Hello everyone,
I hope this week has treated you well.
Last week I wrote about harms of smoking cigarettes and how to quit. I mentioned that if anyone would like to speak about any other harmful habits, they should write in. I so gratefully received many topics which I will get into over the next few weeks. One of the requests was a one word email asking “cigars?” Just because I liked your abruptness and find charm in people who do not like to waste time, I will address yours first.

So, are you aware of what you are smoking? What is a cigar? It is rolled with tobacco leaf, contains nicotine and comes in many types and sizes. Cigars are significantly more popular among men than both women and children. They are portrayed as an accessory for the rich and powerful. They are portrayed as being important for special occasions such as a job promotion or the birth of a child. This is basically peer pressure for the elder and wealthier community. The most recent study on cigars determined that Cigar smoking caused 9000 premature deaths in the United States in 2014.

Let’s do a comparison between cigarettes and cigars.
Firstly and most importantly, the harms of cigars are severely overlooked. Cigarettes come with a warning label while cigars come in an extravagant box. Of course this automatically makes cigars more expensive. Cigars contain more tobacco as it is wrapped with a tobacco leaf while cigarettes are not. Cigars are larger and therefore take longer to smoke- the average cigarettes takes about five minutes to smoke while a good cigar can take up to an hour.

Cigars contain much higher levels of Nicotine than cigarettes- a full sized cigar contains (on average) as much nicotine as an entire large pack of cigarettes. As mentioned when speaking about cigarettes, nicotine is the substance found in cigarettes and cigars that causes addiction.

Unlike cigarettes, most cigar smoke should not be inhaled, although some people still do. It is quite dangerous to do this. I hear you are only supposed savour the taste of the cigar smoke. Considering that cigars do not have the filters that cigarettes do, inhaling would be a bad idea. However, it needs to be mentioned that whether there is inhalation or not, nicotine will still be absorbed through the lining of the mouth when smoking cigars.
Overall, cigar smoke has a higher level of cancer-causing substances, more tar, and more toxins than cigarette smoke.

So, what are some physical harms caused by cigar smoking?
Many studies have determined that due to all the above, cigar smoking causes more injury than cigarette smoking. Yes, there is a decreased risk of lung cancer as cigars smokers do not typically inhale but there is an increase in the risk of mouth and throat cancer.
Cigar smoking increases the risk of heart disease, oral diseases such as gum disease and tooth loss/ decay as well as COPD diseases such as bronchitis or emphysema.
Some studies how that cigars have also been linked to erectile dysfunction and decreased sexual appetite in men.

While it is a myth that second hand smoke is worse than actually smoking, being around someone who is smoking either cigars or cigarettes is harmful to you. This means that smoking either in front of children is not a good idea as it increases risk of asthma and infection. Finally, the chances of becoming addicted to cigars are the same as cigarettes.

So, how can we lower or quit cigar use?
My advice for this will not be much different than that of cigarettes.
First, pick a quit date and tell everyone around you. This will increase your level of support and basically shame you into success. No one likes to fail in other people’s eyes.
I’ve both read and been told that it is easier to quit cigars than cigarettes- mostly because of situational reasons however, such as they are harder to obtain or too expensive.
To start with, if you are a cigar inhaler, do your best to stop this. If you lower your tobacco intake in the beginning, you can still smoke the same amount of cigars. After you have successfully done this, then you can lower the actual amount of cigars you smoke per day/ week.

Write a list of all the benefits of quitting and keep it nearby. Read it every day. Examples- better lungs, more money at the end of the month etc.
Similarly to quitting cigarettes, cigar smokers can also use substitutes. This is possible because either way, it is the nicotine the smoker is trying to come off of. This means that Nicotine replacement gum and E-cigarettes are also good replacements for cigars. These substitutes will help with both withdrawal symptoms and cravings. These usually include irritability, head and neck aches, increased appetite, trouble sleeping etc.

If the withdrawal symptoms are severely interfering and interrupting daily routines, please go to your nearest health centre. There are prescription pills that can make quitting easier. You do not need to feel as frustrated as you are.
Make sure to keep busy- get more active and stick to a healthy diet. Avoid triggers- the people, places or situations that increased your smoking. For example alcohol or smoking bars. Do activities that do not trigger smoke cravings such as movie or swimming.
Do deep breathing exercises. This is useful as most people relapse do to stress. Take a few minutes to yourself- breathe in through the nose for 4 seconds and out through the mouth for 8 seconds- repeat as many times needed.

Finally, when faced with cravings, delay them. Drink a glass of water and wait 10 minutes before giving in to smoke- I promise this will make a difference.
My take away message is that there is no healthy way of smoking tobacco- one is not better than the other and it is best to stop either.
Thanking you for reading. Please keep sending any topics you’d like to talk about to caitlinvieira@gmail.com Or come in to see me at:

Georgetown Public Hospital: Psychiatric Department:
Monday- Friday – 8am- 12pm

Woodlands Hospital: Outpatient Department
Drug and Alcohol group meetings – Mondays 4:15
Good mental health group meetings- Wednesdays 4:15
Suicide Prevention Helpline numbers: 223-0001, 223-0009, 623-4444, 600-7896

Say Yes to Life and No to Drugs! Always