Distribution of carboxyhaemoglobin concentrations in smokers and non-smokers.

Carboxyhaemoglobin concentrations were measured in 3487 subjects comprising 1255 non-smokers, 1933 cigarette smokers, 193 cigar smokers (39 primary, 154 secondary), and 106 pipe smokers (30 primary, 76 secondary). In cigarette smokers the mean carboxyhaemoglobin concentration was 4.78% of the total haemoglobin and 94.7% of smokers had a concentration greater than 1.7%. Primary cigar smokers had a much lower mean carboxyhaemoglobin concentration (0.93%), and only 10.3% had concentrations greater than 1.7%. Primary pipe smokers also had a low mean carboxyhaemoglobin concentration (1.36%) and none had a concentration above 1.7%. Secondary cigar smokers had a high mean concentration (6.80%) and 97.4% had values above 1.7%; the findings in secondary pipe smokers were similar--the mean concentration was 3.39%, 94.7% having values greater than 1.7%. The lower carboxyhaemoglobin concentrations in primary pipe and cigar smokers suggest that in general they do not inhale, and the raised concentrations in cigarette smokers who change to pipes or cigars suggest that they usually continue to inhale and to absorb large amounts of carbon monoxide and other constituents of tobacco smoke.