Smoking Pipe Tobacco: Exposure and Health

Silvana Barbosa, National Center for Health Research

Smoking pipe tobacco has been around for centuries. Pipe smoking typically consists of loose leaf tobacco that is fire-cured and burned in a traditional smoking pipe with a bowl and mouthpiece. Although pipe smoking has dwindled over the years, the proportion of regular users varies by state and ranges from 3% to 13%.1 More surprising, 1.4% of high school students nationwide currently smoke a pipe.2

Is Smoking Pipe Tobacco Safe?

While it is often assumed to be safer than smoking cigarettes, smoking pipe tobacco is still very harmful to the health of the user. Like cigarettes, pipe tobacco contains nicotine and is therefore addictive. In addition, nicotine has a harmful impact on adolescent brain development. This is especially worrisome because 90% of smokers started using tobacco before the age of 18. For pregnant women, nicotine harms the fetal brain and increases the risk of stillbirth and preterm birth. Other harmful effects of nicotine include increased risk for forming a blood clot, lightheadedness, changes in heart rate, and nausea.3

Pipe tobacco contains toxic chemicals that increase the risk for some cancers. A study conducted by the prestigious American Association for Cancer Research found that people who smoke pipe tobacco are more likely to develop cancer of the head and neck, liver, and lung.  This risk was higher for people who smoked more often, had smoked for more years, or who inhaled more deeply. Even if users do not inhale, they are still exposed to toxic chemicals in the tobacco smoke released by the pipe. The only way to reduce the risk of these cancers is to quit smoking. Cancer risk decreases over the years following quitting. 4

According to the National Cancer Institute, the U.S. government’s major research institute on cancer, there is no safe form of tobacco, and all forms of tobacco are harmful and addictive.5

What are the Effects of Smoking Pipe Tobacco Around Others?

Smoking pipe tobacco is not only harmful to the health of the user, but it is also a serious health risk to anyone exposed to its smoke. Secondhand smoke is classified as a known human carcinogen because it contains many of the harmful chemicals that are in the smoke directly inhaled by smokers.

Children exposed to secondhand smoke have an increased risk of sudden infant death syndrome, ear infections, respiratory infections, and far more frequent and severe asthma attacks. Adults exposed to secondhand smoke have increased risk of heart disease, stroke, lung cancer, and reduced fertility. Pregnant women are especially susceptible to the harms of secondhand smoke, because it can cause pregnancy complications such as low birth weights and preterm birth.

Since 1964, approximately 2.5 million nonsmokers have died from health problems caused by exposure to secondhand smoke. Opening windows and using air filters does not protect others from inhaling secondhand smoke. The only way to protect nonsmokers from secondhand smoke is for smokers to stop smoking.6

There are also numerous health hazards associated with exposure to thirdhand smoke. Thirdhand smoke is residue from tobacco smoke that stays on surfaces and objects, like clothing, bedding, and furniture. The tobacco residue may remain on surfaces and objects for several months.

Children are most susceptible to thirdhand smoke. Children breathe faster and inhale more than adults, have greater hand-to-mouth contact, and absorb more chemicals through their skin. Exposed children are more likely to have coughing fits associated with mucus production.

Research also suggests that thirdhand smoke causes genetic damage that can increase the risk of developing cancer in the future. For example, studies in mice found increased risk for lung cancer and liver damage from thirdhand smoke.7 To learn more about thirdhand smoke, please see here.

The Bottom Line

Like cigarettes, smoking pipe tobacco is not safe. Pipe tobacco contains many of the harmful chemicals found in cigarettes, including nicotine and toxic chemicals known to cause cancer. Smoking pipe tobacco is addictive, and users have an increased risk of head and neck, liver, and lung cancers.

Smoking pipe tobacco also jeopardizes the health of those around you. Secondhand smoke causes cancer and is especially harmful to pregnant women and children. Recent studies are discovering the harms of thirdhand smoke. Children face greater health risks than adults because the exposure is proportionally greater. The only way prevent harm from tobacco smoke is for the smoker to quit smoking.

For information on quitting smoking, see here.

All articles are reviewed and approved by Dr. Diana Zuckerman and other senior staff.


1. Centers for Disease Control and Prevention. (2018). State-Specific Prevalence of Tobacco Product Use Among Adults – United States 2014-2015. Morbidity and Mortality Weekly Report 67(3): 97-102
2. Food and Drug Administration. (2018). Pipe Tobacco. Retrieved from Accessed on April 25, 2019.
3. Bahl, Rajiv. (2018). From E-Cigs to Tobacco: Here’s How Nicotine Affects the Body. Retrieved from Accessed on April 25, 2019
4. Malhotra, Jyoti, Borron, Claire, Freedman, Neal D., Abnet, Christian C., van den Brandt, Piet A., White, Emily, Milne, Roger L., Giles, Graham G., and Boffetta,  Paolo. (2017). Association between Cigar or Pipe Smoking and Cancer Risk in Men: A Pooled Analysis of Five Cohort Studies. American Association for Cancer Research 10(12): 704-709
5. National Cancer Institute (2017). Harms of Cigarette Smoking and Health Benefits of Quitting. Retrieved from Accessed April 25, 2019
6. Centers for Disease Control and Prevention. (2018). Secondhand Smoke Facts. Retrieved from Accessed April 25, 2019.
7. Drehmer, Jeremy E., Walters, Bethany Hipple, Nabi-Burza, Emara and Winickoff, Jonathan P. (2017). Guidance for the Clinical Management of Thirdhand Smoke Exposure in the Child Health Care Setting. Journal of Clinical Outcomes Management 24(12): 551-559