In a study of 3528 participants, 9% reported pipe smoking, 11% reported cigar smoking, and 52% reported cigarette smoking.Self-reported current pipe and cigar smokers had elevated urine cotinine levels compared with never-smokers.
Participants who smoked pipes or cigars had increased odds of airflow obstruction.
Pipe and cigar smoking increased urine cotinine levels and was associated with decreased lung function and increased odds of airflow obstruction, even in participants who had never smoked cigarettes.
References:
http://www.annals.org/content/152/4/201.short
http://www.annals.org/content/152/4/259.short
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