The Cigar Resurgence
By Jerome Beck, Dr. P.H.
Although cigars and Camel cigarettes were both included in Advertising
Age’s “Top 10 Products in the News” for 1997, the reasons
behind their newsmaking popularity were quite different. In marked contrast
to the litigious problems besetting the cigarette trade, cigar makers were
enjoying yet another successful year, unencumbered by the growing number
of constraints frustrating their counterparts.
Following a quarter of a century of declining consumption, the 1990s has
witnessed an explosive growth in both the popularity and promotion of cigars.
The significance of this phenomenon is highlighted by the dramatic growth
in cigar sales in the United States, from a low of 100 million cigars sold
in 1992 to more than 2 billion sold in 1995. The following year saw sales
more than double with an impressive 4.5 billion cigars sold in 1996. Although
these numbers pale in comparison
to the roughly 450 billion cigarettes consumed each year in this country,
they nevertheless underscore the rapid reemergence of cigars on the tobacco
scene.
It is tempting to dismiss cigars as simply a faddish and relatively benign
indulgence with minimal long-term health consequences. However, there are
a number of good reasons for public concern and a better understanding of
this phenomenon. Foremost among these is the lack of research regarding
almost all aspects of cigars, ranging from health effects to the current
epidemiology of use. We do know that, as with cigarettes, cigars have become
increasingly popular with youth in the last few years. Three recent surveys
underscore this trend, with a nationwide study finding over one-quarter
of U.S. teenagers reportedly having smoked a cigar in the past year.
Given what we do know about the dangers of tobacco smoke for both users
as well as those exposed to secondhand smoke, it is surprising that cigars
have received so little regulatory scrutiny. Despite ample evidence testifying
to their growing popularity among youth, cigars are not included under current
FDA regulations addressing tobacco advertising, warning labels, or sales
to adolescents. However, in a sign that this state of affairs may soon be
changing, the Federal Trade Commission (FTC) announced earlier this month
that the nation’s largest cigar manufacturers must disclose how much
they spend on advertising and promotions. The FTC also ordered companies
to reveal the tobacco content and additives found in their cigar products.
Contemporary media coverage has generally downplayed or avoided any mention
of health risks associated with cigars. Since cigar packages say 
nothing about
health hazards, and cigar smokers don’t usually inhale, the dangers
associated with the use of this tobacco product are viewed by many as
negligible. Nevertheless, the health risks of cigars are real, and have
been amply documented in the medical literature over the past three decades.
This is particularly true for former cigarette smokers who have switched
to smoking cigars (often for health reasons). Studies have shown this
group to remain at much higher risk for many smoking-related diseases
than either nonsmokers or other cigar users. This greater level of risk
is believed to result from the deeper and more frequent inhalation of
cigar smoke observed among former cigarette smokers seeking a compensatory
fix of nicotine from cigars. A similar phenomenon is evident among the
millions of cigarette smokers who have switched to “low tar/nicotine”
brands, erroneously believing that such a change significantly reduces
their health risks.
The issue of cigar-related environmental tobacco smoke (ETS) represents
an additional concern, although it remains poorly understood and little-addressed
at this juncture. The potential significance of secondhand smoke becomes
readily apparent, however, when taking into account that a medium-sized
cigar emits as many respirable particles as 5 cigarettes, and as much carbon
monoxide as 25 cigarettes.
While the cigar resurgence continues to generate ample amounts of media
coverage (see, for example, the July 21, 1997 Newsweek cover story), the
public health community has only recently begun to take note. The American
Cancer Society has responded to the challenge by sponsoring the upcoming
“Cigar Smoking Health Risks: A State-of-the-Science Conference”,
which will be taking place this June in Washington D.C..
California researchers
are beginning to take a serious look at cigars. In fact, TRDRP recently
awarded funding to three different research efforts devoted to learning
more about this phenomenon:
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Posted 3/30/98