Perhaps you had a grandfather who enjoyed a puff now and again, maybe along with a good whiskey , or you aim to emulate some pipe-smoking artist. Whatever the case, you intend to take up the time-honored tradition of unwinding with a pipe. So, how do you smoke a pipe without looking like an amateur?
As with most endeavors, it all starts with the right equipment. Pipes come in all varieties, from your basic corncob pipe to simple wooden pipes to highly ornate carved pieces that border on works of art. Which is right for you has more to do with personal aesthetic tastes than anything.
Wooden matches or long pipe lighters are the easiest way to get the job done. Not necessarily essential, these are useful for packing your bowl and help add to your overall classy look. Which tobacco is right for you depends on your experience with tobacco and your personal tastes. Ask your local tobacconist for recommendations. The relative risk for death from lung cancer increased from 1. Statistically significant increasing dose response trends were observed with years of smoking for coronary heart disease, chronic obstructive pulmonary disease, and stomach and bladder cancers and with depth of inhalation for coronary heart disease, chronic obstructive pulmonary disease, and pancreas cancer.
We observed an anomalous inverse association with depth of inhalation for cerebrovascular disease that we cannot explain. We also analyzed the relative risks of death from tobacco-associated diseases among former pipe smokers by years since quitting pipe smoking and age at quitting Table 4, 4A. For most diseases, the relative risk decreased with years since quitting and with younger age at quitting. The relative risk among former pipe smokers was intermediate between that of current smokers and never tobacco users in most categories of amount, duration, and depth of inhalation data not shown.
We assessed the potential synergism between pipe smoking and alcohol consumption for cancers of the upper aero-digestive tract Table 5. To examine the effect of cessation of pipe smoking over the year follow-up period, we compared the relative change in death rates among current and former pipe smokers compared with never tobacco users over three 6-year periods of follow-up Table 6.
Among current pipe smokers, no statistically significant trends in the relative risks of death from all causes or from any of the specific causes were evident with increasing follow-up.
Among former smokers, there was a statistically significant decrease in the risk of death from lung cancer with increasing length of follow-up but also a statistically significant increase in the risk of death from cerebrovascular disease.
Generally, the estimates obtained from 18 years of follow-up were similar to but more stable than those from 6 years of follow-up. We compared the relative mortality risk estimates from smoking-attributable diseases associated with exclusive current pipe, cigarette, or cigar smoking among CPS-II men Fig.
For most diseases, cigarette only smokers have the highest risk 37 , 38 , and men who exclusively smoked pipes have risks that are similar to or higher than those associated with smokers of cigars only The association between smoking and death from coronary heart disease does not differ by tobacco product 37 , Results from this large, prospective study provide more precise estimates of the relationship between pipe smoking and death from tobacco-attributable diseases than have been available previously.
In this cohort, pipe smoking conferred a risk similar to or greater than that for cigar smoking for cancers of the lung, larynx, esophagus, and oropharynx and for coronary heart disease 39 , The epidemiologic literature on tobacco use, including pipe and cigar smoking, has been reviewed recently Many of the studies included in that review combined pipe and cigar smokers; however, the studies that examined exclusive pipe smoking showed results similar to ours.
Of the prospective studies, ours is the largest and the only one to adjust for risk factors other than age. Men who smoke pipes exclusively have higher risk of lung cancer than men who have never smoked in most published prospective 9 — 12 , 41 , 42 and case—control 13 — 17 studies. In our study, risk of lung cancer mortality in men was increased fivefold for current pipe smokers; this estimate is higher than that reported in two earlier U.
Like our study, two large European case—control studies 13 , 17 reported that lung cancer risk increased with years of pipe smoking, number of pipes smoked per day, and depth of inhalation and decreased with time since cessation of smoking.
To our knowledge, the association with laryngeal cancer has not previously been assessed among exclusive pipe smokers. A hospital-based case—control study in Beijing observed a fivefold increased risk of oral cancer incidence among both male and female ever pipe smokers The risk of colorectal cancer mortality was highest for men who reported several decades of smoking or smoking 11 or more pipes per day, similar to results observed among cigarette smokers in CPS-II Although no association was observed between current pipe smoking and colon or rectal cancer mortality in the Swedish study 11 , Heineman et al.
Risk of pancreatic cancer mortality associated with pipe smoking was increased in the Swedish prospective study 11 but not in two other prospective studies—the U. A hospital-based case—control study by Muscat et al. Two previous studies in U. The largest study of bladder cancer, a pooled analysis of European case—control studies 20 , reported statistically significantly higher risk with longer duration of pipe smoking, as was also observed in CPS-II.
We did not find an association between pipe smoking and kidney cancer mortality, similar to the results of two case—control studies of kidney cancer incidence 22 , Finally, our estimates of risk for cardiovascular and pulmonary disease are similar to those reported in the large Swedish study 11 and are within the range reported by other prospective A limitation of our study is that smoking habits were reported only at baseline.
For diseases such as lung cancer, in which risk increases exponentially with duration of smoking 46 , the relative risk estimate among continuing smokers would be expected to increase over time. However, we found that the association between lung cancer and current pipe smoking remained relatively constant over time Table 6. The expected increase may have been obscured by misclassification of exposure due to cessation of smoking among current smokers during the year follow-up period.
The effect of this misclassification would be to underestimate the risks of continued smoking and to attenuate dose—response gradients. The main strength of our study was its size, which provided precise estimates of mortality risk associated with pipe smoking among men who smoked pipes exclusively and provided moderately stable estimates of risk for the more common endpoints in relation to the number of pipes smoked daily, duration of smoking, and depth of inhalation among current smokers, and age at quitting and years since quitting among former smokers.
