A single Black & Mild exposes you to significantly more carbon monoxide and tobacco smoke than a single cigarette, largely because it contains more tobacco and takes longer to smoke. But the full picture is more nuanced: cigarette smokers typically smoke far more units per day, and the way you inhale changes the risk profile considerably. Neither product is safe, and each carries serious health consequences through different mechanisms.
More Tobacco, More Smoke Per Session
Black & Milds are cigarillos, thicker and longer-lasting than a standard cigarette, packed with more tobacco. That extra size translates directly into greater exposure during a single smoking session. A 2015 study comparing Black & Mild cigarillo smoking to cigarette smoking in people who used both products found that exhaled carbon monoxide jumped by 25 parts per million after smoking a cigarillo, compared to just 9 ppm after a cigarette. That’s nearly three times the carbon monoxide from one sitting.
Even after adjusting for the amount of tobacco burned, cigarillos still produced more carbon monoxide per gram of tobacco consumed (18 ppm/g versus 12 ppm/g) and per volume of smoke inhaled (19 ppm per 1,000 mL versus 12 ppm per 1,000 mL). The higher carbon monoxide levels suggest that cigarillo smoke also delivers greater amounts of other harmful volatile chemicals, including known carcinogens like benzene and acetaldehyde.
The Inhalation Factor
One of the biggest variables in this comparison is how deeply you inhale. Cigar and cigarillo smoke is more alkaline than cigarette smoke. Cigarillo tobacco has an average pH of about 5.70, compared to 5.46 for cigarettes. That slightly higher pH makes the smoke harsher on the lungs, which is one reason traditional cigar smokers tend to puff without deeply inhaling.
Here’s the catch: many Black & Mild smokers do inhale, especially younger users and people who also smoke cigarettes. When you inhale cigarillo smoke into your lungs the same way you’d inhale a cigarette, you’re pulling in a larger volume of toxic smoke per session. The carbon monoxide data above came from real-world dual users smoking the way they normally would, and the cigarillo numbers were dramatically higher.
Cancer Risk Is Similar Where It Counts
According to the National Cancer Institute, regular cigar smokers and cigarette smokers face similar levels of risk for oral cavity and esophageal cancers. That’s true whether or not you inhale, because every puff directly bathes your lips, mouth, tongue, throat, and voice box in carcinogens. When you swallow saliva containing those chemicals, your esophagus gets exposed too. These direct-contact exposures explain why the cancer risks for the mouth and throat are comparable regardless of the tobacco product.
Lung cancer rates are generally lower in cigar smokers than cigarette smokers, but that comparison reflects the fact that many cigar smokers don’t inhale deeply and don’t smoke as frequently. If you’re inhaling Black & Milds regularly, that gap likely narrows. And cigar smokers still have higher rates of lung cancer, heart disease, and lung disease than nonsmokers.
Heart Disease Risk
A large cohort study that followed over 17,000 men for more than two decades found that cigar smokers who had never smoked cigarettes still had a 27% higher risk of coronary heart disease compared to nonsmokers, independent of other risk factors. Cigar smoking also independently increased the risk of chronic obstructive pulmonary disease and cancers of the upper digestive and respiratory tracts. The idea that cigars or cigarillos are “heart-safe” compared to cigarettes is wrong. They carry lower cardiovascular risk than heavy cigarette use, but meaningfully higher risk than not smoking at all.
Flavoring Adds Another Layer of Concern
Black & Milds come in flavors like wine, crème, jazz, and casino. These flavors aren’t just marketing. They involve chemical additives that produce their own health effects when burned and inhaled. One well-known flavoring chemical, diacetyl, has been linked to irreversible lung damage sometimes called “popcorn lung,” a condition where the tiny airways in the lungs become scarred and narrowed.
Lab testing of Black & Mild products revealed that different flavors produce very different levels of particulate matter and reactive oxygen species, which are unstable molecules that damage cells. The Crème variety, for example, maxed out particulate matter readings across all particle sizes tested, hitting 400 mg/m³ at every measurement point. The Casino flavor produced substantially less. This means two people smoking “the same product” in different flavors could be getting very different toxic exposures, and there’s almost no transparency about what flavoring chemicals are actually in these products.
Frequency Changes Everything
The most important variable in this comparison isn’t the product itself. It’s how often you use it. A pack-a-day cigarette smoker consuming 20 cigarettes daily will almost certainly accumulate more total toxic exposure over time than someone who smokes one or two Black & Milds a week. But per unit, the Black & Mild delivers more smoke, more carbon monoxide, and a longer exposure window.
Many people reach for Black & Milds precisely because they think of them as an occasional, less harmful alternative to cigarettes. That perception is reinforced by sweet flavors and the social framing of cigarillos as something casual. In April 2022, the FDA proposed banning flavored cigars partly to address this misconception, but the rules were withdrawn in January 2025. Flavored cigarillos remain widely available and largely unregulated compared to cigarettes, which face stricter labeling, advertising, and ingredient disclosure requirements.
The Bottom Line on the Comparison
Smoking one Black & Mild delivers roughly three times the carbon monoxide of one cigarette, exposes you to more particulate matter, and carries equal cancer risk for the mouth and throat. It is, by most per-unit measures, worse than a single cigarette. The only scenario where cigarettes come out worse is the pattern most cigarette smokers actually follow: high-frequency daily use that compounds damage over years. If you’re smoking Black & Milds regularly and inhaling, you’re getting the worst of both worlds: the higher per-session toxicity of a cigarillo combined with the deep lung exposure of cigarette-style inhalation.