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Pipe and Cigar Smoking Strongly Associated with Decreased Lung Function, COPD

Video: R. Graham Barr, MD, DrPH, discusses how pipe and cigar smoking negatively affect lung function

Philadelphia, February 16, 2010 – According to a new study being published in Annals of Internal Medicine, the flagship journal of the American College of Physicians, pipe and cigar smoke may be more harmful than once thought. While some believe pipes and cigars are healthier than cigarettes, a major known cause of chronic obstructive pulmonary disease (COPD), the study directly links pipe and cigar smoking to decreased lung function.

Researchers conducted a population-based study to determine whether pipe and cigar smoking was associated with elevated cotinine levels (the end product of tobacco, which can be detected in the urine), decrements in lung function, and increased odds of airflow obstruction. Among 3,528 participants, those who did not smoke cigarettes but did smoke pipes or cigars were more likely to have airflow obstruction than those who had never smoked.

While cotinine levels among current pipe and cigar smokers were lower than among current cigarette smokers, the relative differences in cotinine levels may reflect differences in nicotine absorption but not necessarily exposure to harmful products of tobacco smoke.

“Our study shows that pipe and cigar smoking is associated with decrements in lung function that are consistent with obstructive lung disease,” said R. Graham Barr, MD, Dr.PH, Assistant Professor of Medicine and Assistant Professor of Epidemiology at Columbia Presbyterian and lead author of the study. “These findings, together with increased cotinine levels in current pipe and cigar smokers, suggest that long-term pipe and cigar smoking may damage the lungs and contribute to the development of COPD. Physicians should consider pipe and cigar smoking a risk factor for COPD and counsel their patients to quit.”

In a related editorial, Michael B. Steinberg, MD, MPH, of the University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, stresses the importance of educating the public, and expresses concern for the rising rate of tobacco use in the United States.

“We are now witnessing the concerning trend of increased use of other tobacco products,” Dr. Steinberg writes. “As changes in public health policy have made cigarette smoking less socially acceptable, a distinct set of characteristics are associated with cigar and pipe use, such as sophistication, affluence, education, and celebration. These images, largely fostered by the tobacco industry, perpetuate the idea that these products play a suitable role in our society.”

About ACP
The American College of Physicians is the largest medical specialty organization and the second-largest physician group in the United States. ACP members include 129,000 internal medicine physicians (internists), related subspecialists, and medical students. Internists specialize in the prevention, detection, and treatment of illness in adults. Follow ACP on Twitter and Facebook.

About Annals of Internal Medicine
Annals of Internal Medicine is one of the five most widely cited peer-reviewed medical journals in the world, with a current impact factor of 17.5. The journal has been published for 82 years. It accepts only 7 percent of the original research studies submitted for publication.

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