Nasal Polyps

Hi. I'm a doctor and I can confirm what your physician said. Compared to any other pipe smoker with a comparable risk profile you have no increased cancer risk due to your nasal polyps. That being said smoking pipes does increase cancer risk in general albeit on a much smaller scale than cigarette smoking. Especially oropharyngeal cancers. The risk increases of course with the number of bowls smoked daily (and, sadly, the consumption of hard liquor as well as genetics and other environmental risk factors). Key is moderation as with everything else. Also I'd point out that smoking indoors increases risk due to inhaling of fine particles and cancerigenig substances present in tobacco smoke a risk being reduced when smoking outside. Keep in mind that cancer isn't the only and most important risk associated to smoking. The major killer for smokers are cardiovascular events. If to avoid any risk is the issue, then no smoking would be the best course of action. But then, where would be the fun?

Doctor,
We have been hearing a lot lately about increased risk of oral cancers of the mouth & tongue from drinking alcoholic beverages while pipe smoking. Is that one of the points you are referring to? Does the alcohol kill protective enzymes or something in the mouth? Do those enzymes regenerate after drinking alcohol at other times? I assume what is being implied is that these are two activities that do Increase risk when enjoyed together. Would that be a fair statement?

Can I just add how nice it is to know we have physicians who participate in this forum.

Yes, it is the study you mention I was referring to. I do not think it is known how these factors contribute to increase cancer risk when combined on a molecular level. Alcohol is a tumor promoter in general but I think a moderate consumption does not significantly increase the risk. I must admit that I did not read the study in detail and I do not know the quantity of alcohol consumed in these cases. Some spirits are known as risk factors for oropharyngeal cancer for themselves. Back in medical school I learned that Calvados was associated to esophageal cancer for instance. Also I wanted to point out that I'm not a oncologist. My speciality is public health and I would say that I have a solid knowledge of smokin associated risk factors on a population level. In fact I'm professionally involved in the anti smoking campaigns here in my country and it's a well known fact that anti-smoking legislation has decreased smoking associated burden of disease significantly in western societies (please don't kill me for that). What one accepts on an individual level in terms of risk is a personal choice. For me, 4 to 5 bowls a week along with a nice single malt is perfectly fine. That implies if course that never would put others at risk with my habit. That's the reason I never smoke indoors even where it is allowed.

thomasmartin: I'm impressed! Very realistic and balanced approach to your smoking versus image presented to patients. Good on you!
I endorse your use of "habit" as opposed to the softer sounding "hobby" preferred by many on the forum. I love my pipes but, I would never encourage others to take up the habit. And, I often wonder if a new member, proudly announcing his/her taking up the pipe, has seriously weighed the risks for the reward. I do not begrudge the less than wise choice, I just hope they fully understand the possible ramifications of the decision. If so, more power to them and their choice. I wouldn't deny anyone the pleasure of smoking, cigarettes, cigars or pipes. It's just that on a personal level I hope they have not made the choice frivolously.

There's an interesting conflict here. While you work to eliminate smoking on a national level, you continue to see it's merits on a personal level. Your work, while commendable in that it will help reduce smoking-related illness and death in a broad scope, is concurrently working towards denying people the freedom of enjoyment that you so much appreciate.

I have nasal polyps too (since my birth) and never had any problems with it. I started pipe smoking a year (or so) ago and sometimes I wasn't able to retrohale some kinds of tobacco (the smoke just stuck in my nose ) but had success with Peterson's University Flake. Sometimes a heavier English blend still stuck but I don't care ::

jjm1- Glad to hear the biopsy came back with good news!

Doctor,
Thanks for your reply & candor. I understand there will be some level of personal risk we all assume when we partake in drinking alcoholic beverages and pipe smoking, whether enjoyed together or separately. And I believe I understand what your efforts in anti-smoking campaigns mean: for the greater good in public health. I've always thought the greater good will eventually trump individual "rights" no matter the topic. Therefore I stay away from discussions of tobacco legislation & smokers rights.
Thanks again!

This is a very interesting thread. Thank you Dr. Martin for your insight and honesty. I am a light smoker 2-3 bowls during the work week, and 2-3 a day on the weekend. I may have a whiskey with a bowl...rarely, so this is good to hear. Any advice we share here could be construed as to encourage and aid one another in either enabling a habit, or enhance the hobby experience. Two sides of the same coin really. Don't get me wrong Warren, I enjoy your posts to the upmost, and am eager to read them, as they are both entertaining and informative. I understand full well my choices have consequences, as do they all. Having watched both grand-fathers die of lung cancer from cigarettes, yet my great-grandfather living to 90 puffing on a pipe. Never once have I smoked a cigarette for this reason. JohnnyReb makes an even more salient point which perhaps I need to internalize more. Stay away from political threads.

Yes. I try to stay away from political discussions. That's why I avoid the anti-smoking legislation forum like the plague.

Most who come here have already made the decision to smoke. All, I'm saying is that I sincerely hope they've weighed the risk/reward and are adults possessed of some ability to read, digest and decide. As I said, I do not begrudge anyone the pipe, cigarette or cigar. I do, usually, refrain from responding when a new member arrives wanting to know if they should take up smoking. And, personally I would never encourage anyone to take up the habit and begin to burn money. I enjoy watching people blow up their money with fireworks, I just don't buy any myself. I do, when sometimes in a pensive mood, pipe in mouth, watching my money wafting gently upwards, wonder why I'm so frivolous with my cash. The answer is always because I enjoy it. Very selfish on my part but, we should all cater to ourselves now and then.
That said, it's what I do. I made the decision consciously but, I would not recommend smoking tobacco in any form, to anyone. It's not particularly bright fiscally nor is it beneficial to one's health. Again, I'm not putting anyone down it's simply how I feel about my lifestyle. And, I wouldn't recommend it as a lifestyle to anyone. It fits me though.

The Dr should have a weekly "Ask the Doc" questions for members here. I think it'll be pretty neat.

Oh. I don't think I'm the only physician here and I'm sure that there are more competent ones participating in this forum for smoking related health questions. As I said, I'm a public health expert and not a clinicall active Dr., oncologist, ORL, cardiologists or so. But I'm happy to contribute to discussions.

I wish there was a PM like button .