Cigars and pipes, long promoted by the tobacco industry as status symbols or glamorous cousins of the humble cigarette, are just as lethal – they cause cancer and they kill just like cigarettes do, says a new European study released today by the Lyon (France)-based International Agency For Research On Cancer (IARC).

The study is a boost for global tobacco control experts who have been calling for stricter controls on cigars and pipes. 'The writing on the wall is clear – the time has come to apply the same controls used for cigarettes to cigars and pipes,' said Dr Derek Yach, head of WHO Tobacco Free Initiative (TFI) welcoming the IARC study. 'There's a message in this for politicians, fashion models, movie stars and sports people who glamorize and popularise cigars and pipes by endorsing these products or smoking them in public', he added. Yach suggests controls must include statutory health warnings, taxes in line with tobacco and nicotine levels, and advertising bans.

IARC, a widely respected independent research arm of the World Health Organisation (WHO), and a world leader in research on cancer and carcinogens, conducted the study in seven centres in Germany, Italy and Sweden. The three-country study included 5621 men with lung cancer who were compared to 7255 men without lung cancer. Cigar smokers were nine times more likely to develop lung cancer than non-smokers. Pipe-smokers ran an almost eight-fold risk of getting lung cancer. A dose-response relationship between lung cancer risk and either duration of smoking or average and cumulative consumption was seen for cigar and cigarillo smoking, pipe smoking, and cigarette smoking. Lower rates of lung cancer among cigar and pipe smokers are attributable to the fact that pipe and cigar smokers consume less tobacco on average than cigarette smokers, and not because cigars and pipe tobacco are less harmful.

While numerous studies have documented cigarette-related health risks over the past 30 years, cigars and pipes have until recently escaped scientific scrutiny. Dr Paolo Boffetta of IARC, who led the research team, notes: 'Even though there are some differences in the size of cigars smoked in North America and Europe, our study concludes that control of cigar and pipe smoking is just as important as cigarette control to reduce cancer risk. The risks of cigars and pipe tobacco should therefore be equally reflected in tobacco control legislation.'

A 1998 report by the National Cancer Institute of the US Department of Health and Human Services concluded that cigar smoking causes oral, esophagal, laryngeal and lung cancers. In addition, the US report also concluded that regular cigar smokers who inhale, particularly those who smoke several cigars per day, have an increased risk of coronary heart disease and chronic obstructive pulmonary disease.

For further information, journalists can contact Gregory Hartl, Office of Press and Public Relations, WHO, Geneva. Telephone (41 22) 791 44 58. Fax (41 22) 791 48 58. E-Mail: hartlg@who.int