The findings provide further evidence that cigar, pipe, and cigarette use confers mortality risks, even to nondaily current cigarette users, although the risk is tempered among former users compared with current users. Compared with never tobacco users, exclusive current cigarette smokers and exclusive current cigar smokers had increased all-cause mortality risks (hazard ratios [HR], 1.98 and 1.20, respectively).
The primary outcomes were all-cause and cause-specific mortality as identified as the primary cause of death from death certificate. Daily cigar smokers were 61 percent more likely to die of cancer, while everyday cigar smokers were 58 percent more likely to die.
The researchers noted 51,150 recorded deaths during follow-up.
Christensen, PhD, MPH, from the US Food and Drug Administration in Silver Spring, Maryland, and colleagues used data from the National Longitudinal Mortality Study to examine the mortality risks associated with exclusive use of cigars, pipes, and cigarettes.
The risk of dying from a tobacco-related cancer (including bladder, esophagus, larynx, lung, oral cavity, and pancreas) was increased for exclusive current and former cigarette smokers, exclusive current cigar smokers, and exclusive current pipe smokers (HRs, 4.06, 1.61, and 1.58, respectively).
For current non-daily cigarette smokers, there were statistically significant associations with death from lung cancer (HR 6.24, 95% CI: 5.17-7.54), oral cancer (HR 4.62; 95% CI: 1.84-11.58), circulatory death (HR 1.43, 95% CI: 1.30-1.57), cardiovascular death (HR 1.24; 95% CI: 1.11-1.39), cerebrovascular death (stroke) (HR 1.39, 95% CI: 1.12-1.74), and chronic obstructive pulmonary disease (HR 7.66, 95% CI: 6.09-9.64) as well as for daily smokers. The results also highlight the importance of cessation initiatives to reduce morbidity and mortality from combustible tobacco products.