Health
Do you inhale cigars?
Most cigar smokers don't inhale, according to the National Cancer Institute. The smoke is drawn into the mouth and let out. The NCI also says not inhaling still exposes the mouth and throat to cancer-causing chemicals.
Reported, not advised. The health statements on this page are quoted from the National Cancer Institute, the FDA and the CDC, and cited at the foot of the page. Cigar Primer adds no medical advice of its own.
Cigar smoke is held in the mouth
Smoking a cigar normally means drawing the smoke into your mouth, tasting it and letting it out, without pulling it down into your lungs.
Wikipedia's cigar entry puts it plainly: "The usual way to smoke a cigar is to not inhale, but to draw the smoke into the mouth." It adds that some smokers do inhale, particularly with little cigars.
The NCI describes the same habit from the health side. "Moreover, in contrast with cigarette smoke, cigar smoke is often not inhaled," its fact sheet says. The mechanics of the puff itself, the draw, the pace, the exhale, are on the how to smoke a cigar page.
Six statements on inhaling, side by side
The NCI, FDA and CDC each address both cases: smokers who don't inhale and smokers who do.
| Agency | Case | Exact wording |
|---|---|---|
| NCI | Who inhales | "Unlike nearly all cigarette smokers, most cigar smokers do not inhale." |
| NCI | Not inhaling | "All cigar and cigarette smokers, whether or not they inhale, directly expose their lips, mouth, tongue, throat, and larynx to smoke and its toxic and cancer-causing chemicals." |
| FDA | Not inhaling | "WARNING: Cigar smoking can cause cancers of the mouth and throat, even if you do not inhale." |
| CDC | Not inhaling | "This is also true for people who report they do not inhale cigar smoke when using a cigar." |
| NCI | Inhaling | "Moreover, daily cigar smokers, particularly those who inhale, are at increased risk for developing heart disease and other types of lung disease." |
| CDC | Inhaling | "Heavy cigar smoking and inhaling cigar smoke deeply may increase the risk of developing coronary heart disease." |
The CDC line refers to the sentence just before it on the CDC page: "People who smoke cigars are exposed to nicotine and toxic chemicals, such as those that cause cancer."
Does not inhaling make cigars safe?
No. None of the three agencies says cigars are safe for people who don't inhale, and each says the opposite in its own words.
The FDA's list of cigar warning statements includes "WARNING: Cigars are not a safe alternative to cigarettes." and the mouth-and-throat warning quoted in the table above. The same FDA page reports that a federal district court in Washington, D.C. vacated the requirement to print those warnings, and that firms may choose to comply voluntarily. The wording stands as the FDA's statement either way.
The NCI explains one route that bypasses the lungs entirely: "In addition, when saliva containing the chemicals in tobacco smoke is swallowed, the esophagus is exposed to carcinogens."
Nicotine arrives through the mouth lining
The NCI says nicotine reaches cigar smokers whether or not they inhale, because it is absorbed through the lining of the mouth.
"A cigar smoker can get nicotine by two routes: by inhalation into the lungs and by absorption through the lining of the mouth," the fact sheet says. Wikipedia's cigar article gives the chemistry: cigar smoke "is more alkaline than cigarette smoke," which makes nicotine easier to absorb in the mouth without inhaling.
More of what the agencies say about nicotine, dose and cigar size sits in the cigar nicotine and health guide. How the word strength is used on cigar labels is in strength vs body.
What do the agencies say about inhaling?
The NCI and CDC both name inhaling as something that adds to cigar smokers' risk of heart and lung disease.
The NCI singles out daily smokers "particularly those who inhale" for heart disease and other lung disease. The CDC ties "inhaling cigar smoke deeply" together with heavy smoking for coronary heart disease, and separately says "Heavy cigar smoking increases the risk for lung diseases, such as chronic obstructive pulmonary disease (COPD)."
The CDC's list of cigar risks also opens with a line that applies to everyone: "Cigar smoking can cause lung cancer."
Little cigars blur the line
Little cigars are small, often filtered cigars that the NCI says can look designed to be inhaled like cigarettes.
The NCI writes that "unlike large cigars, some little cigars have a filter, which makes it seem they are designed to be smoked like cigarettes (that is, for the smoke to be inhaled)." Wikipedia's entry adds that research shows people do inhale smoke from little cigars.
Is a retrohale the same as inhaling?
A retrohale is exhaling part of a mouthful of smoke through the nose to smell it, and the smoke goes out through the nasal passage rather than down into the lungs.
Wikipedia describes smokers who "exhale part of the smoke through the nose in order to smell the cigar better." The agency pages quoted here don't single out retrohaling. Their statements on non-inhalers cover the lips, mouth, tongue, throat and larynx, and apply "whether or not they inhale," in the NCI's words.
Inhaling and cigar smoke, answered
Are you supposed to inhale a cigar?
The usual practice is to keep the smoke in the mouth. The NCI reports that "Unlike nearly all cigarette smokers, most cigar smokers do not inhale," and it does not call that safe.
Is it safe to smoke cigars if you don't inhale?
No federal health agency says so. An FDA warning statement reads "Cigar smoking can cause cancers of the mouth and throat, even if you do not inhale."
Does nicotine get in if you don't inhale a cigar?
Yes, according to the NCI: "Even if the smoke is not inhaled, high levels of nicotine (the chemical that causes addiction) can still be absorbed into the body."
Do people inhale little cigars?
The NCI notes that some little cigars have a filter, "which makes it seem they are designed to be smoked like cigarettes (that is, for the smoke to be inhaled)."
The pages behind each inhaling statement
- Cigar Smoking and Cancer (fact sheet), National Cancer Institute
- Cigar Labeling and Warning Statement Requirements, U.S. Food and Drug Administration
- Cigars (Smoking and Tobacco Use), Centers for Disease Control and Prevention
- Cigar: smoking technique and little cigars, Wikipedia