Background. Cigars and cigarettes are both smoked, but much less is known about the former's long-term health effects, due to its low prevalence and infrequent collection of cigar information in national surveys. Purpose. We conducted a follow-up mortality study of cigar-smoking men age 40-79 years in National Health Interview Surveys (NHIS). We utilized Methods. We used pooled NHIS files linked to the National Death Index to obtain follow-up from year of interview to year of death or December

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... 1, 2015. We developed categories of cigarette and cigar smoking that accommodate dual and former use of both products. We used Cox proportional hazards models, adjusted for age, race/ethnicity, marital status, education, income, health status, body mass index, and region to estimate hazard ratios (HRs, 95% confidence intervals, CI) for mortality from all causes, heart diseases, malignant neoplasms, cerebrovascular disease, chronic lower respiratory diseases and two mutually exclusive categories: smoking-related and other diseases.Results. There were 14,628 deaths from all causes, including 3,420 never tobacco users, 3,266 exclusive smokers, and 176 exclusive cigar users. The latter had significantly increased mortality only from chronic lower respiratory diseases (HR = 2.60, CI = 1.04 – 6.50), which was based on 6 deaths. We found no statistically significant evidence among exclusive cigar smokers of increased mortality from any other cause.Conclusions. This study provides evidence that male cigar smokers had elevated mortality risks. However, after accounting for cigarette smoking, we found significantly increased mortality only for chronic lower respiratory diseases.