Cigar

A cigar is a tightly-rolled bundle of dried and fermented tobacco that is ignited so that its smoke may be drawn into the mouth. Cigar tobacco is grown in significant quantities in Brazil, Cameroon, Cuba, the Dominican Republic, Honduras, Indonesia, Mexico, Nicaragua, Philippines, and the Eastern United States.

Contents

Etymology

The word "cigar" originated from sikar, the Mayan-Indian word for smoking, which became cigarro in Spanish, probably from the Mayan sicar ("to smoke rolled tobacco leaves" – from sic, "tobacco;") or from the Spanish word cigarra ("grasshopper"). However, the word itself, and variations on it, did not come into general use until 1730. New names for cigars include "Jules", "Havana", "Vitole" and "Puro".[1]

History

Explorer Christopher Columbus is generally credited with the introduction of tobacco to Europe. Two of Columbus's crewmen during his 1492 journey, Rodrigo de Jerez and Luis de Torres, are said to have encountered tobacco for the first time on the island of Hispaniola, when natives presented them with dry leaves that spread a peculiar fragrance. Tobacco was widely diffused among all of the islands of the Caribbean and therefore they again encountered it in Cuba where Columbus and his men had settled.[2] His sailors reported that the Taínos on the island of Cuba smoked a primitive form of cigar, with twisted, dried tobacco leaves rolled in other leaves such as palm or plantain.

In due course, Spanish and other European sailors caught the habit, as did the Conquistadors, and smoking spread to Spain and Portugal and eventually France, most probably through Jean Nicot, the French ambassador to Portugal, who gave his name to nicotine. Later, the habit spread to Italy and, after Sir Walter Raleigh's voyages to the Americas, to Britain. Smoking became familiar throughout Europe—in pipes in Britain—by the mid-16th century and, half a century later, tobacco started to be grown commercially in America. Tobacco was originally thought to have medicinal qualities, but there were some who considered it evil. It was denounced by Philip II of Spain, and James I of England.[3]

Around 1592, the Spanish galleon San Clemente brought 50 kilograms (110 lb) of tobacco seed to the Philippines over the Acapulco-Manila trade route. The seed was then distributed among the Roman Catholic missionaries, where the clerics found excellent climates and soils for growing high-quality tobacco on Philippine soil.

In the 19th century, cigar smoking was common, while cigarettes were still comparatively rare. In the early 20th century, Rudyard Kipling wrote his famous smoking poem, "The Betrothed." The cigar business was an important industry, and factories employed many people before mechanized manufacturing of cigars became practical.

In 1869, Spanish cigar manufacturer Vicente Martinez Ybor moved his Principe de Gales (Prince of Wales) operations from the important cigar manufacturing center of Havana, Cuba to Key West, Florida to escape the turmoil of the Ten Years' War. Other manufacturers followed, and Key West became another important cigar manufacturing center. In 1885, Ybor moved again, buying land near the then-small city of Tampa, Florida and building the largest cigar factory in the world at the time[4] in the new company town of Ybor City. Friendly rival and Flor de Sánchez y Haya owner Ignacio Haya built his own factory nearby in the same year, and many other cigar manufacturers soon followed, especially after an 1886 fire that gutted much of Key West. Thousands of Cuban and Spanish tabaqueros came to the area from Key West, Cuba and New York to produce hundreds of millions of cigars annually. Local output peaked in 1929, when workers in Ybor City and West Tampa rolled over 500,000,000 "clear Havana" cigars, earning the town the nickname "Cigar Capital of the World"[5][6][7][8]

In New York, cigars were made by rollers working in their own homes. It was reported that as of 1883, cigars were being manufactured in 127 apartment houses in New York, employing 1,962 families and 7,924 individuals. A state statute banning the practice, passed late that year at the urging of trade unions on the basis that the practice suppressed wages, was ruled unconstitutional less than four months later. The industry, which had relocated to Brooklyn and other places on Long Island while the law was in effect, then returned to New York.[9]

As of 1905, there were 80,000 cigar-making operations in the United States, most of them small, family-operated shops where cigars were rolled and sold immediately.[5] While most cigars are now made by machine, some, as a matter of prestige and quality, are still rolled by hand. This is especially true in Central America and Cuba, as well as in small chinchales found in virtually every sizable city in the United States.[5] Boxes of hand-rolled cigars bear the phrase totalmente a mano (totally by hand) or hecho a mano (made by hand).

Historical figures

King Edward VII enjoyed smoking cigarettes and cigars, much to the chagrin of his mother, Queen Victoria. After her death, legend has it, King Edward said to his male guests at the end of a dinner party, "Gentlemen, you may smoke." In his name, a line of inexpensive American cigars has long been named King Edward.

U.S. President Ulysses S. Grant smoked cigars heavily, an estimated up to 12 a day. In late 1884, Grant was diagnosed with an oral cancer consisting of malignant squamous cell carcinoma. With his health failing, Grant devoted his time to his autobiography; five days after finishing it, he became the only U.S. president to die of cancer.

Sigmund Freud, the founder of Psychoanalysis, smoked 20 cigars a day, despite health warnings from colleagues.[10] Because of his frequent references to phallic symbolism, it is often claimed that his colleagues challenged him on the "phallic" shape of the cigar. Freud is supposed to have replied "sometimes a cigar is just a cigar," however, there are no records of such a conversation ever having taken place.[11] Initially concealing a cancerous growth in his mouth in 1923, Freud was eventually diagnosed with the same cancer as Grant's. Despite over 30 surgeries, and complications ranging from intense pain to insects infesting dead skin cells around the cancer, Freud smoked cigars until his life ended. Freud died at age 83 in a morphine-induced coma to relieve the pain from his cancer.[10]

Winston Churchill, who has been credited with the practice of dunking a cigar in port wine or brandy,[12] was rarely seen without a cigar during his time as Britain's wartime leader, so much so that a large cigar size was named in his honor.

Fidel Castro and his comrade Che Guevera were often seen smoking a cigar during the early days of the Cuban Revolution. But Castro has claimed to have given up smoking in the early 1980s as part of a campaign to encourage the Cuban population to smoke less on health grounds.[13] Many other celebrities were well-known cigar smokers, including Groucho Marx, George Burns, Mark Twain, Jack Benny, Milton Berle, Rush Limbaugh, and Bill Cosby.[14]

Rudyard Kipling said in his poem "The Betrothed", "And a woman is only a woman, but a good cigar is a smoke."

