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The Hazards of Using Pipe Tobacco

Armeen Poor, MD, is a board-certified pulmonologist and intensivist. He specializes in pulmonary health, critical care, and sleep medicine.

Smoking tobacco out of a pipe has been a worldwide practice for centuries. Historically, pipes were used in ceremonies with the practice gradually gaining mainstream popularity over the years as an accepted way to smoke tobacco. Shops sprang up that catered to pipe (and often cigar) smokers. Flavored blends sold in bulk could be sampled right on the premises in smoke rooms set up for patrons.

Pipe smoking has been dwindling in use since the 1960s but is still favored by a small percentage (approximately 2%) of smokers in the United States today, especially older men. Pipe smoking is still common in Sweden, where as many as one-quarter of adult males smoke a pipe.

Pipe Tobacco Ingredients

Pipe tobacco is loose-leaf tobacco most commonly grown in northern middle Tennessee, western Kentucky, and Virginia. It is fire-cured, which involves slowly smoking the drying tobacco leaves over a smoldering hardwood fire inside of a barn or structure.

The process can take days to weeks, and the end result is a tobacco that is low in sugar and high in nicotine. Most pipe tobacco is aromatic, having had a flavoring added to the finished product that gives it a depth and richness in taste and smell.

Pipe tobacco is addictive. An average pipe bowl contains 1–3 grams of tobacco, with the nicotine level per gram averaging 30–50 milligrams. Smokers don’t tend to inhale pipe smoke as much as cigarette smokers, but some nicotine still reaches the bloodstream after being absorbed through the lining of the mouth.

Health Impact

You might think that because most pipe smokers don’t inhale, the health risks are minimal. While there isn’t a lot of scientific data on the health effects of pipe smoking, we do know that there are risks.

Pipe smoking is associated with a number of illnesses that are common in cigar and cigarette smokers. For instance, pipe smokers face an elevated risk of cancers of the mouth, including the tongue, larynx, and throat. Smokers who inhale pipe smoke also have an elevated risk of lung, pancreatic, and bladder cancer.

Pipe smokers face an increased risk of developing chronic obstructive pulmonary disease (COPD). While cigarette smoking is usually the main cause of COPD, other forms of tobacco like pipe-smoking and cigars can also result in tobacco smoke inhalation and damage to delicate lung tissue.

People who smoke pipes might face an elevated risk of death from heart disease, especially those who inhale the smoke. More research needs to be done in this area.

Health Risk Comparison

You might wonder how smoking a pipe compares to other types of smoking in terms of health risks. There is data comparing pipe use to cigarette and hookah use.

Cigarettes

Researchers who have looked at health risk differences between the pipe smoking and cigarettes have concluded that they both carry essentially the same risks for early death from a number of diseases that can be linked to tobacco including:

  • Cardiovascular disease
  • Ischaemic heart disease
  • Lung cancer
  • Stroke
  • Various other smoking-related cancers

The only appreciable difference between the two forms of tobacco use is method and frequency of use. Pipe smokers tend not to inhale (as much) as cigarette smokers, and they smoke less often during the course of a day.

Hookah

Starting with the knowledge that both hookah tobacco and pipe tobacco are hazardous to health, let’s take a look at the differences between the two.

Amount and Frequency

A hookah pipe bowl can contain 10–15 grams of tobacco, while most regular pipe bowls hold 1–3 grams of tobacco. Hookah is typically smoked at a hookah lounge or in a social setting, so hookah smokers might only smoke once every few days or once a week. Pipe smokers also smoke infrequently, but many light up a pipe once (or a few times) a day.

Nicotine Level

A hookah session can lasts 45 minutes to an hour, with smokers inhaling as much as 10mg of nicotine from the 300mg to 750mg of nicotine in the tobacco. A bowl of pipe tobacco is smaller and smokers don’t inhale as much, so getting an accurate measure of nicotine absorption is difficult. However, a 3-gram bowl of tobacco with 150mg of nicotine can deliver a small amount of nicotine into the bloodstream.

