Dear Dr. Bill,

My husband is a cigar smoker. He is convinced that, because he "doesn't inhale" those cigars are safer than the cigarettes. Because I hate the smell, I've been able to convince him to smoke them outside of the house. However, when we go to a restaurant, he insists on sitting in the area where smoking is allowed so he can have his usual after dinner cigar…the odor of which causes even cigarette smokers to move away from us. I guess I can handle that, but I can't believe that that awful smelling smoke isn't doing us both harm in the long run. What are your thoughts?

T.H.-Apline

Dear T.H.-Apline,

As I noted in my column about teenage cigar smoking last June, "tobacco smoke is tobacco smoke" and there is no known "safe" level of exposure; that one cigar contains more tobacco than a pack of cigarettes and contains 7 times as much tar, 11 times as much carbon monoxide and 4 times as much nicotine; that cigar smoke is so alkaline that it enters the bloodstream directly through the mouth, causing as severe a nicotine dependency as that caused by cigarettes. I also mentioned the cigar boom due to the carefully orchestrated marketing push by the tobacco industry to equate cigar smoking as an activity for the "rich and famous." (I equate cigar smoking to cigarette smoking…they both smell bad, and are both causes of an early, painful death.)

Why do I think that way?… The results of a study conducted for the American Cancer Society and published in an article in the Washington Post just two weeks ago has linked cigar smoking to coronary artery disease and to an increase the risk of death from other forms of heart disease. The study found that smoking one cigar a day appears to increase the incidence of coronary heart disease by 30 percent in men aged 75 and younger. The study of 121,738 men over the age of 30 began in 1982 and lasted unitl 1991. During the study, 2,508 participants died form coronary heart disease. The study's findings "allege that smoking cigars increases risk of early death from coronary hear disease," said lead author Eric J. Jacobs, senior epidemiologist at the American Cancer Society. Most cigar smokers say they don't inhale but studies suggest that "even inhaling a small amount of cigar smoke could conceivably have important effects," Jacobs said. "The myth that cigar smoking is relatively safe has probably contributed to the massive increase in cigar smoking in this country."

Consider this rather recent study: regular cigar smokers are almost twice as likely as nonsmokers to develop throat, mouth, and lung cancer, according to a study in the June 10, 1999 issue of the NEW ENGLAND JOURNAL OF MEDICINE. In addition, the study found that regular cigar smokers have a 27 percent increased risk of pulmonary heart disease, and increase their risk of coronary heart disease by 45 percent. "Many people still believe it is safe to smoke cigars. Our research shows that there are serious health consequences for cigar smokers," said Dr. Carlos Iribarren, lead author of the study which was funded by the National Cancer Institute, examined the medical history of 17,000 men who didn't didn't smoke cigarettes, but 1,500 of whom smoked several cigars a day. Surgeon General David Satcher, in the accompanying editorial said, "Restrictions on the sale of cigars (through the setting of excise rates, for example) ought to be at least as stringent as those currently applied to other tobacco products."

Your husband is addicted to a drug…an essential ingredient of a death dealing product….deadly, not only for him but also for his wife.