Apart from certain forms of heavily cured and strong snuff, the cigar is the most potent form of self-dosing with tobacco, it has long had associations of being a male rite of passage, as it may have had during the pre-Columbian era in America. Its fumes and rituals have in American and European cultures established a "men's hut"; in the 19th century, men would retire to the "smoking room" after dinner to discuss serious issues.

Manufacture

Tobacco leaves are harvested and aged using a process that combines use of heat and shade to reduce sugar and water content without causing the large leaves to rot. This first part of the process, called curing, takes between 25 and 45 days and varies substantially based upon climatic conditions as well as the construction of sheds or barns used to store harvested tobacco. The curing process is manipulated based upon the type of tobacco, and the desired color of the leaf. The second part of the process, called fermentation, is carried out under conditions designed to help the leaf die slowly. Temperature and humidity are controlled to ensure that the leaf continues to ferment, without rotting or disintegrating. This is where the flavor, burning, and aroma characteristics are primarily brought out in the leaf.

Once the leaves have aged properly, they are sorted for use as filler or wrapper based upon their appearance and overall quality. During this process, the leaves are continually moistened and handled carefully to ensure each leaf is best used according to its individual qualities. The leaf will continue to be baled, inspected, un-baled, re-inspected, and baled again repeatedly as it continues its aging cycle. When the leaf has matured according to the manufacturer's specifications, it will be used in the production of a cigar.

Quality cigars are still hand-made. An experienced cigar-roller can produce hundreds of very good, nearly identical, cigars per day. The rollers keep the tobacco moist — especially the wrapper — and use specially designed crescent-shaped knives, called chavetas, to form the filler and wrapper leaves quickly and accurately. Once rolled, the cigars are stored in wooden forms as they dry, in which their uncapped ends are cut to a uniform size. From this stage, the cigar is a complete product that can be "laid down" and aged for decades if kept as close to 21°C (70°F), and 70% relative humidity, as the environment will allow. Once cigars have been purchased, proper storage is usually accomplished by keeping the cigars in a specialized wooden box, or humidor, where conditions can be carefully controlled for long periods of time. Even if a cigar becomes dry, it can be successfully re-humidified so long as it has not been handled carelessly and done so gradually. The loss of original tobacco oils, however, will greatly affect the taste.

Some cigars, especially premium brands, use different varieties of tobacco for the filler and the wrapper. Long filler cigars are a far higher quality of cigar, using long leaves throughout. These cigars also use a third variety of tobacco leaf, called a "binder", between the filler and the outer wrapper. This permits the makers to use more delicate and attractive leaves as a wrapper. These high-quality cigars almost always blend varieties of tobacco. Even Cuban long-filler cigars will combine tobaccos from different parts of the island to incorporate several different flavors.

In low-grade and machine-made cigars, chopped tobacco leaves are used for the filler, and long leaves or a type of "paper" made from tobacco pulp is used for the wrapper which binds the cigar together. This alters the burning characteristics of the cigar, causing hand-made cigars to be sought-after.

Historically, a lector or reader was always employed to entertain cigar factory workers. This practice became obsolete once audio books for portable music players became available, but it is still practiced in some Cuban factories. The name for the Montecristo cigar brand may have arisen from this practice.

Dominant manufacturers

Two firms dominate the cigar industry. Altadis, the world's largest cigar producer, produces cigars in the United States, the Dominican Republic, and Honduras, and has a 50% stake in Corporación Habanos in Cuba. It also makes cigarettes. Swedish Match, the second largest producer, produces cigars in Honduras, Belgium, Germany, Indonesia, the United States, and the Dominican Republic; it also makes chewing and pipe tobacco, snuff, lighters, and matches.[15]

Families in the cigar industry

Nearly all modern cigar makers are members of long-established cigar families, or purport to be [1] The art and skill of hand-making premium cigars has been passed from generation to generation; families are often shown in many cigar advertisements and packaging [16]

In 1992, Cigar Aficionado magazine created the "Cigar Hall of Fame" and recognized the following six individuals:[17]

Perhaps the best-known cigar family in the world is the Arturo Fuente family. Now led by father and son Carlos Fuente, Sr. and Jr. The Fuente family has been rolling their Arturo Fuente and Montesino cigars since 1912. The release of the Fuente Fuente OpusX in 1995 heralded the first quality wrapper grown in the Dominican Republic. The oldest Dominican Republic cigar maker is the León family, who have been making their León Jimenes and La Aurora cigars on the island since 1905.

Not only are premium cigar-makers typically families, but so are those who grow the premium cigar tobacco. The Oliva family has been growing cigar tobacco since 1934 and their family's tobacco is found in nearly every major cigar brand sold on the US market. Some families, such as the well-known Padrons, have crossed over from tobacco growing to cigar making. While the Padron family has been growing tobacco since the 1850s, they began making cigars that bear their family's name in 1964. Like the Padrons, the Carlos Torano family first began growing tobacco in 1916 before they started rolling their own family's brands, which also bear the family name, in the 1990s.

Families are such an important part of the premium cigar industry that the term "cigar family" is a registered trademark of the Arturo Fuente and J.C. Newman families, used to distinguish and identify their families, premium cigar brands, and charitable foundation. Even the premium cigars made by the cigar industry's two corporate conglomerates, Altadis and Swedish Match, are overseen by members of two cigar families, Altadis' Benjamin Menendez and Swedish Match's Ernesto Perez-Carrillo.

