Pipes are the least commonly used tobacco product in the United States, and use has been falling, from 14% in 1965 to 2% in 1991. However, pipe smoking remains common among some populations, such as American Indians, and since 1999, use has been rising among American middle and high school students. Although the associations between smoking and cancer and other diseases have been well studied, few studies have focused on those who smoke pipes exclusively, and those that have were small and not able to consider confounding factors, such as socioeconomic status and alcohol use.
To better estimate the risks associated with exclusive pipe smoking, Jane Henley of the American Cancer Society in Atlanta, and colleagues analyzed data from 138,307 men (15,263 current or former pipe users, and 123,044 men who had never used tobacco products) enrolled in the Cancer Prevention Study II, a prospective cohort study. Over the 18 years after initial data was collected in 1982, 23,589 men died. Based on this follow-up data, the researchers determined the risks of nine cancers (bladder, colon/rectum, esophagus, kidney, larynx, lung, oropharynx, pancreas, and stomach) and three other diseases (coronary heart disease, cerebrovascular disease, and chronic obstructive pulmonary disease) in exclusive pipe smokers compared with nonsmokers.
Current pipe smoking was associated with an increased risk of six out of the nine cancers-- colon/rectum, esophagus, larynx, lung, oropharynx, and pancreas--and the three other diseases. The greatest increased risk was for cancers in the larynx, lung, and oropharynx. The risks were smaller than those associated with cigarette smoking but similar to those associated with cigar smoking.
"All tobacco products cause excessive morbidity and mortality," the authors write. "Comprehensively documenting the deleterious health effects of pipe smoking is important in countering efforts by the tobacco industry to promote pipes as a desirable alternative to cigarettes or cigars."
Contact: Taka Wiley, American Cancer Society, 404-417-5860, taka.wiley@cancer.org
Citation: Henley SJ, Thun MJ, Chao A, Calle EE. Association Between Exclusive Pipe Smoking and Mortality From Cancer and Other Diseases. J Natl Cancer Inst 2004;96:853-61.
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