Columbia University Medical Center

Pipe & Cigar Smokers Show Early Signs Of Lung Disease

NEW YORK (Feb. 24, 2010) – Findings from a new study show that pipe and cigar smokers are twice as likely as non-smokers to have signs of abnormal lung function that contributes to chronic obstructive pulmonary disease, the fourth leading cause of death in the United States. Those who also smoke cigarettes may be at more than triple the risk. The research, led by a Columbia University Medical Center team, appears in the current issue of Annals of Internal Medicine.

“These findings demonstrate that the notion that cigar and pipe smoke is not inhaled, is simply not true: the smoke is absorbed systemically and is associated with a gradual decrease in lung function consistent with chronic obstructive pulmonary disease,” said Graham Barr, M.D., Dr. PH., assistant professor of medicine and epidemiology at Columbia University Medical Center, an internist at NewYork-Presbyterian Hospital/Columbia, and senior author of the paper. “Most people are well aware that cigarette smoking causes COPD. This study shows us that there is no safe way to smoke tobacco.”

In the study 3,528 people ages 48 to 90 were given breathing tests and surveys about their smoking histories. Cigar/pipe smoking history was compared with lung function. Among the participants, 56 had smoked only pipes or cigars; 428 smoked pipes or cigars along with cigarettes; and 1,424 smoked only cigarettes. The participants were part of the MESA Lung Study, an extension of the Multi-Ethnic Study of Atherosclerosis (MESA), supported by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health. Dr. Barr is principal investigator of the MESA Lung Study.

Participants who smoked pipes or cigars showed decrements in lung function, and increased odds of airflow obstruction, whether they had also smoked cigarettes or not compared with participants with no smoking history. These pipe and cigar smokers were also found to have higher levels of the nicotine byproduct cotinine (the part of tobacco smoke that is absorbed by the body) than nonsmokers, though less than what is typically found in cigarette smokers.

“Long-term pipe and cigar smoking may damage the lungs and contribute to the development of COPD,” said Dr. Barr.

“Physicians should consider pipe and cigar smoking a risk factor for chronic obstructive pulmonary disease and counsel their patients to quit, regardless of whether or not they have ever smoked cigarettes,” said Dr. Barr. “Like cigarettes, pipes and cigars are associated with chronic obstructive pulmonary disease, heart disease, lung cancer, and cancers of the mouth and throat.”

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