Health consequences of pipe versus cigarette smoking.
OBJECTIVE
To estimate the risk of dying from all causes and from specified smoking-related diseases in men who were exclusive daily pipe smokers at two consecutive examinations, and in men who switched from smoking cigarettes only to pipe only.


METHODS
A prospective cohort study.


METHODS
Three counties in Norway.


METHODS
16, 932 men, aged 20-49, screened for cardiovascular disease risk factors in the mid-1970s, re-screened after 3-13 years, and followed throughout 2007.


RESULTS
Absolute mortality and relative risks adjusted for confounding variables, of dying from all causes and ischaemic heart disease, stroke, cardiovascular disease, lung cancer and other smoking-related cancer.


RESULTS
Altogether, the men were observed for 403, 327 years, and during the observation period, 4933 deaths occurred. With sustained never smokers as reference, the sustained smokers of a pipe only had adjusted relative risk (95% CI), of dying from any cause that was 1.99 (1.73 to 2.27). At comparable tobacco consumption, no significant difference in risk between pipe and cigarette smokers appeared. As to survival, no difference was found between sustained smokers of a pipe only and of cigarettes only. Men who switched from cigarettes only to pipe only had a risk which was not significantly different from the risk in sustained smokers of cigarettes only.


CONCLUSIONS
Between pipe and cigarette smokers, no or only minor differences were found in mortality from any cause and the specified smoking-related diseases. Pipe smoking is not safer than cigarette smoking.
Fridtjof Nansens vei 24 B, N-0369 Oslo, Norway.
Aage
A
Tverdal
Kjell
K
Bjartveit
D000328:Adult; D002318:Cardiovascular Diseases / Q000401:mortality*; D002423:Cause of Death; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality*; D009664:Norway / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000401:mortality*; D055815:Young Adult