of cigars do not have to report such levels to any federal agency.

Cigarettes and smokeless tobacco products cannot be advertised on television, radio, or any other form of electronic communication regulated by the Federal Communications Commission. However, this ban does not include cigars.

Cigars are accessible, especially for youth. A study conducted several years ago at the University of California found more than 140 Internet sites marketing cigars, with almost one third having potential youth appeal. Only about one quarter of these sites prohibited sales to minors. On about one third of the sites, cigars could be purchased with money orders, cashier’s checks, or cash-on-delivery (COD) -- options that make it hard to verify the age of the buyer.

Federal tax rates for cigars are increasing, but they are much lower than the federal tax on cigarettes. Small cigars have a federal tax rate of 4 cents per pack of 20. Large cigars have a federal tax of 5 cents maximum per cigar. Taxes on cigars are also collected by many (but not all) states at varying rates.

Federal tax rates for cigars are increasing, but they are much lower than the federal tax on cigarettes. Small cigars have a federal tax rate of 4 cents per pack of 20. Large cigars have a federal tax of 5 cents maximum per cigar. Taxes on cigars are also collected by many (but not all) states at varying rates.

Conclusion

Tobacco in any form is a deadly product. Ongoing research is giving us more and more evidence that cigar smoking can cause a number of serious health problems. The rising current rates of cigar smoking, especially among young people, indicate the need for public awareness and a comprehensive national policy to deal with this growing public health problem.

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