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Harvard Commentaries
35320
Harvard Commentaries
Reviewed by the Faculty of Harvard Medical School


Tobacco Products: Differences and Similarities


April 17, 2012

Tobacco Cessation
22017
Basics
Tobacco Products: Differences and Similarities
Tobacco Products: Differences and Similarities
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If you think cigarettes are the only tobacco products that can kill you, you may be making a deadly mistake.
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InteliHealth
2012-04-17
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InteliHealth Medical Content
2015-04-23

Reviewed by the Faculty of Harvard Medical School

Tobacco Products: Differences and Similarities
If you think cigarettes are the only tobacco products that can kill you, you may be making a deadly mistake.
Millions of Americans continue to gamble with their health by using tobacco products. Cigarettes remain "king of the killers," but all tobacco products, including cigars, pipe tobacco and chewing tobacco, contain carcinogens and other cancer-causing ingredients.
Tobacco use is the leading cause of preventable illness and death in the United States.
Cigarettes
A cigarette has about one gram of tobacco and takes about 10 minutes to smoke. Although cigarettes contain only one to two milligrams of nicotine, the addictive substance in tobacco, they are highly addictive. This is because cigarette smokers usually inhale smoke directly into their lungs, which allows for rapid absorption of nicotine into the bloodstream.
Cigarette smoke contains more than 40 possible cancer-causing chemicals. Smoking has a variety of health consequences. It is the leading cause of lung cancer, oral cancers and some gastrointestinal cancers. In addition, cigarette smoking contributes to heart disease, respiratory problems, poor oral health and a wide variety of other problems.
Your risk increases the more you smoke. Most cigarette smokers smoke every day.

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Cigars
One cigar can contain as much tobacco as an entire pack of cigarettes. In general, a single cigar has between five and 17 grams of tobacco and takes about one to two hours to smoke. And cigars contain more than 100 milligrams of nicotine. The only reason cigars are not particularly addictive for most users is because most cigar smokers do not inhale.
Cigar smokers absorb nicotine orally, through the cells lining the mouth. Oral absorption of nicotine can be addictive, and some younger individuals seem to develop this type of addiction to cigars.
Cigars use a different type of tobacco than cigarettes do. In theory, cigars could cause a higher risk of oral cancer than cigarettes do. However, most people smoke fewer cigars than cigarettes.
A few more cigar facts:
  • The number of cases of oral cancer caused by cigars is similar to, not higher than, the number caused by cigarettes.
  • The risk of heart disease and respiratory problems is lower for cigar smokers.
  • Although the risk of lung cancer is four times greater for cigar smokers than for nonsmokers, the risk is lower than that for cigarette smokers.
  • As with cigarettes, your risk of health problems increases as you smoke more cigars. However, most people who smoke cigars do so only occasionally.
Of concern, many cigar smokers eventually become cigarette smokers.

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Pipe Tobacco
The number of carcinogens in pipe tobacco is equivalent to that in cigars and cigarettes. However, smokers of pipes usually smoke on an infrequent basis and usually do not inhale pipe smoke. These habits make pipe tobacco less addictive than cigarettes for most pipe users.
Pipe smokers use a different type of tobacco than cigarette smokers do. This type of tobacco is associated with a greater risk of oral cancer. However, because pipes are smoked less frequently than cigarettes, the number of cases of oral cancer is lower among pipe smokers than among cigarette smokers. And although the risk of other cancers is also lower for pipe smokers than for cigarette smokers, it is still considerably greater than that for nonsmokers. The risk of heart problems is the same for pipe smokers and cigarette smokers.
As with all tobacco products, your risk of health problems increases the more you smoke.

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Chewing Tobacco
Chewing tobacco contains more than 25 possible cancer-causing ingredients. Although this number is smaller than the number of cancer-causing ingredients in cigarettes, the amount of nicotine absorbed from one use of chewing tobacco is usually two to three times greater than that from a single cigarette. Although absorption is usually slower, the nicotine from chewing tobacco stays in the body longer.
This makes chewing tobacco very addictive. And it is associated with many of the same health risks as other tobacco products. Eight to 10 "chews" per day is equivalent to smoking almost two packs of cigarettes.
Oral cancer is a particular risk, as chewing tobacco stays in the mouth for a long period. In addition to oral cancer, chewing tobacco can lead to other oral problems, including gum disease and tooth decay. High blood pressure and increased heart problems may also occur.

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