Marketing and distribution

Cigars are marketed via advertisements, product placement in movies and other media, sporting events, cigar-friendly magazines such as Cigar Aficionado, and cigar dinners. Advertisements often include depictions of affluence, sexual imagery, and explicit or implied celebrity endorsement.[18]

Cigar Aficionado, launched in 1992, was credited both by cigar companies and readers in transforming the U.S. cigar smoking market from a small blue-collar segment to an upscale market promoted in places like luxury hotels and golf courses. The magazine presents cigars as symbols of a successful lifestyle, and is a major conduit of advertisements that do not conform to the tobacco industry's voluntary advertisement restrictions since 1965, such as a restriction not to associate smoking with glamour. The magazine also systematically presents pro-smoking arguments at length, arguing that cigars are safer than cigarettes, that life is dangerous anyway, that (contrary to the evidence discussed in Health effects) cigar smoking has health benefits, that moderation eliminates most or all health risk, that cigar smokers live to old age, that health research is flawed, and that strategically selected health-research results support claims of safety.[19] Like its competitor Smoke, Cigar Aficionado differs from marketing vehicles used for other tobacco products in that it makes cigars the focus of the entire magazine, creating a symbiosis between product and lifestyle.[20]

In the U.S., cigars are exempt from many of the marketing regulations that govern cigarettes. For example, the Public Health Cigarette Smoking Act of 1970 exempted cigars from its advertising ban,[21] and cigar ads, unlike cigarette ads, need not mention health risks.[18] As of 2007, cigars were taxed far less than cigarettes, so much so that in many U.S. states, a pack of little cigars cost less than half as much as a pack of cigarettes.[21] It is illegal for minors to purchase cigars and other tobacco products in the U.S., but laws are unevenly enforced: a 2000 study found that three-quarters of Internet cigar marketing sites allowed minors to purchase cigars.[22]

Inexpensive cigars are sold in convenience stores, grocery stores, and pharmacies, mostly as self-serve items. Premium cigars are sold in tobacconists, cigar bars, and other specialized establishments.[23] Some cigar stores are part of chains, which have varied in size: in the U.S., United Cigar Stores was one of only three outstanding examples of national chains in the early 1920s, the others being A&P and Woolworth's.[24] Non-traditional outlets for cigars include hotel shops, restaurants, vending machines[23] and the Internet.[22]

Composition

Cigars are composed of three types of tobacco leaves, whose variations determine smoking and flavor characteristics:

Wrappers

A cigar's outermost leaves, or wrapper, come from the widest part of the plant. The wrapper determines much of the cigar's character and flavor, and as such its color is often used to describe the cigar as a whole. Over 100 wrapper shades are identified by manufacturers, but the seven most common classifications are as follows, from lightest to darkest:[25]

Color Description
Double Claro very light, slightly greenish (also called Candela, American Market Selection or jade); achieved by picking leaves before maturity and drying quickly, the color coming from retained green chlorophyll; formerly popular, now rare.
Claro very light tan or yellowish. Indicative of shade-grown tobacco.
Colorado Claro medium brown, includes Natural and English Market Selection
Colorado Distinctive reddish-brown (also called Rosado or Corojo)
Colorado Maduro darker brown; often associated with African wrapper from Cameroon, and Honduran or Nicaraguan grown wrapper from Cuban seed.
Maduro Very dark brown or black; primarily grown in Connecticut, Mexico, Nicaragua and Brazil.
Oscuro Very black, (also called Double Maduro), often oily in appearance; has become more popular in the 2000s; mainly grown in Cuba, Nicaragua, Brazil, Mexico, and Connecticut, USA.

Some manufacturers use an alternate designation:

Designation Acronym Description
American Market Selection AMS synonymous with Double Claro
English Market Selection EMS typically Colorado Claro, but can refer to any color stronger than Double Claro but milder than Maduro
Spanish Market Selection SMS either of the two darkest colors, Maduro and Oscuro

In general, dark wrappers add a touch of sweetness, while light ones add a hint of dryness to the taste.

Fillers

The majority of a cigar is made up of fillers, wrapped-up bunches of leaves inside the wrapper. Fillers of various strengths are usually blended to produce desired cigar flavors. In the cigar industry this is referred to as a "blend". Many cigar manufacturers pride themselves in constructing the perfect blend(s) that will give the smoker the most enjoyment. The more oils present in the tobacco leaf, the stronger (less dry) the filler. Types range from the minimally flavored Volado taken from the bottom of the plant, through the light-flavored Seco (dry) taken from the middle of the plant, to the strong Ligero from the upper leaves exposed to the most sunlight. Fatter cigars of larger gauge hold more filler, with greater potential to provide a full body and complex flavor. However, this effect can be diminished because of the generally poorer burn characteristics of thicker cigars (greater than 50 ring gauge), and the fact that these cigars burn cooler. This can prevent the full spectrum of flavors from being easily detectable. When used, Ligero is always folded into the middle of the filler because it burns slowly.

Fillers can be either long or short; long filler uses whole leaves and is of a better quality, while short filler, also called "mixed", uses chopped leaves, stems, and other bits. Recently some manufacturers have created what they term "medium filler" cigars. They use larger pieces of leaf than short filler without stems, and are of better quality than short filler cigars. Short filler cigars are easy to identify when smoked since they often burn hotter and tend to release bits of leaf into the smoker's mouth. Long filled cigars of high quality should burn evenly and consistently. Also available is a filler called "sandwich" (sometimes "Cuban sandwich") which is a cigar made by rolling short leaf inside long outer leaf. If a cigar is completely constructed (filler, binder and wrapper) of tobacco from only one country, it is referred to in the cigar industry as a "puro" which in Spanish means "pure."

Binders

Binders are elastic leaves used to hold together the bunches of fillers. Essentially, binders are wrappers that are rejected because of holes, blemishes, discoloration, or excess veins.

Size and shape

Cigars are commonly categorized by the size and shape of the cigar, which together are known as the vitola.

The size of a cigar is measured by two dimensions: its ring gauge (its diameter in sixty-fourths of an inch) and its length (in inches).

Parejo

The most common shape is the parejo, sometimes referred to as simply "coronas", which have traditionally been the benchmark against which all other cigar formats are measured. They have a cylindrical body, straight sides, one end open, and a round tobacco-leaf "cap" on the other end which must be sliced off, have a V-shaped notch made in it with a special cutter, or punched through before smoking.

Parejos are designated by the following terms:

Term Length in inches Width in 64ths of an inch Metric length Metric width Etymology
Rothschild 4 + ½ 48 11 cm 19 mm after the Rothschild family
Robusto 4 + ⅞ 50 12 cm 20 mm
Small Panatela 5 33 13 cm 13 mm
Petit Corona 5 + ⅛ 42 13 cm 17 mm
Carlota 5 + ⅝ 35 14 cm 14 mm
Corona 5 + ½ 42 14 cm 17 mm
Corona Gorda 5 + ⅝ 46 14 cm 18 mm
Panatela 6 38 15 cm 15 mm
Toro 6 50 15 cm 20 mm
Corona Grande 6 + ⅛ 42 16 cm 17 mm
Lonsdale 6 + ½ 42 17 cm 17 mm named for Hugh Cecil Lowther, 5th Earl of Lonsdale
Churchill 7 47-50 18 cm 19–20 mm named for Sir Winston Churchill
Double Corona 7 + ⅝ 49 19 cm 19 mm
Presidente 8 50 20 cm 20 mm
Gran Corona 9 + ¼ 47 23 cm 19 mm
Double Toro/Gordo 6 60 15 cm 24 mm

These dimensions are, at best, idealized. Actual dimensions can vary considerably.

