When it comes to tobacco use, there is no ‘lesser evil’

From the traditional cigarette to the modern electronic cigarette, from the communal hookah to the discreet pinch of smokeless tobacco, each has proven to be detrimental to a person’s health. In this Mayo Clinic Minute, Dr. Jon Ebbert, medical director of the Mayo Clinic Nicotine Dependence Center, discusses why there is no “lesser evil” when it comes to tobacco use.

Smoked tobacco has the strongest association with cancer, and it goes beyond cigarettes.

“Hookah, which is a smoked and inhaled tobacco, has a similar cancer risk because it’s the process of smoking and inhaling those 7,000 chemicals that increases the risk for cancer,” said Ebbert.

There’s no safe, or safer, way to consume tobacco. A common misconception is that cigars are less harmful than cigarettes.

“All the same risks that you get with cigars that you inhale are exactly the same risks you have with conventional cigarettes,” said Ebbert.

He said even cigar users, who tend not to inhale, are still at risk.

“If you smoke a cigar and just hold it in your mouth and exhale, all the tissues in your mouth that are exposed to the cigar smoke have an increased risk for cancer,” said Ebbert.

Head and neck cancers are more common in people who smoke cigars as well as those who use smokeless tobacco, which is also associated with pancreatic and kidney cancer.

“With electronic cigarettes specifically, we don’t have enough longitudinal data to know whether those products are associated strongly with cancer,” said Ebbert. “But we do know that those products result in the release of carbonyls and heavy metals. And those are known, theoretically, to lead to cancer.”

All forms of tobacco consumption carry significant health risks and can lead to cancer.

“We always say it’s never too late to stop smoking, and the risk for cancer after quitting cigarette smoking, for example, goes down. But it takes some time. So, if you think about reductions in cancer risk for lung cancer, in about 15 years, you have half the risk of cancer that you would if you had continued to smoke. So it takes some time, but it’s never too late to stop smoking,” said. Ebbert.