Cigar smoking

Ischaemic heart disease - Cigar smoking Factor

If there is a history of cigar smoking it will be necessary to obtain information about:

• the quantity smoked (the number of cigars smoked per week);
• when this took place; and
• the reasons for smoking.

The evidence gathered should be as complete and accurate as possible. Information already held in departmental files, eg in previous statements and clinical notes, should not be overlooked. Conflicting evidence should be resolved.

Before a causal link between a smoking habit and service may be established, consideration must be given to Repatriation Commission Guideline CM5030 - Guideline for claims assessors on smoking and alcohol related conditions and military service.

Last reviewed for CCPS 27 April 2010.

Investigative Documents

Preliminary questions [7883]

26916 there is some evidence that cigar smoking may be a factor in the development or worsening of the condition under consideration.

9190     the veteran has established the causal connection between the cigar smoking and VEA service for ischaemic heart disease.

7946     the veteran has established the causal connection between the cigar smoking and VEA service for the clinical onset of ischaemic heart disease.

7947     the veteran has established the causal connection between the cigar smoking and operational service for the clinical onset of ischaemic heart disease.

4921     the veteran has some period or periods of cigar smoking that are causally related to operational service.

or

7948     the veteran has established the causal connection between the cigar smoking and eligible service for the clinical onset of ischaemic heart disease.

4922     the veteran has some period or periods of cigar smoking that are causally related to eligible service.

or

7334     the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.

7335     the condition under consideration permanently worsened.

9191     the veteran has established the causal connection between the cigar smoking and VEA service for the clinical worsening of ischaemic heart disease.

9192     the veteran has established the causal connection between the cigar smoking and operational service for the clinical worsening of ischaemic heart disease.

33469 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the cigar smoking is causally related.

or

9193     the veteran has established the causal connection between the cigar smoking and eligible service for the clinical worsening of ischaemic heart disease.

33474 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the cigar smoking is causally related.

Clinical onset and operational service [7947]

26917 the veteran had ceased smoking cigars at the time of the clinical onset of the condition under consideration.

27818  the veteran has established the causal connection between the cigar smoking which had ceased prior to the clinical onset of ischaemic heart disease and operational service for the clinical onset of ischaemic heart disease.

26921   the veteran smoked 20 pack years of operational service cigars prior to the clinical onset of ischaemic heart disease.

or

26920   the veteran smoked 5 or more, but less than 20, pack years of operational service cigars and the clinical onset of the condition under consideration occurred within fifteen years of smoking cessation.

or

27851   the veteran smoked 5 pack years of operational service cigars before the clinical onset of ischaemic heart disease.

27850   the veteran smoked 1 or more, but less than 5, pack years of operational service cigars and the clinical onset of the condition under consideration occurred within five years of smoking cessation.

or

27848  the veteran has established the causal connection between the cigar smoking which had not ceased prior to the clinical onset of ischaemic heart disease and operational service for the clinical onset of ischaemic heart disease.

27852   the veteran smoked an average of at least 1 operational service cigar per day for at least the 1 year before the clinical onset of the condition under consideration.

or

27853   the veteran smoked at least 1 pack year of operational service cigars before the clinical onset of the condition under consideration.

Clinical onset and eligible service [7948]

26917 the veteran had ceased smoking cigars at the time of the clinical onset of the condition under consideration.

27820  the veteran has established the causal connection between the cigar smoking which had ceased prior to the clinical onset of ischaemic heart disease and eligible service for the clinical onset of ischaemic heart disease.

27302   the veteran smoked at least 5 pack years of cigars and the clinical onset of the condition under consideration occurred within five years of smoking cessation.

or

26919   the veteran smoked 5 pack years of cigars before the clinical onset of ischaemic heart disease.

26918   the veteran smoked 1 or more, but less than 5, pack years of cigars and the clinical onset of the condition under consideration occurred within three years of smoking cessation.

or

27819  the veteran has established the causal connection between the cigar smoking which had not ceased prior to the clinical onset of ischaemic heart disease and eligible service for the clinical onset of ischaemic heart disease.

7949     the veteran smoked an average of at least 1 cigar per day for at least the 1 year before the clinical onset of ischaemic heart disease.

or

27824   the veteran smoked at least 1 pack year of cigars before the clinical onset of ischaemic heart disease.

Clinical worsening and operational service [9192]

26923 the veteran had ceased smoking cigars at the time of the clinical worsening of the condition under consideration.

27821  the veteran has established the causal connection between the cigar smoking which had ceased prior to the clinical worsening of ischaemic heart disease and operational service for the clinical worsening of ischaemic heart disease.

26926   the veteran smoked at least 20 pack years of operational service cigars before the clinical worsening of ischaemic heart disease.

or

26925   the veteran smoked 5 or more, but less than 20, pack years of cigars and the clinical worsening of ischaemic heart disease occurred within fifteen years of smoking cessation.

or

27855   the veteran smoked 5 pack years of operational service cigars prior to the clinical worsening of ischaemic heart disease.

27854   the veteran smoked 1 or more, but less than 5, pack years of operational service cigars and the clinical worsening of the condition under consideration occurred within five years of smoking cessation.

or

27849  the veteran has established the causal connection between the cigar smoking which had not ceased prior to the clinical worsening of ischaemic heart disease and operational service for the clinical worsening of ischaemic heart disease.

27856   the veteran smoked an average of at least 1 operational service cigar per day for at least the 1 year before the clinical worsening of the condition under consideration.

or

27857   the veteran smoked at least 1 pack year of operational service cigars before the clinical worsening of ischaemic heart disease.

Clinical worsening and eligible service [9193]

26923 the veteran had ceased smoking cigars at the time of the clinical worsening of the condition under consideration.

27823  the veteran has established the causal connection between the cigar smoking which had ceased prior to the clinical worsening of ischaemic heart disease and eligible service for the clinical worsening of ischaemic heart disease.

27303   the veteran smoked at least 5 pack years of cigars and the clinical worsening of the condition under consideration occurred within five years of smoking cessation.

or

27825   the veteran smoked 5 pack years of cigars prior to the clinical worsening of ischaemic heart disease.

26924   the veteran smoked 1 or more, but less than 5, pack years of cigars and the clinical worsening of the condition under consideration occurred within three years of smoking cessation.

or

27822  the veteran has established the causal connection between the cigar smoking which had not ceased prior to the clinical worsening of ischaemic heart disease and eligible service for the clinical worsening of ischaemic heart disease.

9194     the veteran smoked an average of at least 1 cigar per day for at least the 1 year before the clinical worsening of ischaemic heart disease.

or

27827   the veteran smoked at least 1 pack year of cigars before the clinical worsening of ischaemic heart disease.