The Latest Anti-Cigar Study: A Voyage to Nowhere

Would you buy a package of bacon next to a picture of a man in the throes of heart failure? How about a box of cake mix with a close-up of a diabetic amputee? What if there were fatty livers on the refrigerators of the beer aisle? Would a lifesize cut out of a morbidly obese couple make you think twice about walking into your community picnic?

In a recent article published by UNC Family Medicine, researchers presented detailed evidence that consumers don’t buy products–in this case, cigars–next to disgusting illustrations of disease. But what readers should take away as genuinely groundbreaking is that the slush fund for anti-tobacco research has become so large that a study like this is even considered worth funding. Not just because they’re burning research dollars to state the obvious but because it’s irrelevant.

The study by Sarah Kowitt, Ph.D., MPH, and her colleagues suggests that graphic and text warnings are more effective than the FDA’s proposed text-only warnings. The article then directly compares cigarettes and premium cigars, lumping them together as equal contributors to health risks. While this tactic helps secure future research funding for a “tobacco-free society,” it’s been debunked by the National Academies of Science as unhelpful in the pursuit of knowledge about the real impact of premium cigars on public health.

Type “anatomy of a cigarette” into any search engine, and you’ll learn in 30 seconds that whole-leaf tobacco isn’t the main ingredient. Cigarettes and premium cigars may be considered tobacco products. Still, they are distinct enough in their material content, construction, and usage patterns that the Population Assessment of Tobacco and Health, the national longitudinal study conducted by the National Institutes of Health, makes a distinction. Unsurprisingly, the public health impacts between the two are night and day.  

That’s why, in 2020, a federal judge found that FDA “failed to supply a reasoned explanation to substantiate applying health warnings to premium cigar products because the warnings themselves are factually unfounded for such products [and] the agency did not adequately justify the need for health warnings for premium cigars because premium-cigar consumers already appreciate the risks of regular use.”  

Premium cigars are hardly a public health crisis. Less than 1% of the population enjoys smoking premium cigars. The average age of initiation is 30, and the average consumption is less than two units per month. They produce smoke that is not conducive to inhalation, and use patterns are inconsistent with nicotine addiction. It’s no surprise that, politically, premium cigars have won favor over the anti-tobacco crusaders. Sound science doesn’t support the narrative that all tobacco products carry the same risk for disease, nor should they be regulated the same.

Yet, just as all calories contribute to obesity, Adam Goldstein, MD, MPH, director of the UNC Tobacco Intervention Programs, reminds us of the importance of educating premium cigar smokers that combustible tobacco can cause cancer. What he doesn’t boast about are the resources UNC wasted on an obvious voyage to nowhere. Perhaps he could illustrate just how deeply the corporate interests of the “tobacco-free society” have permeated academia in an effort to reverse their losing record at regulating, taxing, and shaming adults that enjoy premium cigars. That picture would be worth a thousand words.