We all know that smoking is bad (mmkay): Tobacco kills more than seven million people each year, and nearly 900,000 of those deaths are the result of non-smokers being exposed to secondhand smoke. But what you might not know is that some smokable tobacco products are (kinda, sorta) worse for your health than others (although every single one is absolutely terrible for you).
Below, you’ll find every smokable tobacco product, ranked from bad to worse (at least, according to current research).
While e-cigarettes are technically less harmful than regular cigarettes — e-cigarette vapor generally contains fewer toxic chemicals — they’re by no means harmless. A 2015 study analyzed 42 models from 14 different brands of refill liquids for e-cigarettes, and found that they all contain formaldehyde (a known carcinogen). Not to mention, the authors conclude with this less-than-optimistic statement: “None of the products under scrutiny were totally exempt of potentially toxic compounds.”
That said, e-cigarettes still appear to be a much safer route if you absolutely need your nicotine fix. A 2014 study found that the levels of toxicants in e-cigarette vapor are nine to 450 times lower than in cigarette smoke. “Our findings are consistent with the idea that substituting tobacco cigarettes with electronic cigarettes may substantially reduce exposure to selected tobacco-specific toxicants,” the authors conclude. “E-cigarettes as a harm reduction strategy among smokers unwilling to quit warrants further study.”
“It’s very safe to say that e-cigarettes contain fewer cancer-causing chemicals than combustible cigarettes, but there are some oxidative gases (which contribute to cardiovascular disease, chronic bronchitis and emphysema) in e-cigarettes that we need to take a closer look at,” says Gary Giovino, an internationally renowned authority on tobacco and nicotine as well as professor and chair of community health and health behavior at the University of Buffalo School of Public Health and Health Professions. “But if I were to decide whether to smoke a Marlboro or an e-cigarette, I would vape an e-cigarette.”
Cigar smokers might believe they’re doing their lungs a solid by avoiding standard cigarettes, but cigars can be equally as debilitating (depending on how you go about smoking them). According to the FDA, “Large cigars can deliver as much as 10 times the nicotine, 2 times the tar and more than 5 times the carbon monoxide of a filtered cigarette.” This means smoking as few as two cigars per day is just as bad as smoking a pack of cigarettes, if not worse.
Cigar wrappers are also less porous than cigarette wrappers, which prevents the tobacco from burning thoroughly — this results in even higher concentrations of harmful chemicals (nitrogen oxides, ammonia, carbon monoxide and tar).
Of course, not inhaling cigar smoke (which is the traditional method) might reduce your risk of lung disease, but it also might increase your risk of mouth and neck disease. “The sort of classic use of cigars a long time ago was people didn’t inhale too much, so they tended to generate more mouth and neck cancers and less lung cancer than a cigarette does,” Stanton Glantz, a professor at University of California San Francisco’s Center for Tobacco Control Research and Education told U.S. News & World Report a couple of years ago. “But people have increasingly inhaled them — and when you inhale them, you get all the same effects as a cigarette, except that you’re taking in and burning a lot more tobacco.”
According to a 2004 study published in the Journal of the National Cancer Institute, “For most diseases, cigarette-only smokers have the highest risk, and men who exclusively smoked pipes have risks that are similar to or higher than those associated with smokers of cigars only.” This is probably because pipe smokers — like cigar smokers — traditionally don’t inhale. As a result, pipe smokers face elevated risks of cancers of the mouth, including the tongue, larynx and throat (but lower lung cancer risks).
While it’s true that RYO cigarettes don’t contain all of the 7,000 chemical compounds found in factory-made cigarettes — simply because they’re not stuffed with them during manufacturing — they still contain numerous harmful additives and chemicals. (Some argue that the concentration of additives is actually higher in many loose tobacco products.) These include tobacco-specific nitrosamines (which are some of the most potent carcinogens found in tobacco smoke), tar, nicotine and carbon monoxide.
Because of these chemicals, the risks associated with RYO cigarettes might be slightly less than those associated with regular cigarettes (but even that’s up for debate). “A useful analogy that has been used is that arguing over the difference between roll-ups and straights is like arguing whether it’s safer to jump out of the 20th or 15th floor of a building,” Deborah Arnott, chief executive of the U.S. anti-smoking organization ASH, told Independent. “Either way you’re going to hit the ground and die.”
The most widespread means of tobacco delivery, cigarettes are definitely up there on the unhealthy scale. Lighting a cigarette creates a chemical reaction called combustion, which releases at least 70 cancer-causing chemicals (as we mentioned above, there are more than 7,000 chemicals found in tobacco smoke) — e.g., acetaldehyde, arsenic, cadmium, lead and formaldehyde.
In addition to causing cancer, some of these chemicals are known to cause heart disease, lung disease and other serious health problems (most of these chemicals come from the burning of tobacco leaves, rather than the additives included in the cigarette, which explains why many of the above products are equally terrible for you).
Worse yet, smoking less than one cigarette per day is nearly as bad as smoking 10: A recent study found that smoking half a cigarette per day over a lifetime meant a 64 percent increased mortality risk, while smoking 10 cigarettes a day translated to an 87 percent greater risk.
This might be a surprising number one, but according to a 2010 study, hookah smokers inhale far more tobacco smoke per session (90,000 milliliters) than cigarette smokers (500 to 600 milliliters). Hookah smoke also contains eight times more carbon monoxide and 36 times more tar than cigarette smoke, which likely puts you at an even higher risk of lung and oral cancers, heart disease and other serious illnesses.
Now, it’s worth noting that no smokable tobacco product is “safe.” And while some methods of smoking may lead you to inhale more harmful chemicals than others, all are more than capable of killing you and the people around you (yes, even e-cigarettes). “I’d rather see people eat green, leafy vegetables than burn up green, leafy vegetables in a cigarette,” Giovino emphasizes.
So let’s cool it with the huge clouds, mmkay?