Current cigar, pipe tobacco, and cigarette use is linked with a significant cancer- and non-cancer-related mortality risk, according to research published in JAMA Internal Medicine.1

While research consistently shows that cigarette smoking confers a high mortality risk, few studies have evaluated the specific risks of cigar and pipe use. While cigarette use in the United States has declined by 38.7% since 2000, non-cigarette tobacco use has increased by over 100%, including an 85.2% increase in cigar use and a 556.4% increase in pipe tobacco use.

For this study, researchers evaluated data from the National Longitudinal Mortality Study (NLMS) to update previous estimates about the mortality risks associated with cigar and pipe tobacco use. Participants provided survey-based data from 1985 through 2011. Former cigarette users reported smoking at least 100 cigarettes in their lifetime.

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Most of the 357,420 participants who were current or former cigar or pipe users were men, though only 46% of current daily smokers were men. Current cigarette-only smokers had a 2-fold risk of all-cause mortality compared with the non-smoking population (hazard ratio [HR], 1.98), and current cigar-only users had an HR for all-cause mortality of 1.2.

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Death from a tobacco-related cancer occurred at a higher rate among current pipe smokers (HR, 1.58) and current cigar smokers (HR, 1.61), but especially among current cigarette smokers (HR, 4.06).

Former cigarette and cigar users had a higher risk of mortality than that of never-users, but lower than that of current cigarette, cigar, or pipe users.

The authors concluded that this study “provides further evidence that cigar, pipe, and cigarette use confers mortality risks, even among nondaily current cigarette users, with lower risks observed among former users than current users.”


  1. Christensen CH, Rostron B, Cosgrove C, et al. Association of cigarette, cigar, and pipe use with mortality risk in the US population. JAMA Intern Med. 2018 Feb 19. doi: 10.1001/jamainternmed.2017.8625 [Epub ahead of print]