Figurado

Irregularly shaped cigars are known as figurados and are sometimes considered of higher quality because they are more difficult to make.

Historically, especially during the 19th century, figurados were the most popular shapes; however, by the 1930s they had fallen out of fashion and all but disappeared. They have, however, recently received a small resurgence in popularity, and there are currently many brands (manufacturers) that produce figurados alongside the simpler parejos. The Cuban cigar brand Cuaba only has figurados in their range.

Figurados include the following:

Figurado Description
Torpedo Like a parejo except that the cap is pointed.
Pyramid Has a broad foot and evenly narrows to a pointed cap.
Perfecto Narrow at both ends and bulged in the middle.
Presidente/Diadema shaped like a parejo but considered a figurado because of its enormous size and occasional closed foot akin to a perfecto.
Culebras Three long, pointed cigars braided together.
Tuscan/Toscano The typical Italian cigar, created in the early 19th century when Kentucky tobacco was hybridized with local varieties and used to create a long, tough, slim cigar thicker in the middle and tapered at the ends, with a very strong aroma. It is also known as a cheroot, which is the largest selling cigar shape in the United States.

Arturo Fuente, a large cigar manufacturer based in the Dominican Republic, has also manufactured figurados in exotic shapes ranging from chilli peppers to baseball bats and American footballs. They are highly collectible and extremely expensive, when publicly available. In practice, the terms Torpedo and Pyramid are often used interchangeably, even among very knowledgeable cigar smokers. Min Ron Nee, the Hong Kong-based cigar expert whose work An Illustrated Encyclopaedia of Post-Revolution Havana Cigars is considered to be the definitive work on cigars and cigar terms, defines Torpedo as "cigar slang". Nee thinks the majority is right (because slang is defined by majority usage) and torpedoes are pyramids by another name.

Little cigars

Little cigars (sometimes called small cigars or miniatures in the UK) differ greatly from regular cigars. They weigh less than cigars and cigarillos,[26] but, more importantly, they resemble cigarettes in size, shape, packaging, and filters.[27] Sales of little cigars quadrupled in the U.S. from 1971 to 1973 in response to the Public Health Cigarette Smoking Act, which banned the broadcast of cigarette advertisements and required stronger health warnings on cigarette packs. Cigars were exempt from the ban, and perhaps more importantly, were taxed at a far lower rate. Little cigars are sometimes called "cigarettes in disguise", and unsuccessful attempts have been made to reclassify them as cigarettes. In the United States, sales of little cigars reached an all-time high in 2006, fueled in great part by their taxation loophole.[21]

Smoking

To smoke a cigar, a smoker cuts the closed end or 'cap', lights the other end, then puts the unlit end into the mouth and draws smoke into the mouth. Some smokers inhale the smoke into the lungs, particularly with little cigars, but this is uncommon otherwise. A smoker may swirl the smoke around in the mouth before exhaling it, and may exhale part of the smoke through the nose in order to smell the cigar better as well as to taste it.

Cutting

Although some cigars are cut on both ends, or twirled at both ends, the vast majority come with one straight cut end and one end in a "cap". Most quality handmade cigars, regardless of shape, will have a cap which is one or more small pieces of a wrapper pasted on to one end of the cigar with either a natural tobacco paste or with a mixture of flour and water. The cap end of a cigar must be cut off for the cigar to be smoked properly. It is the rounded end without the tobacco exposed, and this is the end one should always cut. If the cap is cut jaggedly or without care, the end of the cigar will not burn evenly and smokeable tobacco will be lost. Some cigar manufacturers purposely place different types of tobacco from one end to the other to give the cigar smokers a variety of tastes, body and strength from start to finish. Smoking a cigar from the wrong end may result in a bad experience.

There are three basic types of cigar cutters:

Lighting

The "head" of the cigar is usually the end closest to the cigar band. The opposite end of the cigar is called the "foot". The band identifies the type of the cigar and may be removed or left on. The smoker cuts the cap from the head of the cigar and ignites the foot of the cigar. The smoker draws smoke from the head of the cigar with the mouth and lips, usually not inhaling into the lungs.

When lighting, the cigar should be rotated to achieve an even burn and the air should be slowly drawn with gentle puffs. Cigars can be lit with the use of butane-filled lighters. Butane is colorless, odorless and burns clean with very little, if any, flavor. It is not recommended to use fluid-filled lighters and paper matches since they can influence the taste. Another option is wooden matches. They are not treated and soaked with sulfur and thus the smoke is not affected with chemicals. [28]

Cigars packaged in metal tubes will typically include a thin wrapping of cedar. This may be used to light the cigar, eliminating the problem of lighters or matches affecting the taste.

Flavor

Each brand and type of cigar tastes different. While the wrapper does not entirely determine the flavor of the cigar, darker wrappers tend to produce a sweetness, while lighter wrappers usually have a "drier" taste. Whether a cigar is mild, medium, or full bodied does not correlate with quality. Some words used to describe cigar flavor and texture include; spicy, peppery (red or black), sweet, harsh, burnt, green, earthy, woody, cocoa, roasted, aged, nutty, creamy, cedar, oak, chewy, fruity, and leathery.

Cigar smoke, which is rarely inhaled, tastes of tobacco with nuances of other tastes. Many different things affect the scent of cigar smoke: tobacco type, quality of the cigar, added flavors, age and humidity, production method (handmade vs. machine-made) and more. A fine cigar can taste completely different from inhaled cigarette smoke. When smoke is inhaled, as is usual with cigarettes, the tobacco flavor is less noticeable than the sensation from the smoke. Some cigar enthusiasts use a vocabulary similar to that of wine-tasters to describe the overtones and undertones observed while smoking a cigar. Journals are available for recording personal ratings, description of flavors observed, sizes, brands, etc. Cigar tasting is in such respects similar to wine, brandy, whisky, tea, coffee, and beer tasting.

