Background: The aim of this study was to investigate the sociodemographic characteristics, smoking habits, the prevalence of respiratory symptoms and chronic obstructive pulmonary disease (COPD) in four groups of smokers: of cigarettes (SCt), of cigars (SCigar), of both (SB), of cigars currently but of cigarettes in the past (SCigarExCt) and of cigarettes currently but of cigars in the past (SCtExCigar).
Method: A multicenter epidemiological study enrolling 4,035 subjects aged between 40 and 69 years. One thousand nine hundred sixty-three were non-smokers and 1,146 were current smokers. Among the smokers, 869 were SCt, 37 were SCigar, 97 were SB, 86 were SCigarExCt and 57 were SCtExCigar. We analyzed sociodemographic characteristics, smoking and the prevalence of respiratory symptoms and COPD.
Results: Cigar smokers were usually men, of lower socioeconomic status (p < 0.001) and older than cigarette smokers (p < 0.001), but CO concentrations in expired air were lower in the SCigar group than in the SCt group (5 ppm vs 15.7; p < 0.001). Informants who believed their smoking was not detrimental to their health or to that of second-hand smokers made up 86.5% of the SCigar group and 79.1% of the SCigarExCt group. COPD was diagnosed in 13.2% of the SCt group, in 24.7% of the SB group, and in 12.8% of the SCigarExCt group, in comparison with 4% of the non-smokers (p < 0.001 for all comparisons).
Conclusions: SCigar are mainly older men with lower educational levels. Their concentrations of CO in expired air are low and they have little awareness of the health risks posed by their habit. SCigar who were once smokers of cigarettes have a higher prevalence of respiratory symptoms and COPD than non-smokers and the same prevalence of COPD as SCt.