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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.

Busting the myth that roll-your-own tobacco has fewer additives

My last column, reported on the huge growth of Australians using roll-your-own tobacco in the past few years. Because of a tobacco tax anomaly, which will end in September this year, many smokers have migrated to roll-your-own as a less expensive alternative to factory made cigarettes.

The shift to roll-your-own tobacco is certainly one factor that has slowed the decline in smoking in Australia in the past three years.

There is unanimous agreement in public health that price and high public acceptance of the harms of smoking are the two single most important factors that reduce tobacco use. This is why all industries, including Big Tobacco, engage in price discounting and lobbying to keep sales taxes low.

While the relative cheapness of roll-your-own tobacco is a major explanation of its rising popularity, several other factors are also relevant. Many people who use it like the ritual of rolling their cigarettes, feeling it is a creative and relaxing ritual.

One 25-year-old man, Sam, told an Otago University research group:

“There’s something nice and relaxing about rolling your own as opposed to just pulling one out of the packet, … the sort’ve process of it is quite enjoyable … and also the whole sort’ve ritual just around smoking in general, like sit down and have a coffee, have a cigarette sorta thing … so it’s ritualistic in that sense.”

Many smokers believe roll-your-own tobacco is somehow less harmful than factory made cigarettes. The latter are seen as being pickled in artificial chemical additives that make the tobacco “unnatural” and to be avoided. Twenty-year-old woman Brenda told the same researchers:

“I just imagine that um, tailor made has more chemicals in it. But I don’t know if that’s true but it kind’ve tastes that way … I dunno, it’s hard to explain it’s just not as, like, clean … tasting.”

Why use additives at all?

Tobacco products contain additives to:

  • make the smoking sensation “taste” or feel better (known as “mouth feel”)
  • make the smoke less irritating to smokers’ mouths and throats, particularly to novice smokers
  • increase the efficiency with which nicotine and artificial nicotine analogues reach the brain to maximise addiction
  • regulate the burn temperatureprevent the cigarette from going out when not being inhaled and to prevent the tobacco “sparking” and sending cinders onto smokers’ clothing
  • reduce the smell of tobacco smoke
  • retain optimum moisture in the tobacco (using compounds known as humectants) to stop tobacco drying out when stored or exposed to air.

This last category of additives, humectants, are particularly important with roll-your-own tobacco. That’s because it’s exposed to air every time a smoker opens the tobacco pouch or does not seal it properly, making it more likely to dry out.

In 1990, the New Zealand government became the first to require the tobacco industry submit data on the volume of additives used in tobacco products. Most tobacco products sold in New Zealand at that time were imported from Australia.

So much for the enduring myth that roll-your-own tobacco has less additives than cigarettes. Nearly a quarter of every lungful of smoke inhaled from a roll-your-own cigarette contains particles and gases from the thermal partial decomposition of chemical additives in the tobacco mix.

Why don’t we know more about these additives?

Unlike every other product (food, drinks, medicines) intended to be taken into the body, cigarettes are immune from government quality and safety standards. Manufacturers can use any legal, natural or artificial ingredient they wish from a long list of approved additives.

These additives have been approved for use in foods, but the Australian government has not signed off on their safety when each smoker burns and inhales them many thousands of times a year.

Each year the three main tobacco companies operating in Australia voluntarily disclose the additives used in each brand of cigarettes. However, they do not disclose which “processing aids” they use in each brand, nor do they describe what “processing aids” are.

Instead, the industry reassures us:

“Processing aids and preservatives that are not significantly present in, and do not functionally affect, the finished product are grouped as ‘processing aids’ and/or ‘preservatives’ [my emphasis].”

What “functionally affect” means here is also anyone’s guess. Significantly, manufacturers do not disclose the same information for roll-your-own tobacco.

‘Extremely high’ pesticide residues

In 1981, the National Health and Medical Research Council’s Pesticides and Agricultural Chemicals Committee tabled information stating that average levels of the now banned organochlorine DDT in Australian samples of cigarettes were 43 times higher than found in US and UK cigarettes.

When I questioned in 1986 why this monitoring had been stopped, I was advised government policy was that all cigarette smoking was very dangerous, regardless of the levels of additives and pesticide residue they contained.

One official told me:

“Our view is that smoking in like being in health hell and the extra impact of additives is like turning the temperature up just another degree.”

In this paper I published in 2003, internal industry documents made available after litigation in the USA, showed that tobacco used in Australian cigarettes contained alarming levels of pesticide residue, including organochlorines like DDT and dieldrin.

A 1978 Philip Morris report noted:

“Extremely high pesticide residue levels have been found in all samples submitted by PM-Australia, eg. DDT group, 300 ppm; HCH-group up to 100 ppm; dieldrin, up to 22 ppm.”

PM-Australia refers to Philip Morris Australia, the HCH-group to hexachlorocyclohexane additives and ppm to parts per million.

These levels are astronomical compared with the 7.5 ppm maximum standard for DDT that had been recommended in a 1976 report of the Commission of the European Communities and adopted by the German government.

We have no more recent public data on pesticide residue in cigarettes sold in Australia. But all cigarette and hand-rolling tobacco sold in Australia is grown overseas, often in less developed nations where agricultural practices can be poorly regulated. It is possible, even likely, pesticide contamination continues today.

So as actor Yul Brynner famously advised as he was dying from lung cancer at just 65 years “whatever you do .. don’t smoke”. And don’t kid yourself that it’s only the additives that are the problem.

This article was originally published on The Conversation. Read the original article.

Busting the myth that roll-your-own tobacco has fewer additives My last column, reported on the huge growth of Australians using roll-your-own tobacco in the past few years. Because of a tobacco ]]>