Smoke

Smoke is produced by incomplete combustion of tobacco during which at least three kinds of chemical reactions occur: pyrolysis breaks down organic molecules into simpler ones, pyrosynthesis recombines these newly formed fragments into chemicals not originally present, and distillation moves compounds such as nicotine from the tobacco into the smoke. For every gram of tobacco smoked, a cigar emits about 120–140 mg of carbon dioxide, 40–60 mg of carbon monoxide, 3–4 mg of isoprene, 1 mg each of hydrogen cyanide and acetaldehyde, and smaller quantities of a large spectrum of volatile N-nitrosamines and volatile organic compounds, with the detailed composition unknown.[29]

The most odorous chemicals in cigar smoke, and arguably the most responsible for the odor, are pyridines. Along with pyrazines, they are also the most odorous chemicals in cigar smoker's breath. These substances are noticeable even at extremely low concentrations of a few parts per billion. During smoking, it is not known whether these chemicals are generated by splitting the chemical bonds of nicotine, or by Maillard reaction between amino acids and sugars in the tobacco.[30]

Cigar smoke is more alkaline than cigarette smoke, and therefore dissolves and is absorbed more readily by the mucous membrane of the mouth, making it easier for the smoker to absorb nicotine without having to inhale.[31]

Humidors

The level of humidity in which cigars are kept has a significant effect on their taste. It is believed that a cigar's flavor best evolves when stored at a relative humidity of approximately 68-74% and a temperature of 64 °F. An ideal rate of humidity allows an even burning of the cigar. Conversely, dry cigars become fragile and burn faster while damp cigars burn unevenly and take on a heavy acidic flavor. Humidors together with their humidifiers are then used to serve this purpose. Humidor's interior lining is basically constructed with three types of wood: Spanish cedar, American (or Canadian) red cedar, and Honduran mahogany.

Most humidors come with a plastic or metal case with a sponge that works as the humidifier, although most recent versions come on polymer acryl. The latter must be filled only with distilled water, and the former may use a solution of propylene glycol and distilled water. Humidifiers may become contaminated with bacteria and should be replaced every two years to avoid such contamination.

Humidors also come with analog or digital hygrometers. There are three systems of analog hygrometers: analog hygrometers with a metal spring, analog natural hair hygrometers, and analog synthetic hair hygrometers.[32]

Accessories

There are a wide variety of cigar accessories on the market. Their prices may vary depending on the materials used and the quality of the finishing.

Cigar travel cases

Travel cases are intended to protect cigars from the environmental elements and to avoid the possibility of cigars being crushed. Most travel cases come in expandable or sturdy leather. They should be thick enough to protect cigars, and the inside should not have a strong leather smell that could affect the cigar's taste. Some of these cases come with either cardboard or metal tubes that add protection and prevent the cigar from becoming permeated with the leather.

Silver and brass cigar travel cases are also available as well as wood cigar cases. The latter can range from affordable cases to handcrafted ones, while the former tend to be quite expensive.

Cigar tubes

Cigar tubes are used to carry small numbers of cigars, typically one or five. The latter tube would be called 5-finger tube and the former 1-finger tube. They are usually made from stainless steel. Cigar tubes are normally used when one is out for a few hours, but if it is necessary to spend longer periods of time out, there are tubes that come with a built in humidifier and hygrometer.

Cigar holders

Cigar holders are also known as cigar stands and are used to keep the cigars out of ashtrays. Also, cigar holders may refer to a tube in which the cigar is held while smoked. These are mostly used by women, and rarely by men.

Health effects

Like other forms of tobacco use, cigar smoking poses a significant health risk depending on dosage: risks are greater for those who inhale more when they smoke, smoke more cigars, or smoke them longer.[33] The risk of dying from any cause is statistically greater for cigar smokers than for people who have never smoked, with the risk higher for smokers less than 65 years old, and with risk for moderate and deep inhalers reaching levels similar to cigarette smokers.[34] For those who inhale or smoke several cigars a day, types of health risk can be similar to those associated with cigarette smoking: nicotine addiction, periodontal disease, tooth loss, and many types of cancer, including cancers of the mouth, throat, and esophagus.[35] Cigar smoking can also cause cancers of the lung and larynx. Cigar smoking can also increase the risk of lung and heart diseases such as chronic obstructive pulmonary disease.[35][33] Little cigars are commonly inhaled and likely pose the same health risks as cigarettes.[36] When cigar smokers don’t inhale or smoke few cigars per day, the risks of disease are greatly reduced compared to heavy cigar smokers.[35] The increased risk for those smoking 1–2 cigars per day is too small to be statistically significant,[34] and the health risks of the 3/4 of cigar smokers who smoke less than daily are not established,[37] and are hard to measure.

Popularity

The prevalence of cigar smoking varies depending on location, historical period, and population surveyed, and prevalence estimates vary somewhat depending on the survey method. The U.S. is the top consuming country by far, followed by Germany and the UK; the U.S. and western Europe account for about 75% of cigar sales worldwide.[15] The 2005 U.S. National Health Interview Survey estimated that 2.2% of adults smoke cigars, about the same as smokeless tobacco but far less than the 21% of adults who smoke cigarettes; it also estimated that 4.3% of men but only 0.3% of women smoke cigars.[38] The 2002 U.S. National Survey of Drug Use and Health found that adults with serious psychological distress are significantly more likely to smoke cigars than those without.[39] A 2007 California study found that gay men and bisexual women smoke significantly fewer cigars than the general population of men and women, respectively.[40] Substantial and steady increases in cigar smoking were observed during the 1990s and early 2000s in the U.S. among both adults and adolescents.[27] Data suggest that cigar usage among young adult males increased threefold during the 1990s, a 1999–2000 survey of 31,107 young adult U.S. military recruits found that 12.3% smoked cigars,[41] and a 2003–2004 survey of 4,486 high school students in a Midwestern county found that 18% smoked cigars.[42]

Cuban cigars

Cuban cigars are rolled from tobacco leaves found throughout the country of Cuba. The filler, binder, and wrapper may come from different portions of the island. All cigar production in Cuba is controlled by the Cuban government, and each brand may be rolled in several different factories in Cuba. Cuban cigar rollers or "torcedores" are claimed by cigar experts to be the most skilled rollers in the world. Torcedores are highly respected in Cuban society and culture and travel worldwide displaying their art of hand rolling cigars.[43]

