Are cigars “sin tax worthy”?

Smoking in many ways has rightfully become a modern-day taboo, voluntarily damaging your body by bringing acidic, chemical-laced smoke into your lungs is something society should not be encouraging.

The downside to this cognitive distancing from harmful tobacco products is that far less dangerous tobacco products get painted with the same broad brush. This almost always means regulations.

Smoking such things as premium cigars and pipes may have visual similarities to cigarettes, but treating them as equals may be unjustified, especially in light of current research done by the US Food and Drug Administration (FDA).

A 2016 study review conducted by FDA staff found that one to two cigars per day is associated with minimal significant health risks. The FDA staff, led by Cindy Chang, had said that their actions were “not a formal dissemination of information by the FDA and did not represent agency position or policy.” Although later, the FDA would push back the date to regulate premium cigars in the US from March 26th, 2018 to 2021 for further study.

In the statement regarding the change to the timeline, one of the rationales for doing so was the potential that cigars posed different health effects from other products planned to be regulated in 2018, like cigarettes.

This should be obvious as the use of cigars involves no inhaling of smoke, so treating them like cigarettes for the longest while was at the very least lazy.

The actual findings themselves were quite compelling upon closer study.

Not only was the conclusion by the FDA staff that 1-2 cigars per day had little significant health effects (despite the average cigar tending to just 0.5 per day), but the study had used a large sample size of 22 previous studies, which each had to meet a 95 percent statistical confidence rating.

What was significant about these 22 studies is that in this case, the FDA accurately categorized respondents into primary and secondary cigar/pipe smokers. Primary smokers were those who currently smoke cigars or pipes with no history of cigarette smoking, and secondary cigar smokers who currently smoke cigars but have smoked cigarettes in the past.

Often in the past, the stats between the two categories were mixed, which is why cigar smokers had results much closer to that of cigarette smokers.

Overall when looking at all causes or smoking-related mortality (ie: oral and throat cancers, stomach cancer, liver cancer, pancreatic cancer, lung cancer and COPD, bladder cancer, coronary heart disease, strokes, and aortic aneurysms), the review found primary cigar smokers have an only 8 percent higher mortality rate from smoking-related causes compared to lifelong non-smokers.

Out of context, an 8 percent higher mortality rate seems entirely wrong, although in context what must be remembered is that this is only studying illness that has some connection with smoking and that the 8 percent figure is taking into account for all frequencies of smoking (1-8+).

This is a slight rise in a fraction of mortality causes for non-smokers.

Oddly enough because of the small increase in all-cause mortality, some studies had even shown inverse associations with it, likely due to a survey finding itself on the negative end of a margin of error.

Certain conditions like strokes, and coronary heart disease were found to only have slight rises in mortality rates in a few of the studies used, with the rest showing ether virtually no change or an inverse relationship that was not on the extreme end of the margin of error (without having to adjust for smoking frequency).

Although there are useful data behind it, this is not to say cigar smoking had a positive effect in these cases, but unlike cigarettes, it is not having a consistently measurable negative impact on these conditions.

When looking at specific diseases exasperated by cigar smoking, you can see why very few regulators bother to contextualize the statistics.

First cigar smokers who had 1-2 per day saw an around 112 percent increase in oral cancer mortality, a 545 percent increase in larynx cancer mortality, and a 128 percent increase in esophageal cancer mortality. Again this seems like a lot, but this is an increase in the numbers of deaths compared to non-smokers who are very unlikely to die of any of these conditions.

In the case of the larynx cancer all three studies which had data on deaths of larynx cancer saw an approximate 900 percent (without frequency taken into account) increase in mortality, but that meant in the Kahn study with the largest sample size of tens of thousands of primary and secondary cigar smokers only 12 deaths from larynx cancer were reported. This is mostly true with all areas of significant increase.

Comparing these mortality increases without context would be equivalent to stating a specific type of shoe made you one thousand percent more likely to be crushed by a vending machine while withholding the average number of people who perish that way per year. Many anti-tobacco groups with good intentions do these sorts of comparisons with cigars.

This lack of contextualizing seems to based on the need to be anti-tobacco, as letting one tobacco product go unregulated would seem like a violation of the lobbies goals despite the lack of risk premium cigars pose.

Politically it is entirely understandable why cigars are demonized by anti-tobacco groups, as they do not want to shrink their area of influence, but it also doesn’t mean they are working in good faith.

The funny thing is that despite the majority of American states and Canadian provinces having high sin taxes on cigars (the majority of which punch above 35 percent) certain acceptably products like on the general public in similar use frequency.