FOR IMMEDIATE RELEASE
Friday, April 10, 1998
NCI Press Office
Background on Cigar Monograph: Cigars: Health Effects and Trends
- Health effects associated with occasional cigar smoking (less than daily use).
- Nicotine dependence for cigar users, including withdrawal symptoms for both regular and occasional cigar users.
- Smoking patterns of primary and secondary cigar smokers (primary smokers have had no prior smoking history, unlike secondary smokers who have smoked other tobacco products.)
- Biological uptake of toxic and carcinogenic smoke constituents by primary and secondary cigar smokers along with the metabolism of critical constituents of cigar smoke.
- Surveillance mechanisms that tract the trends in the prevalence of cigar smoking among teenagers and adults.
- Measurement of environmental tobacco smoke (ETS, also know as secondhand smoke) exposures from cigars and their health effects on high-risk populations, particularly nonsmoking employees in bars and restaurants, at catered cigar events, and in casinos where cigar smoking is encouraged. Exposure levels of ETS and their health effects should also be studied in the children and spouses of cigar smokers.
- Chemical studies to better understand the toxicity and carcinogenicity of cigars and cigar smoke. The individual constitutents found in different types of cigars should be measured and compared to other tobacco products, such as cigarettes and smokeless tobacco.
16. How was the monograph put together?
Cigars: Health Effects and Trends was developed under the editorial supervision of Donald R. Shopland, coordinator of the Smoking and Tobacco Control Program at the National Cancer Institute (NCI) in Bethesda, Md. The NCI supports more than $80 million in smoking-related research annually, and since 1991, the Institute has published an on-going monograph series on smoking and tobacco-use control. The current report on cigars is the ninth monograph in the series.
More than 50 scientists and other experts were involved in the compilation of the monograph, including 30 who participated as peer reviewers. Topics covered include trends in cigar use, the health consequences of smoking cigars, indoor air pollution resulting from cigar smoke, the toxic and carcinogenic compounds found in cigar smoke, the addictive potential of cigars, marketing and promotion of cigars, and policies regulating taxation, labeling and sale of cigars.
David M. Burns, M.D., professor of Medicine at the University of California in San Diego, Calif., was the senior scientific editor for the monograph. Consulting scientific editors were Dietrich Hoffmann, Ph.D., associate director, American Health Foundation, Valhalla, N.Y., and K. Michael Cummings, Ph.D., M.P.H., senior research scientist, Roswell Park Cancer Institute, Buffalo, N.Y.
17. Who are the authors of the monograph?
Trends in Cigar Consumption:
Karen K. Gerlach, Ph.D., M.P.H, Centers for Disease Control and Prevention,
Atlanta, Ga. (now with Robert Wood Johnson Foundation, Princeton, N.J.)
K. Michael Cummings, Ph.D., M.P.H., Roswell Park Memorial Institute, Buffalo, N.Y.
Andrew Hyland, M.S., Roswell Park Memorial Institute, Buffalo, N.Y.
Elizabeth A. Gilpin, M.S., University of California, San Diego, Calif.
Michael D. Johnson, Ph.D., California Department of Health Services, Sacramento, Calif.
John Pierce, Ph.D., University of California, San Diego, Calif.
Chemistry and Toxicology of Cigars:
Dietrich Hoffmann, Ph.D., American Health Foundation, Valhalla, N.Y.
Ilse Hoffmann, B.S., American Health Foundation, Valhalla, N.Y.
Disease Consequences of Cigar Smoking:
Thomas G. Shanks, M.P.H., M.S., University of California, San Diego, Calif.
David M. Burns, M.D., University of California School of Medicine, San Diego, Calif.
Indoor Air Pollution from Cigar Smoke:
James L. Repace, M.S., U.S. Environmental Protection Agency, Washington, D.C.
Wayne Ott, Ph.D., Stanford University, Stanford, Calif.
Neil Klepeis, M.S., Lockheed Martin Environmental, Las Vegas, Nev.
Pharmacology of Abuse Potential of Cigars:
Reginald V. Fant, Ph.D., Pinney Associates, Bethesda, Md.
Jack E. Henningfield, Ph.D., The Johns Hopkins University School of Medicine and Pinney Associates, Bethesda, Md.
Marketing and Promotion of Cigars:
John Slade, M.D., Robert Wood Johnson Medical School, New Brunswick, N.J.
Policies Regulating Cigars:
Gregory N. Connolly, D.M.D., M.P.H., Massachusetts Department of Public Health, Boston, Mass.
18. What are the sources of the data for the report?
The report contains new data in nearly every chapter. In some instances, new studies were commissioned, while in others new, more detailed data analyses of previous studies were conducted.
For example, in Chapter 2, which reviews trends in cigar smoking, two new data sets which examine cigar smoking behavior among both adults and children were made available to the NCI by the California State Department of Health. New analyses were conducted on data from national surveys (National Health Interview Surveys and the Current Population Surveys).
For Chapter 3, the NCI provided a small amount of funding to the American Health Foundation to analyze the chemical composition of leading brands of small (cigarette- sized) cigars, machine-made mass-produced cigars, and hand-rolled premium cigars and to compare them to the best selling brands of filter and non-filter cigarettes.
In the chapter on disease consequences, Chapter 4, new analyses of the data from the Cancer Prevention Study (CPS-I) were undertaken to distinguish the health risks of cigar-only smokers from the health risks of cigarette-only smokers (450,000 white males in total). (CPS-I, conducted between 1959 and 1972 by the American Cancer Society, followed more than one million people for 12 years.) Risk information on male cigar smokers is presented for each major disease in this chapter.
For Chapter 5, the authors performed three separate experiments to assess the contribution of cigar smoke to indoor air pollution. One study, using a stationary monitor, measured environmental tobacco smoke (ETS) in the home comparing one Marlboro cigarette with one, large premium cigar (Paul Garmirian Churchill). In two other experiments, using a personal monitor, one of the authors measured ambient carbon monoxide levels at two separate cigar events, a cigar party and a cigar dinner both held in the San Francisco Bay Area.
Chapters 6, 7, and 8 each contain considerable quantities of new information. For example, in Chapter 7, information is presented on market share of various brands of cigars as well as market share by company. Data are also presented showing the feature stories or news coverage of cigars in 20 daily newspapers from 1990 through 1996. Chapter 8 contains information on state tax rates for cigars as well as which states have laws that specifically address youth access to cigars.
19. Are copies of the monograph currently available?
Copies of the monograph are available by calling 1-800-4-CANCER (1-800-422-6237). By May 1, the text will be available on NCI's website: http://rex.nci.nih.gov; click on "Public," then "Prevention."