Habanos SA and Cubatabaco between them do all the work relating to Cuban cigars, including manufacture, quality control, promotion and distribution, and export. Cuba produces both handmade and machine made cigars. All boxes and labels are marked Hecho en Cuba (made in Cuba). Machine-bunched cigars finished by hand add Hecho a mano, while fully hand-made cigars say Totalmente a mano in script text, though not all Cuban cigars will include this statement. Because of the perceived status of Cuban cigars, counterfeits are somewhat commonplace.[44]

Despite American trade sanctions against Cuban products, cigars remain one of the country's leading exports. The country exported 77 million cigars in 1991, 67 million in 1992, and 57 million in 1993, the decline attributed to a loss of much of the wrapper crop in a hurricane.[45]

United States embargo against Cuba

On February 7, 1962, United States President John F. Kennedy imposed a trade embargo on Cuba to sanction Fidel Castro's communist government. According to Pierre Salinger, then Kennedy's press secretary, the president ordered him on the evening of February 6 to obtain 1,200 H. Upmann brand petit corona Cuban cigars; upon Salinger's arrival with the cigars the following morning, Kennedy signed the executive order which put the embargo into effect.[47] Richard Goodwin, a White House assistant to Presidents Kennedy and Johnson, revealed in a 2000 New York Times article that in early 1962 JFK told him, "We tried to exempt cigars, but the cigar manufacturers in Tampa objected."[48]

The embargo prohibited US residents from legally purchasing Cuban cigars and American cigar manufacturers from importing Cuban tobacco. As a result, Cuba was deprived of its major customer for tobacco and American cigar manufacturers either had to find an alternative source of tobacco or go out of business.[49]

In the United States, authentic Cuban-made cigars are seen as "forbidden fruit" for Americans to purchase. Upon the expropriation of private property in Cuba, many former Cuban cigar manufacturers moved to other countries (primarily the Dominican Republic) to continue production.[50] The Dominican Republic's production of tobacco grew significantly as a result.[51] After reallocation, most Cuban manufacturers continued to use their known company name, seed, and harvesting technique while Cubatabaco, Cuba's state tobacco monopoly after the Revolution, independently continued production of cigars using the former private company names.[50] As a result, cigar name brands like Romeo y Julieta, Gloria Cubana, Montecristo among others, exist in both Cuba and the Dominican Republic.[52] Honduras and Nicaragua are also mass manufactures of cigars. Some Cuban refugees make cigars in the U.S. and advertise them as "Cuban" cigars, using the argument that the cigars are made by Cubans.[53]

It remains illegal for US residents to purchase or import Cuban cigars regardless of where they are in the world,[54] although they are readily available across the northern border in Canada and the southern border in Mexico. While Cuban cigars are smuggled into the USA and sold at high prices, counterfeiting is rife; it has been said that 95% of Cuban cigars sold in the USA are counterfeit.[55] Although Cuban cigars cannot legally be imported into the USA, the advent of the Internet has made it much easier for people in the United States to purchase cigars online from other countries, especially when shipped without bands. Cuban cigars are openly advertised in some European tourist regions, catering to the American market, even though it is illegal to advertise tobacco in most European regions.[56]

Cigars specific to other countries

Italy produces the sigaro toscano (Tuscan cigar), a dry cigar, very different from the moist Havana style. Tuscan-style cigars are also manufactured in the United States, only by The Avanti Cigar Co. of Scranton, Pennsylvania. Their brands include Parodi, De Nobili, Petri, and the anisette-flavored Avanti.[57]

The cheroot is traditionally associated with Burma and India.

In popular culture

Major U.S. print media portray cigars favorably; they generally frame cigar use as a lucrative business or a trendy habit, rather than as a health risk.[58] Rich people are often caricatured as wearing top hats and tails and smoking cigars. Cigars are often smoked to celebrate special occasions: the birth of a child, a graduation, a big sale. The expression "close but no cigar" comes from the practice of giving cigars as prizes in games involving good aim at fairgrounds.

