Cigarettes were the most common form of tobacco until vaping took over in 2014. The Oxford Dictionary defines a cigarette as a “thin cylinder of finely cut tobacco rolled in paper for smoking.” There are a variety of cigarettes which each offer a different experience. However, whether its filter-less or filtered, menthol or regular, smoking cigarettes is detrimental to our health.

Vaping  is technically a type of smokeless tobacco, but given the rise in popularity, it has become its own type of tobacco. Vaping is the more common term for e-cigarettes and electronic nicotine delivery systems or ENDS. Vaping is done through a battery-operated device to heat up a liquid, which contains nicotine (or marijuana), flavoring, and chemicals. When the liquid is heated, it creates the vapors which are then inhaled and exhaled. There are more than 450 different kinds of vaping devices on the market. Vaping is the number one form of tobacco used by youth smokers. In 2023, 1 out of every 22 middle school student and 1 in every 10 high school student had vaped within the last month

Cigars and Cigarillos  are unique as they not only contain the tobacco within their casing, but their casing is traditionally a tobacco leaf. In fact, according to the US tax code, the wrapping must contain tobacco as well. It’s tobacco on tobacco! Cigars are the largest form for smoking tobacco, with cigarillos being smaller than cigars but larger than cigarettes.

There are unique perspectives on cigar smoking which show clear differences between race and socioeconomic class. Cigarello usage is highest in young Black male populations, while cigar smoking is higher with older while male populations.  Cigar smoking is perceived as more attractive than cigarette smoking with adults and seen to be less addictive than cigarettes with youth.

The bottom line is that cigar smoking is just as bad for someone’s health as smoking a cigarette, vaping, or smokeless tobacco because tobacco is present in all of these forms

Smokeless tobacco is defined as tobacco usage through chewing or snuffing. Tobacco meant for chewing is simply dried tobacco leaves which are chewed to activate nicotine. Snuff comes in two forms—dry and wet.  Dry is not common in the US, as it is finely ground and meant to be snorted. Wet snuff, also called dip, is loose or pre-packed pouched of ground tobacco that is placed around the gum and the nicotine is absorbed through the gumline.

Smokeless tobacco was in the news in 2023 when the FDA noted that it was better than cigarettes. Context is critical here as they said it was only better when looking at lung cancer. Since this type of tobacco is not inhaled and never gets to the lungs, that makes sense. It does, however, have a significantly higher rate of cancer in the mouth and esophagus.

Pipes are rare in the tobacco use world—it’s so small there is not a pipe-smoking only statistic, as they lump it in with smokeless tobacco, which was only 2.6% in 2020. Research shows pipe smokers are generally male, over 45, and located in the Midwest.  But it is a form of tobacco use, with the dried leaves being placed in a pipe, lit, and then inhaled.

Hookahs are similar to pipes, but uses charcoal to heat the tobacco and water to cool the smoke before it is inhaled. While some may think this layer of “filtration” helps lower the risk, it does not. In fact, because hookahs use charcoal to heat the tobacco, there are increased levels of carbon monoxide, metals, and other carcinogens. Additionally, the juice the hookah produces is linked to increased mouth cancers.