Out with cigarettes and in with cigars, right? Well, cigars certainly have taken on a luxury image, smoked by celebrities and stocked in expensive cigar bars.

Several studies are spilling the ugly truth: cigars are just as bad for you as cigarettes. The news is timely since the sales of large cigars grew over two hundred percent in the past decade, and cigar smoking doubled in the US.

Cigars come in three basic sizes. The smallest are the size of cigarettes, and come in flavors such as chocolate and mint. The next size up are cigarillos or cheroots, which are flavored and inhaled deeply. The classic cigars are large, contain more than a half ounce of tobacco, and can enough to equal a pack of cigarettes, and take up to two hours to smoke.

Scientists measured the levels of cotinine and NNAL, two biomarkers for tobacco in 25-thousand cigar smokers. Both toxins were found in elevated levels compared to nonsmokers. In fact, the amount of NNAL, a potent carcinogen, was found in equal levels in both cigar and cigarette smokers.

This means regular cigar smokers are four to ten times more likely to die from cancers of the mouth, larynx and esophagus than non-smokers. Those who inhale have eleven times the risk of getting lung cancer, seven times the risk for cancers of the tongue, mouth or throat, and 39 times the risk for laryngeal or voice box cancer.

One long term study determined that cigar or pipe smoking people lost 5 years of being healthy and died on average 5 years earlier than non-smokers. And, just like cigarettes, cigars are addictive. So before you light up, ask yourself if your image trumps your health.