Pipe Smoking and Health: "Risky business or casual pleasure?"
by Mark Beale, MD
In making the decision to smoke or not, we must educate ourselves about the risks and benefits. Unfortunately, the scientific data which attempts to quantify the risks of pipe smoking remain sparse. In 1964, the Surgeon General of the United States issued a landmark report on tobacco usage. This report, which described the dangers of cigarette smoking, including heart disease, lung damage, and an increased cancer risk, raised the public's awareness regarding the health consequences of certain behaviors.
Specifically, this report confirmed what had been suspected for quite some time, that cigarette smoking could be dangerous. However, the conclusion drawn from several studies about pipe smokers was that they tended to live longer than the general population!
A subsequent revision of this report, which appeared in 1979, concluded that pipe smoking increased the mortality ratio slightly, when compared with non-smokers, but the effect was minimal when compared to cigarette smokers. Pipe smokers using four or fewer bowls of tobacco per day had a lower mortality ratio than non-smokers - meaning the death rate was less for occasional pipe smokers than for the general population.
Since then, other reports have emerged, including the 1982 Surgeon General's report which concluded that pipe smokers have a 2 - 4.3 times greater risk of lung cancer than non-smokers. However, the studies upon which this conclusion is based did not differentiate between inhalers and non-inhalers. Presumably, non-inhaling pipe smokers would have had a lower lung cancer risk than inhalers.
Other interesting findings include a Swedish twin study which found that pipe smoking twins lived longer than non-smoking twins. This same study found a much higher mortality rate in cigarette smoking twins compared to their non-smoking siblings.
Other Potential Risks
Importantly, there is more to health risks than death! In pipe smokers these risks include heart disease, chronic lung disease, and cancer of the lip, tongue and throat. In fact, the largest risk for pipe smokers may be in developing cancer of the lip. This type of cancer is more responsive to treatment than, for example, lung cancer and therefore is not reflected in studies examining mortality.
When a Feller Needs a Friend
The old advertising slogan for Briggs Pipe Tobacco "When a Feller Needs a Friend", I think emphasizes the psychological aspects of pipe smoking. This phenomenon of pipe smoking as mental comfort can be found in other advertising slogans as well, including the phrase, "Relax with a Marxman", used by the popular New York pipe firm. Indeed, when we examine the risks and potential benefits of pipe smoking, we must also consider the psychological aspects of the hobby.
Many pipe smokers will tell you that one of life's greatest pleasures is to enjoy a fine tobacco in a favorite pipe. The key word here is "enjoy".
The psychological benefits of pipe smoking have been described by many who have enjoyed the hobby, including Mark Twain, Albert Einstein and others. Einstein felt that pipe smoking facilitated his mental clarity when working on a difficult project. Many pictures of him at work show that he favored billard-shaped pipes. Pipe smokers often like to recite one of his most relevant quotes: "I believe that pipe smoking contributes to a somewhat calm and objective judgment in all human affairs". Indeed, it is difficult to measure the calming qualities of pipe smoking and the possible beneficial effects on our work, productivity, relationships, and relaxation.
With further study we may find that enjoying a pipe in moderation can prolong life, in a way analogous to the recent finding that consuming alcohol in moderation may protect against the development of certain types of heart disease.
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