Toxins

All tobacco products contain a number of toxins that come from a variety of sources: pesticides in the field, additives, and chemical changes that occur when tobacco with additives are burned. Tar, arsenic, carbon monoxide, and polonium-210 are just a few of the chemicals that are harmful to human health in tobacco smoke.

To date, upwards of 250 poisonous chemicals and 70 carcinogenic compounds have been identified in tobacco and tobacco smoke.

Federal Regulations

In 2016, the Food and Drug Administration (FDA) extended a rule that gives the FDA regulatory authority over all tobacco products, including pipe tobacco. The manufacture, packaging, and labeling of all tobacco products must meet FDA guidelines, as well as how products are advertised, promoted, sold and even imported.

As of Dec. 20, 2019, the legal age limit is 21 years old for purchasing cigarettes, cigars, or any other tobacco products in the U.S.  

The FDA also has authority over components used with tobacco products. In this case, that would mean the pipes used to smoke the tobacco.

Labeling Guidelines

All newly regulated tobacco products in the U.S. are required to include the following warning label on packaging: “WARNING: This product contains nicotine. Nicotine is an addictive chemical.”

If the manufacturer submits a self-certification form to the FDA, along with proof that their newly regulated product is nicotine-free, then the required label will read: “This product is made from tobacco.”

Ultimately, federal regulation over tobacco products helps to protect consumers. While all tobacco products are hazardous to health, FDA guidelines are meant to ensure that manufacturers are not able to secretly manipulate tobacco recipes in ways that could cause more harm than they already do.

A Word From Verywell

It has been well documented that there is no safe level of exposure to tobacco smoke. This is true regardless of the form tobacco comes in. Smokers and non-smokers all face risks to their health when breathing in tobacco smoke. If you are a smoker who is trying to find a “healthier” alternative to cigarettes, know that the only good choice is to wean yourself off of tobacco entirely.

There are a number of ways to quit successfully. Nicotine addiction is enslaving, and quitting is difficult, but it’s possible to do the work now to quit and shed the limits addiction puts on your life. Others have done it and you can, too.

Is pipe smoking a healthier way to use tobacco than smoking cigarettes? Learn about the risks associated with pipe smoking.

Effects of Smoking Pipes and Cigars

Articles On Reasons to Quit Smoking

Reasons to Quit Smoking
Reasons to Quit Smoking – Effects of Smoking Pipes and Cigars
  • Reasons to Quit
  • Smoking and Heart Disease
  • Effects of Secondhand Smoke
  • Effects of Pipes & Cigars
  • Effects of E-Cigarettes
  • Nicotine Poisoning

Pipe and cigar smokers often wave off worries that smoking is bad for their health. They claim their habit is harmless and perpetuate the common misperception that pipes and cigars are somehow safer than cigarettes. In reality, these tobacco products carry the same health risks as cigarettes.

Cigars and pipes differ in design from cigarettes, which are made from tobacco wrapped in thin paper. Cigars are wrapped in tobacco leaves, and unlike cigarettes, they don’t typically have filters. In pipes, the tobacco sits in a bowl at the end, and a stem connects the bowl to the mouthpiece. Pipes can be equipped with filters, however.

Another type of pipe, the water pipe, consists of a body filled with water, a bowl in which the tobacco is placed, and an attached tube and mouthpiece through which the pipe is smoked. Water pipes, or hookahs, originated in ancient Persia and India about 400 years ago and are still popular today. Hookahs are filled with fragrant tobaccos in a variety of flavors, such as cherry, apple, or mint.

Cigar and Pipe Smoking vs. Cigarettes

Cigar and pipe smokers often argue that their health isn’t at risk because they only smoke one or two a day and they don’t inhale. There is also the claim that pipes and cigars aren’t addictive. Yet research shows that cigar and pipe smoking still increase your risk for cancer more than not smokers.

