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Smoke Exposure in Pipe and Cigar Smokers: Title and subTitle BreakSerum Thiocyanate Measures FREE

Terry F. Pechacek, PhD; Aaron R. Folsom, MD; Regis de Gaudermaris, MD; David R. Jacobs, Jr, PhD; Russell V. Luepker, MD; Richard F. Gillum, MD; Henry Blackburn, MD
[+] Author Affiliations

Reprint requests to University of Minnesota School of Public Health, Division of Epidemiology, Stadium Gate 27, 611 Beacon St SE, Minneapolis, MN 55455 (Dr Pechacek).


JAMA. 1985;254(23):3330-3332. doi:10.1001/jama.1985.03360230062023
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Pipe or cigar smoking traditionally has been considered a less risky alternative to cigarette smoking. Some surveys and experimental studies have suggested, however, that former cigarette smokers who switch to cigars and/or pipe (CP) are more likely to inhale then CP users who never smoked cigarettes; but this relationship has not been consistently noted. To clarify smoke-exposure levels from CP smoking, smoking histories and serum thiocyanate (SCN) levels were studied in 9,106 adults aged 25 to 74 years in population-based surveys of seven upper Midwestern communities. Analyses of the 306 male CP smokers indicated a significantly higher SCN level in the ex-cigarette-smoking CP users vs the CP users who never smoked cigarettes. Serum thiocyanate levels of both CP groups were significantly higher than those of nonsmokers and lower than cigarette-only smokers. However, the number of pipe bowls or cigars smoked per day was also significantly related to SCN levels, and this could account for much of the association between SCN and previous cigarette smoking status. Individuals currently smoking four or more pipe bowls or four or more cigars per day had an elevated smoke exposure equivalent to about ten cigarettes per day, whether or not they previously smoked cigarettes. Because of these findings and because former cigarette smokers were more likely to report heavy CP usage, cigarette smokers should be advised to quit rather than to switch to a pipe or cigar.

(JAMA 1985;254:3330-3332)

REFERENCES

Smoking and Health: A Report of the Surgeon General , Public Health Service publication 79-50066. US Dept of Health, Education, and Welfare, 1979;,  chap 13 .
Goldman AL:  Cigar inhaling . Am Rev Respir Dis 1976;;113:87-89.
Goldman AL:  Carboxyhemoglobin levels in primary and secondary cigar and pipe smokers . Chest 1977;;72:33-35.
Castleden CM, Cole PV:  Inhalation of tobacco smoke by pipe and cigar smokers . Lancet 1973;;2:21-22.
Cowie J, Sillett RW, Ball KP:  Carbon monoxide absorption by cigarette smokers who change to smoking cigars . Lancet 1973;;1:1033-1035.
Turner JA, Sillett, RW, McNicol MW:  Effects of cigar smoking on carboxyhaemoglobin and plasma nicotine concentrations in primary pipe and cigar smokers and ex-cigarette smokers . Br Med J 1977;;2:1387-1389.
Turner JA, Sillett RW, McNicol MW:  The inhaling habits of pipe smokers . Br J Dis Chest 1981;;75:71-76.
Wald NJ, Idle M, Boreham J, Baily A, Van Vanakis H:  Serum cotinine levels in pipe smokers: Evidence against nicotine as cause of coronary heart disease . Lancet 1981;;2:775-777.
Kornitzer M, Vanhemeldonch A, Bourdoux P, et al:  Belgian heart disease prevention project: Comparison of self-reported behaviors with serum thiocyanate concentrations . J Epidemiol Community Health 1983;;37:732-736.
McCusker K, McNabb E, Bone R:  Plasma nicotine levels in pipe smokers . JAMA 1982;; 248:577-578.
Pechacek TF, Fox BH, Murray DM, et al:  Review of techniques for measurement of smoking behavior , in Matarazzo JD, Miller NE, Weiss SM, et al (eds): Behavioral Health: A Handbook of Health Enhancement and Disease Prevention . New York, John Wiley and Sons Inc, 1984;.
Armitage AK, Turner DM:  Absorption of nicotine in cigarette and cigar smoke through the oral mucosa . Nature 1970;;226:1231-1233.
Stewart RD:  The effects of carbon monoxide on humans . Ann Rev Pharm 1975;;15:409-425.
Brunnemann KD, Yu L, Hoffman D:  Chemical studies on tobacco smoke: XLIX. Gas chromatographic determination of hydrogen cyanide and cyanogen in tobacco smoke . J Anal Toxicol 1977;;1:38-42.
Gillum RF, Prineas RJ, Luepker RV, et al:  Decline in coronary deaths: A search for explanation . Minn Med 1982;;65:235-238.
Folsom AR, Luepker RV, Gillum RF, et al:  Improvement in hypertension detection and control from 1973-1974 to 1980-1981: The Minnesota Heart Survey Experience . JAMA 1983;;250:916-921.
Blackburn H, Luepker R, Kline FG, et al:  The Minnesota Heart Health Program: A research and demonstration project in cardiovascular disease prevention , in Matarazzo JD, Miller NE, Weiss SM, et al (eds): Behavioral Health: A Handbook of Health Enhancement and Disease Prevention . New York, John Wiley & Sons Inc, 1984;.
Butts WC, Kuehneman J, Widdowson GM:  Automated method for determining serum thiocyanate to distinguish smokers from nonsmokers . Clin Chem 1974;;20:1344-1348.
Dixon WJ: BMDP Statistical Software: 1981 . Los Angeles, University of California Press, 1981;.
Hickey N, Malcahey R, Daly L, et al:  Cigar and pipe smoking related to four year survival of coronary patients . Br Heart J 1983;;49:423-426.

