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December 3, 1997

Cigar Smoke Syncope

Author Affiliations

Michigan State University East Lansing
Ingham Regional Medical Center Lansing, Mich

JAMA. 1997;278(21):1744. doi:10.1001/jama.1997.03550210042035

To the Editor.  —Although the prevalence of cigar smoking had been declining since 1970, recently it has increased with a US consumption of 4.5 billion cigars in 1996.1 Cigar dinners are a "fashionable" forum in which cigar smoking is encouraged. In this report, we describe a patient who had a syncopal episode most likely attributable to the toxic effects of cigar smoke.

Report of a Case.  —A 61-year-old man was brought to the hospital by ambulance after a syncopal episode. He was at a crowded cigar dinner and had just finished smoking 2 cigars (Manifiesto Gran Reserva-Corona, 13.8 g; CAO-Robusto, 11.3 g). After beginning the third cigar (El Sublimato-Churchill), he developed light-headedness, diaphoresis, and nausea. He was in a confined space with a great deal of surrounding smoke and went outside the restaurant to "get fresh air." He lost consciousness (for approximately 12 minutes), only to reawaken in the

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