See also

Footnotes

  1. ^ "Online Etymology Dictionary". Etymonline.com. http://www.etymonline.com/index.php?search=cigar&searchmode=none. Retrieved 2010-10-25. 
  2. ^ Van Lancker JL (1977). "Smoking and disease" (PDF). NIDA Res Monogr (17): 230–88. PMID 417256. http://nida.nih.gov/pdf/monographs/17.pdf#page=243. 
  3. ^ "A bit of History". Cigars Review. http://www.cigars-review.org/history.htm. Retrieved 8 April 2011. 
  4. ^ Ybor City Museum State Park
  5. ^ a b c "Frank, Michael "Wise old hands", ''Cigar Aficionado'' (Winter 1993)". Cigaraficionado.com. 1993-12-01. http://www.cigaraficionado.com/Cigar/CA_Archives/CA_Show_Article/0,2322,803,00.html. Retrieved 2010-10-25. 
  6. ^ Ingalls, Robert (2003). Tampa Cigar Workers: A Pictorial History. Gainesville, Florida: University Press of Florida. ISBN 0813026024. 
  7. ^ Jamison, Gayla (Producer, Director, Writer) (1987). Living in America: 100 Years of Ybor City (video documentary). Tampa, Fl: Lightfoot Films, Inc.. 
  8. ^ Lastra, Frank (2006). Ybor City: The Making of a Landmark Town. University of Tampa Press. ISBN 159732003X. 
  9. ^ ""Tenement cigar making", ''New York Times'' (January 30, 1884)". New York Times. http://query.nytimes.com/mem/archive-free/pdf?_r=1&res=9F0CE7DF1238E033A25753C3A9679C94659FD7CF. Retrieved 2010-10-25. 
  10. ^ a b Hafner JW, Sturgis EM (2008). "The famous faces with oral cavity and pharyngeal cancer" (PDF). Tex Dent J 125 (5): 410–29. PMID 18561797. http://doep.org/ODU2008.pdf. Retrieved 2009-06-05. 
  11. ^ Attributed in Bartlett, Familiar Quotations 15th Ed. 679
  12. ^ Online Havana Cigars (2008). "Cigar Tips". http://www.onlinehavanacigars.com/pages/cigarTips.htm. Retrieved 2008-12-09. 
  13. ^ Stubbs J (2005). "Tobacco in the Contrapunteo: Ortiz and the Havana cigar". In Font MA, Quiroz AW (eds.). Cuban Counterpoints: the Legacy of Fernando Ortiz. Lexington. pp. 105–24. ISBN 978-0739109687. 
  14. ^ "The top 100 cigar smokers of the twentieth century". Cigar Aficionado. Nov/Dec 1999. http://www.cigaraficionado.com/Cigar/CA_Archives/CA_Show_Article/0,2322,1140,00.html. 
  15. ^ a b Rarick CA (2008-04-02). Note on the premium cigar industry. SSRN. SSRN 1127582. 
  16. ^ "The Change at C.A.O. | Cigar Stars". Cigar Aficionado. 2004-04-01. http://www.cigaraficionado.com/Cigar/CA_Profiles/Cigar_Stars_Profile/0,2547,138,00.html. Retrieved 2010-10-25. 
  17. ^ "Cigar Aficionado Magazine Cigar Hall of Fame". Cigaraficionado.com. 2002-12-01. http://www.cigaraficionado.com/Cigar/CA_Archives/CA_Show_Article/0,2322,1320,00.html. Retrieved 2010-10-25. 
  18. ^ a b Baker F, Ainsworth SR, Dye JT et al. (2000). "Health risks associated with cigar smoking". JAMA 284 (6): 735–40. doi:10.1001/jama.284.6.735. PMID 10927783. 
  19. ^ DeSantis AD, Morgan SE (2003). "Sometimes a cigar [magazine] is more than just a cigar [magazine]: pro-smoking arguments in Cigar Aficionado, 1992–2000". Health Commun 15 (4): 457–80. doi:10.1207/S15327027HC1504_05. PMID 14557079. 
  20. ^ Wenger LD, Malone RE, George A, Bero LA (2001). "Cigar magazines: using tobacco to sell a lifestyle". Tob Control 10 (3): 279–84. doi:10.1136/tc.10.3.279. PMC 1747592. PMID 11544394. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1747592. 
  21. ^ a b c Delnevo CD, Hrywna M (2007). "'A whole 'nother smoke' or a cigarette in disguise: how RJ Reynolds reframed the image of little cigars". Am J Public Health 97 (8): 1368–75. doi:10.2105/AJPH.2006.101063. PMC 1931466. PMID 17600253. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1931466. 
  22. ^ a b Malone RE, Bero LA (2000). "Cigars, youth, and the Internet link" (PDF). Am J Public Health 90 (5): 790–2. doi:10.2105/AJPH.90.5.790. PMC 1446234. PMID 10800432. http://www.ajph.org/cgi/reprint/90/5/790.pdf. 
  23. ^ a b Slade J (1998). "Marketing and promotion of cigars". In Shopland DR, Burns DM, Hoffman D, Cummings KM, Amacher RH (eds.) (PDF). Cigars: Health Effects and Trends. Smoking and Tobacco Control Monograph No. 9. National Cancer Institute. pp. 195–219. http://cancercontrol.cancer.gov/tcrb/monographs/9/m9_7.PDF. Retrieved 2008-12-11. 
  24. ^ Hayward WS, White P, Fleek HS, Mac Intyre H (1922). "The chain store field". Chain Stores: Their Management and Operation. New York: McGraw-Hill. pp. 16–31. OCLC 255149441. 
  25. ^ Perelman, Richard, Perelman's Pocket Cyclopedia of Cigars Perelman, Pioneer & Co. ISBN 1-893273-05-09 (2004) p.12
  26. ^ Connolly GN (1998). "Policies regulating cigars". In Shopland DR, Burns DM, Hoffman D, Cummings KM, Amacher RH (eds.) (PDF). Cigars: Health Effects and Trends. Smoking and Tobacco Control Monograph No. 9. National Cancer Institute. pp. 221–32. http://cancercontrol.cancer.gov/tcrb/monographs/9/m9_8.PDF. Retrieved 2008-03-15. 
  27. ^ a b Delnevo CD (2006). "Smokers' choice: what explains the steady growth of cigar use in the U.S.?" (PDF). Public Health Rep 121 (2): 116–9. PMC 1525261. PMID 16528942. http://www.publichealthreports.org/userfiles/121_2/121116.pdf. 
  28. ^ Lighting Cigars Article, Cigars4Dummies, 2009
  29. ^ Hoffmann D, Hoffmann I (1998). "Chemistry and toxicology". In Shopland DR, Burns DM, Hoffman D, Cummings KM, Amacher RH (eds.) (PDF). Cigars: Health Effects and Trends. Smoking and Tobacco Control Monograph No. 9. National Cancer Institute. pp. 55–104. http://cancercontrol.cancer.gov/tcrb/monographs/9/m9_3.PDF. Retrieved 2008-03-15. 
  30. ^ Bazemore R, Harrison C, Greenberg M (2006). "Identification of components responsible for the odor of cigar smoker's breath". J Agric Food Chem 54 (2): 497–501. doi:10.1021/jf0519109. PMID 16417311. 
  31. ^ Viegas CA (2008). "Noncigarette forms of tobacco use". J Bras Pneumol 34 (12): 1069–73. doi:10.1590/S1806-37132008001200013. PMID 19180343. http://scielo.br/scielo.php?script=sci_arttext&pid=S1806-37132008001200013&lng=en&nrm=iso&tlng=en. 