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Smoking and Health: A Report of the Surgeon General , Public Health Service publication 79-50066. US Dept of Health, Education, and Welfare, 1979;,  chap 13 .
Goldman AL:  Cigar inhaling . Am Rev Respir Dis 1976;;113:87-89.
Goldman AL:  Carboxyhemoglobin levels in primary and secondary cigar and pipe smokers . Chest 1977;;72:33-35.
Castleden CM, Cole PV:  Inhalation of tobacco smoke by pipe and cigar smokers . Lancet 1973;;2:21-22.
Cowie J, Sillett RW, Ball KP:  Carbon monoxide absorption by cigarette smokers who change to smoking cigars . Lancet 1973;;1:1033-1035.
Turner JA, Sillett, RW, McNicol MW:  Effects of cigar smoking on carboxyhaemoglobin and plasma nicotine concentrations in primary pipe and cigar smokers and ex-cigarette smokers . Br Med J 1977;;2:1387-1389.
Turner JA, Sillett RW, McNicol MW:  The inhaling habits of pipe smokers . Br J Dis Chest 1981;;75:71-76.
Wald NJ, Idle M, Boreham J, Baily A, Van Vanakis H:  Serum cotinine levels in pipe smokers: Evidence against nicotine as cause of coronary heart disease . Lancet 1981;;2:775-777.
Kornitzer M, Vanhemeldonch A, Bourdoux P, et al:  Belgian heart disease prevention project: Comparison of self-reported behaviors with serum thiocyanate concentrations . J Epidemiol Community Health 1983;;37:732-736.
McCusker K, McNabb E, Bone R:  Plasma nicotine levels in pipe smokers . JAMA 1982;; 248:577-578.
Pechacek TF, Fox BH, Murray DM, et al:  Review of techniques for measurement of smoking behavior , in Matarazzo JD, Miller NE, Weiss SM, et al (eds): Behavioral Health: A Handbook of Health Enhancement and Disease Prevention . New York, John Wiley and Sons Inc, 1984;.
Armitage AK, Turner DM:  Absorption of nicotine in cigarette and cigar smoke through the oral mucosa . Nature 1970;;226:1231-1233.
Stewart RD:  The effects of carbon monoxide on humans . Ann Rev Pharm 1975;;15:409-425.
Brunnemann KD, Yu L, Hoffman D:  Chemical studies on tobacco smoke: XLIX. Gas chromatographic determination of hydrogen cyanide and cyanogen in tobacco smoke . J Anal Toxicol 1977;;1:38-42.
Gillum RF, Prineas RJ, Luepker RV, et al:  Decline in coronary deaths: A search for explanation . Minn Med 1982;;65:235-238.
Folsom AR, Luepker RV, Gillum RF, et al:  Improvement in hypertension detection and control from 1973-1974 to 1980-1981: The Minnesota Heart Survey Experience . JAMA 1983;;250:916-921.
Blackburn H, Luepker R, Kline FG, et al:  The Minnesota Heart Health Program: A research and demonstration project in cardiovascular disease prevention , in Matarazzo JD, Miller NE, Weiss SM, et al (eds): Behavioral Health: A Handbook of Health Enhancement and Disease Prevention . New York, John Wiley & Sons Inc, 1984;.
Butts WC, Kuehneman J, Widdowson GM:  Automated method for determining serum thiocyanate to distinguish smokers from nonsmokers . Clin Chem 1974;;20:1344-1348.
Dixon WJ: BMDP Statistical Software: 1981 . Los Angeles, University of California Press, 1981;.
Hickey N, Malcahey R, Daly L, et al:  Cigar and pipe smoking related to four year survival of coronary patients . Br Heart J 1983;;49:423-426.
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