Association of Cigarette, Cigar, and Pipe Use With Mortality Risk in the US Population

Christensen CH, Rostron B, Cosgrove C, et al. JAMA Intern Med. 2018 Feb 19. [Epub ahead of print] [CrossRef] [PubMed]

The authors investigated the mortality risks associated with current and former use of cigars, pipes, and cigarettes. Participants in The National Longitudinal Mortality Study provided tobacco use information from 1985 and through 2011. The study included 357,420 participants including those who reported exclusively using cigar, pipes, or cigarettes or reported never using any type of tobacco product. All-cause and cause-specific mortality as identified as the primary cause of death were obtained from death certificate information. Exclusive current cigarette smokers (hazard ratio [HR], 1.98; 95% CI, 1.93-2.02) and exclusive current cigar smokers (HR, 1.20; 95% CI, 1.03-1.38) had higher all-cause mortality risks than never tobacco users. Exclusive current cigarette smokers (HR, 4.06; 95% CI, 3.84-4.29), exclusive current cigar smokers (HR, 1.61; 95% CI, 1.11-2.32), and exclusive current pipe smokers (HR, 1.58; 95% CI, 1.05-2.38) had an elevated risk of dying from a tobacco-related cancer (including bladder, esophagus, larynx, lung, oral cavity, and pancreas). This study provides further evidence that exclusive use of cigar, pipes, and cigarettes each confers significant mortality risks. This study provides further evidence that exclusive use of cigar, pipes, and cigarettes each confers significant mortality risks. The study may have important implications for the Traditional Cigar Manufacturing and Small Business Jobs Preservation Act of 2017 (HR 564, S294) now pending before the US Congress. These bills amend the Federal Food, Drug, and Cosmetic Act to exempt cigars from regulation by the Food and Drug Administration (FDA) and from user fees assessed on tobacco products by the FDA.