A single large cigar can contain more than a 1/2 ounce of tobacco — as much tobacco as an entire pack of cigarettes. One cigar also contains 100 to 200 milligrams of nicotine, while a cigarette averages only about 8 milligrams. That extra nicotine may be why smoking just a few cigars a week is enough to trigger nicotine cravings. Cigar smokers are at greater risk for oral cancers.

Topbacco used in pipes is cured and contains both nicotine and the same carcinogens as cogaretts. Pipe smokers are more likely to dveelop cancer of the lungs, liver, head and neck than non smokers.

Health Effects of Smoking Pipes and Cigars

Here are just a few of the harmful health effects of smoking pipes and cigars:

Continued

Cancer. Even if you don’t inhale, you can get a number of different cancers from smoking pipes and cigars. People who smoke cigars regularly are four to 10 times more likely than nonsmokers to die from cancers of the mouth, larynx, and esophagus. Oral cancer can develop anywhere the smoke touches, including the lips, mouth, throat, and tongue. People who inhale also increase their risk for cancers of the lung, pancreas, and bladder.

Lung disease . Cigar and pipe smoking double the risk for the airway damage that leads to chronic obstructive pulmonary disease (COPD), a lung disease that includes chronic bronchitis and emphysema. Smoking can also worsen existing asthma.

Heart disease . Smoking cigars or pipes increases the likelihood of having heart disease or a stroke. Cigars boost the risk of early death from coronary heart disease by 30%.В Cigar smoke contains many of the same toxic and carcinogenic compounds that are found in cigarette smoke, and subjects who smoke four or more cigars per day are exposed to an amount of smoke equivalent to 10 cigarettes; even those who do not inhale are exposed to their own environmental smoke.

Teeth problems. Smoking pipes or cigars wreaks havoc on your mouth, contributing to gum disease, stained teeth, bad breath, and tooth loss. One study showed that pipe and cigar smokers had an average of four missing teeth.

Erectile dysfunction . Smokers are twice as likely to have erectile dysfunction as nonsmokers.

Cigars and pipes aren’t just dangerous to the people who smoke them. They also give off secondhand smoke filled with toxic chemicals like carbon monoxide and hydrocarbons. Because a cigar wrapper (which is made from a tobacco leaf) is less porous than a cigarette wrapper, it doesn’t burn as thoroughly as a cigarette wrapper. This increases the concentration of cancer-causing substances like ammonia, tar, and carbon monoxide released into the air.

Despite their sweet aroma, water pipes are also dangerous to your health. During a typical hookah smoking session, you’ll inhale 100 to 200 times the volume of smoke that you’d get from a cigarette. Water pipes deliver at least as much nicotine and toxins as cigarettes, and put users at similar risk for cancer and other smoking-related diseases.

The same advice is true for pipe and cigar smokers as for cigarette smokers: quit. If you can’t kick the habit on your own, get help from your doctor, another health professional, or a smoking cessation service (1-800-QUIT-NOW). Also make sure to get regular checkups — including mouth exams to look for signs of oral cancer.В

Sources

American Cancer Society web site: “Cigar Smoking.”

Jacobs, E.J. Archives of Internal Medicine, 1999; vol 159: pp 2413-2418.

Health Services at Columbia web site: “Go Ask Alice! Cigar and pipe smoking: Safer than cigarettes?”

Rodriguez, J. Annals of Internal Medicine, Feb. 16, 2010; vol 152: pp 201-210.

Henley, S.J. Journal of the National Cancer Institute, June 2, 2004; vol 96: pp 853-861.

Albandar, J.M. Journal of В Periodontology, December 2000; vol. 71: pp 1874-1881.

Ohio State University Medical Center.

Rakel, Robert E. Textbook of Family Medicine, Saunders Elsevier, 2007.

WebMD explains the negative health effects of smoking pipes and cigars, not just cigarettes.