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. The tobacco industry has repeatedly demonstrated its ability to create new markets by reviving interest in tobacco products that had appeared to have become obsolete, especially among youth and young adults.
Results from this large, prospective study strongly support a causal relationship between pipe smoking and mortality from cancers of the lung, larynx, esophagus, and oropharynx, and chronic obstructive pulmonary disease.
Although the risk of dying from tobacco-associated diseases is lower for pipe smokers than for cigarette smokers, pipe smoking is as harmful as, and perhaps more harmful than, cigar smoking.
All tobacco products cause excessive morbidity and mortality. Our findings may help deter efforts by the tobacco industry to imply, directly or indirectly, as it has with smokeless tobacco 48 , 49 and low-yield cigarettes 50 , that any tobacco product has negligible adverse health effects. Estimates for pipe smoking are from Table 2.
The associations between cigarette and cigar smoking and tobacco-attributable diseases in CPS-II men have been published previously 37 — Estimates for the association between cigar smoking and cancer of the lung, oropharynx, esophagus, pancreas, larynx, and bladder are from Shapiro et al. Demographic and other characteristics of CPS-II men who, at enrollment in , reported either never use of tobacco products or exclusive smoking of pipes.
Death rates are per person-years and are age-standardized to the CPS-II male person-year distribution. From Cox proportional hazards models, adjusted for age, race, educational level, body mass index, and alcohol consumption.
Analysis for all causes excluded men who reported prevalent cancer, heart disease, diabetes, stroke, emphysema, or chronic bronchitis in Analyses for cancers excluded men who reported any prevalent cancer in Analysis for coronary heart disease excluded men who reported prevalent heart disease or diabetes in Analysis for cerebrovascular disease excluded men who reported prevalent stroke in Analysis for chronic obstructive pulmonary disease excluded men who reported prevalent emphysema or chronic bronchitis in Upper aero-digestive tract cancers include oropharynx, esophagus, and larynx International Classification of Diseases, 9 th edition [ICD-9] codes —, Cox proportional hazards models are adjusted for age.
Analysis for lung cancer excluded men who reported any prevalent cancer in We are grateful to the 1. Doll R. Uncovering the effects of smoking: historical perspective. Stat Methods Med Res ; 7 : 87 — Surveillance for selected tobacco-use behaviors—United States, — The health benefits of smoking cessation: a report of the Surgeon General.
Rockville MD : U. CDC Pipe smoking in the United States, — prevalence and attributable mortality. Prev Med ; 25 : 91 —9.
Department of Health and Human Services. Tobacco use among U. A report of the Surgeon General. Atlanta GA : U. Chinese Academy of Preventive Medicine. Smoking and health in China: national prevalence survey of smoking pattern. Youth tobacco surveillance—United States, — Tobacco use among middle and high school students—United States, Hammond EC, Horn D. Smoking and death rates: report on forty-four months of follow-up of , men. Measure ad performance.
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Smoking tobacco out of a pipe has been a worldwide practice for centuries. Historically, pipes were used in ceremonies with the practice gradually gaining mainstream popularity over the years as an accepted way to smoke tobacco.
Shops sprang up that catered to pipe and often cigar smokers. Flavored blends sold in bulk could be sampled right on the premises in smoke rooms set up for patrons. Pipe smoking has been dwindling in use since the s but is still favored by a small percentage approximately 1. Pipe smoking is still common in Sweden, where as many as one-quarter of adult males smoke a pipe. Pipe tobacco is loose-leaf tobacco most commonly grown in northern middle Tennessee, western Kentucky, and Virginia. It is fire-cured, which involves slowly smoking the drying tobacco leaves over a smoldering hardwood fire inside of a barn or structure.
The process can take days to weeks, and the end result is a tobacco that is low in sugar and high in nicotine. Most pipe tobacco is aromatic, having had a flavoring added to the finished product that gives it a depth and richness in taste and smell.
Pipe tobacco is addictive. An average pipe bowl contains 1—3 grams of tobacco, with the nicotine level per gram averaging 30—50 milligrams. Smokers don't tend to inhale pipe smoke as much as cigarette smokers, but some nicotine still reaches the bloodstream after being absorbed through the lining of the mouth.
You might think that because most pipe smokers don't inhale, the health risks are minimal. While there isn't a lot of scientific data on the health effects of pipe smoking, we do know that there are risks. Pipe smoking is associated with a number of illnesses that are common in cigar and cigarette smokers. For instance, pipe smokers face an elevated risk of cancers of the mouth, including the tongue, larynx, and throat.
Smokers who inhale pipe smoke also have an elevated risk of lung, pancreatic, and bladder cancer. Pipe smokers face an increased risk of developing chronic obstructive pulmonary disease COPD.
While cigarette smoking is usually the main cause of COPD, other forms of tobacco like pipe-smoking and cigars can also result in tobacco smoke inhalation and damage to delicate lung tissue. They are now enjoying something of a resurgence in popularity in India and the Middle East, where they are said to have originated. In the Middle East the trend has extended to teenagers and women, many of whom do not smoke cigarettes.
This shisha cafe culture has also extended to Europe, Brazil and the United States. If I run home from my office in London, I pass a street filled with cafes where groups of people sit outside engulfed in clouds of honey-scented smoke. In the United States many hookah cafes have opened in college towns and a recent study found that as many as a fifth of American students have tried it. In many countries these pipes are seen as safe enough to be exempt from legislation on smoking in public places.
One of the main misconceptions is that the risks of tobacco are minimised because it is purified as it passes through the water. But this ignores the complete source of the smoke that enters your mouth. The tobacco burns in a small dish on top of the main body of the water-pipe. You inhale through a mouthpiece connected by a pipe to a reservoir of water at the bottom. As you breathe in smoke is drawn from the burning tobacco and bubbles through the water and up into your mouth.
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