The effect of cigar and pipe smoking on the risk of myocardial infarction was evaluated in an interview study of 572 men with non-fatal first myocardial infarctions and 934 hospital controls. The study was conducted in the north eastern United States from 1980 to 1983. All subjects were 40-54 years of age, and none had smoked cigarettes for at least two years. Among men who had never smoked cigarettes the relative risk of myocardial infarction for those who smoked at least five cigars a day, compared with not smoking cigars and pipes and allowing for other risk factors, was estimated to be 1.7 (95% confidence interval 0.6 to 4.8). Among ex-smokers of cigarettes the corresponding estimate for those who smoked at least five cigars a day was 4.5 (2.2 to 9.2). The estimates for men who smoked fewer cigars, or pipes, were closer to 1.0 and not significant. Men who stop smoking cigarettes and switch to at least five cigars a day apparently continue to have an increased risk of myocardial infarction, possibly because they continue to inhale the smoke.
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