A recent report issued by the Centers for Disease Control noted that although during the last ten years there has been a 32.8% decline in cigarette smoking in the USA, during the same period of time there has been a 123% increase in consumption of loose tobacco (pipe smoking) and cigars. Major reasons include less federal regulation and lower prices due to lower taxes on these tobacco products. Many people think that these products are ‘safer’ than cigarettes. Although we have less data regarding the health effects of other tobacco products, consider the following: In two separates studies men who smoked cigars for 12-25 years had 2-5 times the risk of lung cancer of a non-smoker. A large study of over 300 cigar smokers found that lung function is decreased in cigar smokers, who were noted to have lower FEV 1 (forced expiratory volume in 1 sec.) in a large study of over 300 cigar smokers.
In an 18 years follow up of men who smoked pipes, they had 5 times the risk of dying from lung cancer as nonsmokers. Both pipe and cigar smoking were associated with airflow obstruction more than 3 times as much as non-smokers.
Cigarette smoking is a well-known risk for bladder cancer where in one study almost half of the men with bladder cancer smoked cigarettes. However, several studies have also noted pipe and cigar smoking also increase the risk of bladder cancer.
Smokeless tobacco or chewing tobacco is associated with cancers of the mouth and nicotine addiction. A recent study measuring the effects of SNUS (Swedish chewing tobacco) on heart function noted a significant decline in the relaxation of the heart muscle between heart beats.
In a long term 80 years follow up study of 1373 men from the Netherlands cigar or pipe smoking reduced life expectancy by 4.7 years. Cigarette smoking reduced life expectancy by 8.8 years.
Recently, the e-cigarette has become quite popular. They deliver nicotine and other chemicals such as flavors using an internal heat source which turns nicotine and other chemicals into a vapor and the nicotine is absorbed through the lining of the mouth. Between 2009 and 2010, the number of people reporting ever using e-cigarettes more than quadrupled despite not being approved as safe by the FDA. Further, there are no data that show the e-cigarette is effective in helping smokers to stop smoking cigarettes.
So, while many “non-cigarette tobacco products” are less harmful than cigarettes they are not without hazards to health and do not offer a safe alternative for cigarette smokers.