Health
Cigar nicotine and health
The FDA, the National Cancer Institute and the CDC all say cigars are not safe. The NCI says cigar smokers absorb nicotine through the lining of the mouth, even without inhaling.
Reported, not advised. Every statement on this page comes from a US federal health agency and is cited at the foot of the page. Cigar Primer adds no medical advice of its own.
Three federal agencies, one answer on safety
The FDA, the National Cancer Institute (NCI) and the Centers for Disease Control and Prevention (CDC) each state that cigar smoking is not safe.
| Agency | On safety | On nicotine |
|---|---|---|
| FDA | "Cigars are not a safe alternative to cigarettes and cigar smoke is at least as toxic as cigarette smoke, if not more." | "Large cigars can deliver as much as 10 times the nicotine, two times the tar, and more than five times the carbon monoxide of a filtered cigarette." |
| NCI | "There is no safe level of tobacco use." | "A single cigar can potentially provide as much nicotine as a pack of cigarettes." |
| CDC | "Using any commercial tobacco product is unsafe." | "Cigars contain nicotine, which is highly addictive." |
The FDA's cigar page adds that "young adults may think that cigars are less addictive and present fewer health risks than cigarettes, but cigars may actually be worse."
How does nicotine get in without inhaling?
The NCI says nicotine reaches a cigar smoker two ways: "by inhalation into the lungs and by absorption through the lining of the mouth."
Its fact sheet is direct about the second route. "Even if the smoke is not inhaled, high levels of nicotine (the chemical that causes addiction) can still be absorbed into the body," it says. "Either way, the smoker becomes addicted to the nicotine that gets into the body."
The CDC makes the same point. It says people who smoke cigars are exposed to nicotine and toxic chemicals, and that "This is also true for people who report they do not inhale cigar smoke when using a cigar."
Cancers the agencies link to cigar smoking
The NCI states: "Cigar smoking causes cancer of the oral cavity, larynx, esophagus, and lung. It may also cause cancer of the pancreas."
The NCI also reports that "Regular cigar smokers and cigarette smokers have similar levels of risk for oral cavity and esophageal cancers," and that "The more you smoke, the greater the risk of disease." It adds that daily cigar smokers, "particularly those who inhale, are at increased risk for developing heart disease and other types of lung disease."
The CDC's list includes "cancers of the esophagus, larynx (voice box), pharynx (throat), and oral cavity (lip, tongue, mouth)." The CDC also says "Cigar smoking can increase the risk of gum disease and tooth loss."
What if a cigar smoker never inhales?
The NCI says cigar smokers who don't inhale still expose their lips, mouth, tongue, throat and larynx to smoke and its cancer-causing chemicals.
In the NCI's words: "Although cigar smokers have lower rates of lung cancer, coronary heart disease, and lung disease than cigarette smokers, they have higher rates of these diseases than those who do not smoke cigars." The fact sheet goes on: "when saliva containing the chemicals in tobacco smoke is swallowed, the esophagus is exposed to carcinogens."
Why cigar size matters to exposure
The NCI says large cigars "typically contain between 5 and 20 grams of tobacco" and "can take between 1 and 2 hours to smoke."
According to the NCI, "Some premium cigars contain the tobacco equivalent of an entire pack of cigarettes," and "the larger size of most cigars (more tobacco) and longer smoking time result in higher exposure to many toxic substances." The NCI lists carbon monoxide, hydrocarbons, ammonia and cadmium among them.
The NCI also reports that nitrosamines "are found at higher levels in cigar smoke than in cigarette smoke," and that "For every gram of tobacco smoked, there is more cancer-causing tar in cigars than in cigarettes."
Secondhand cigar smoke in shared rooms
The NCI says "Cigar smoke can be a major source of indoor air pollution" and "There is no safe level of exposure to tobacco smoke."
The CDC says cigar smoke is harmful to people who smoke cigars and to people exposed to it, including people who do not smoke but breathe in secondhand smoke from cigars.
Where the agencies point people who want to quit
The NCI's fact sheet says "Limited research has been completed to determine the usefulness of NRT for people who smoke cigars," referring to nicotine replacement therapy.
The same fact sheet says: "For help with quitting cigar smoking, ask your doctor or pharmacist about NRT, as well as about individual or group counseling, telephone quitlines, or other methods." The FDA notes that federal law makes it illegal for a retailer to sell any tobacco product, cigars included, to anyone under 21.
How cigar labels use the word strength is covered separately in Cigar Primer's strength vs body guide.
Cigar nicotine and risk questions
Do you absorb nicotine from a cigar if you don't inhale?
Yes, according to the National Cancer Institute, which says nicotine can be absorbed "by absorption through the lining of the mouth" and that "high levels of nicotine" can still be absorbed even if the smoke is not inhaled.
Are cigars safer than cigarettes?
The FDA says "Cigars are not a safe alternative to cigarettes," and the National Cancer Institute says "There is no safe level of tobacco use."
How much nicotine is in one cigar?
The National Cancer Institute says "A single cigar can potentially provide as much nicotine as a pack of cigarettes." The FDA says large cigars can deliver as much as 10 times the nicotine of a filtered cigarette.
What cancers does cigar smoking cause?
The National Cancer Institute says cigar smoking causes cancer of the oral cavity, larynx, esophagus and lung, and may also cause cancer of the pancreas.
The agency pages quoted on this page
- Cigar Smoking and Cancer (fact sheet), National Cancer Institute
- Cigars, Cigarillos, Little Filtered Cigars, U.S. Food and Drug Administration
- Cigars (Smoking and Tobacco Use), Centers for Disease Control and Prevention