  32. ^ "Humidor Guide". http://www.humidor-guide.com. Retrieved 2010-05-19. 
  33. ^ a b Symm B, Morgan MV, Blackshear Y, Tinsley S (2005). "Cigar smoking: an ignored public health threat". J Prim Prev 26 (4): 363–75. doi:10.1007/s10935-005-5389-z. PMID 15995804. 
  34. ^ a b Shanks TG, Burns DM (1998). "Disease consequences of cigar smoking". In Shopland DR, Burns DM, Hoffman D, Cummings KM, Amacher RH (eds.) (PDF). Cigars: Health Effects and Trends. Smoking and Tobacco Control Monograph No. 9. National Cancer Institute. pp. 105–160. http://cancercontrol.cancer.gov/tcrb/monographs/9/m9_4.PDF. Retrieved 2008-10-21. 
  35. ^ a b c Burns DM (1998). "Cigar smoking: overview and current state of the science". In Shopland DR, Burns DM, Hoffman D, Cummings KM, Amacher RH (eds.) (PDF). Cigars: Health Effects and Trends. Smoking and Tobacco Control Monograph No. 9. National Cancer Institute. pp. 1–20. http://cancercontrol.cancer.gov/tcrb/monographs/9/m9_1.PDF. Retrieved 2008-12-02. 
  36. ^ Dollar KM, Mix JM, Kozlowski LT (2008). "Little cigars, big cigars: omissions and commissions of harm and harm reduction information on the Internet". Nicotine Tob Res 10 (5): 819–26. doi:10.1080/14622200802027214. PMID 18569755. 
  37. ^ "Questions and answers about cigar smoking and cancer". National Cancer Institute. 2000-03-07. http://www.cancer.gov/cancertopics/factsheet/Tobacco/cigars. Retrieved 2008-10-21. 
  38. ^ Mariolis P, Rock VJ, Asman K et al. (2006). "Tobacco use among adults—United States, 2005". MMWR Morb Mortal Wkly Rep 55 (42): 1145–8. PMID 17065979. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5542a1.htm. 
  39. ^ Hagman BT, Delnevo CD, Hrywna M, Williams JM (2008). "Tobacco use among those with serious psychological distress: results from the national survey of drug use and health, 2002". Addict Behav 33 (4): 582–92. doi:10.1016/j.addbeh.2007.11.007. PMC 2696205. PMID 18158218. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2696205. 
  40. ^ Gruskin EP, Greenwood GL, Matevia M, Pollack LM, Bye LL, Albright V (2007). "Cigar and smokeless tobacco use in the lesbian, gay, and bisexual population". Nicotine Tob Res 9 (9): 937–40. doi:10.1080/14622200701488426. PMID 17763109. 
  41. ^ Vander Weg MW, Peterson AL, Ebbert JO, Debon M, Klesges RC, Haddock CK (2008). "Prevalence of alternative forms of tobacco use in a population of young adult military recruits". Addict Behav 33 (1): 69–82. doi:10.1016/j.addbeh.2007.07.005. PMC 2101765. PMID 17706889. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2101765. 
  42. ^ Brooks A, Gaier Larkin EM, Kishore S, Frank S (2008). "Cigars, cigarettes, and adolescents". Am J Health Behav 32 (6): 640–9. doi:10.5555/ajhb.2008.32.6.640. PMID 18442343. http://png.publisher.ingentaconnect.com/content/png/ajhb/2008/00000032/00000006/art00008. 
  43. ^ RIVERA, Maricarmen (2002-04-29). "CUBAN GOLD GETS ROLLED IN VINELAND / STORE OFFERS CIGARS ROLLED BY CUBAN HANDS". The Press of Atlantic City. http://nl.newsbank.com/nl-search/we/Archives?p_product=AC&p_theme=ac&p_action=search&p_maxdocs=200&p_topdoc=1&p_text_direct-0=0F338C43ACDEC4B0&p_field_direct-0=document_id&p_perpage=10&p_sort=YMD_date:D&s_trackval=GooglePM. Retrieved 2009-03-08. 
  44. ^ "Identifying Counterfeit Cuban Cigars". Decaturspirits.com. http://www.decaturspirits.com/cigars/fakecubans/. Retrieved 2010-10-25. 
  45. ^ Marvin R. Shanken, "Inside Cuban Cigars: Cigar Aficionado Interviews Cubatabaco's Top Official, Francisco Padron", Cigar Aficionado, vol. 2, no. 3 (Spring 1994), pp. 75-83.
  46. ^ "Che's Habanos" by Jesus Arboleya and Roberto F. Campos, Cigar Aficionado, October 1997
  47. ^ "Kennedy, Cuba and Cigars". Cigar Aficionado. 1992-09-01. http://www.cigaraficionado.com/Cigar/CA_Archives/CA_Show_Article/0,2322,862,00.html. Retrieved 2010-10-25. 
  48. ^ Goodwin R (2000-07-05). "President Kennedy's plan for peace with Cuba". New York Times. http://query.nytimes.com/gst/fullpage.html?res=9E0DEFDB1039F936A35754C0A9669C8B63. Retrieved 2008-09-20. 
  49. ^ "Florida Cigars: Artistry, Labor, and Politics in Florida’s Oldest Industry" - Archives of the State of Florida
  50. ^ a b Tad Gage (1997). The Complete Idiot's Guide to Cigars. Alpha Books. p. 80. ISBN 9780028619750. http://books.google.com/books?id=XA6UfOmVfAMC&pg=PA80. Retrieved 2 August 2010. 
  51. ^ Economist Intelligence Unit (Great Britain) (1998). Country report: Cuba, Dominican Republic, Haiti, Puerto Rico. The Unit. http://books.google.com/books?id=x9iyAAAAIAAJ. Retrieved 2 August 2010. 
  52. ^ Bret Saxon; Steve Stein (1 March 1998). The Art of the Shmooze. SP Books. pp. 224–30. ISBN 9781561719761. http://books.google.com/books?id=m6QibvnDErMC&pg=PA229. Retrieved 2 August 2010. 
  53. ^ Gould LE (2007-05-30). "Las Vegas cigar lounges roll out the welcome mat". Los Angeles Times. http://travel.latimes.com/articles/la-trw-vegas3jun03. Retrieved 2008-09-11. 
  54. ^ "Office of Foreign Assets Control: "Cuban Cigar Update"" (PDF). 2004-09-30. http://www.treasury.gov/resource-center/sanctions/Documents/ccigar2.pdf. Retrieved 2011-10-15. 
  55. ^ Steve Saka (2002-02-22). "The Ultimate Counterfeit Cuban Cigar Primer". http://www.cigarnexus.com/counsel/counterfeit. Retrieved 2008-03-12. 
  56. ^ Karen Slama (1995). Tobacco and health. Springer Science & Business. pp. 78–. ISBN 9780306451119. http://books.google.com/books?id=iomVoBt-qFcC&pg=PA78. Retrieved 2 August 2010. 
  57. ^ www.avanticigar.com/avarticle.html
  58. ^ Wenger L, Malone R, Bero L (2001). "The cigar revival and the popular press: a content analysis, 1987–1997". Am J Public Health 91 (2): 288–91. doi:10.2105/AJPH.91.2.288. PMC 1446522. PMID 11211641. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1446522. 

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