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Cornacchione Ross J, Kowitt SD, Jarman KL, Ranney LM, Lazard AJ, Thrasher JF, Sheeran P, Goldstein AO. Perceived message effectiveness of cigar warning themes among adults in the United States. Prev Med Rep 2023; 34:102236. [PMID: 37234566 PMCID: PMC10206194 DOI: 10.1016/j.pmedr.2023.102236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 03/04/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023] Open
Abstract
Most tobacco warnings focus on health harms to the consumer, but other message themes may be promising. We assessed perceived message effectiveness (PME) among adults who smoke cigars for 12 cigar warning statements to discourage smoking, and measured PME across four message themes: explicit health effects to the consumer, secondhand smoke effects, chemicals/constituents, and toxicity. Between April 23 and May 7, 2020, we conducted an online study with U.S. adults who used any cigar type in the past 30 days (n = 777). Participants were randomly assigned to view two out of 12 warnings and rate each one on PME. We analyzed PME mean ratings (range 1 [low] to 5 [high]). The warning statements for lung cancer (M = 3.91) and heart disease (M = 3.77) had the highest PME ratings; secondhand smoke (M = 3.50) and formaldehyde (M = 3.48) had the lowest PME ratings. Multilevel analyses showed that the explicit health effects theme was associated with higher PME ratings compared to other warning themes (ps < 0.05 for chemicals/constituents and secondhand smoke effects) except toxicity (p =.16). Higher awareness of consequences was associated with higher PME ratings (p <.001). Higher nicotine dependence was also associated with higher PME ratings (p = .004). Warning statements with information addressing the themes of health harms and toxicity could potentially inform those who smoke cigars about the broader harms of cigar use and should be considered in FDA labeling regulations for cigars.
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Affiliation(s)
- Jennifer Cornacchione Ross
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston Salem, NC 27157, USA
- Department of Health Law, Policy, and Management, School of Public Health, Boston University, Boston, MA 02118, USA
| | - Sarah D. Kowitt
- Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Kristen L. Jarman
- Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Leah M. Ranney
- Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Allison J. Lazard
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - James F. Thrasher
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Paschal Sheeran
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Adam O. Goldstein
- Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
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Nighbor TD, Browning KO, Reed EN, Oliver AC, DeSarno MJ, Kurti AN, Bickel WK, Higgins ST. Using an experimental tobacco marketplace to pilot test the substitutability of JUUL e-cigarettes and other alternative nicotine and tobacco products for conventional cigarettes among vulnerable populations. Prev Med 2022; 165:107122. [PMID: 35787842 PMCID: PMC9724801 DOI: 10.1016/j.ypmed.2022.107122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 05/21/2022] [Accepted: 06/27/2022] [Indexed: 11/15/2022]
Abstract
The Experimental Tobacco Marketplace (ETM) is an online research marketplace where increasing the cost of cigarettes is used to investigate the substitutability of other fixed-price tobacco products such as electronic nicotine delivery systems (ENDS). The ETM is useful for modeling effects of potential policy changes on use of various concurrently available products. To our knowledge, the ETM has not been used to investigate substitutability of newer generation e-cigarettes or populations at increased risk for smoking, heavy smoking, nicotine dependence, and smoking-attributable adverse effects. In the current pilot study, participants were 30 adult daily smokers with socioeconomic disadvantage or comorbid psychiatric conditions (substance-use disorder or mental illness). In each session, cigarette prices increased ($0.12, $0.25, $0.50, $1.00. and $2.00 per cigarette) while prices for alternative products remained fixed. Across three ETM sessions, either all products, all products except little cigars and cigarillos (LCCs), or all products except ENDS (JUUL e-cigarettes) were available. Linear regression was performed on individual participant data using log-transformed cigarette price to determine demand and substitution. Cigarette demand decreased as price increased across sessions (significantly non-zero slopes, ps ≤ 0.0001). When all products were available, ENDS substitution increased as cigarette price increased (significantly non-zero slope, p = .016). When LCCs were unavailable, ENDS again were a significant substitute (p = .008). When ENDS were unavailable, LCCs did not substitute (ps ≥ 0.48). In all sessions, participants rarely purchased other products (e.g., snus). Overall, ENDS were the most robust substitute for cigarettes, further underscoring the potential importance of ENDS availability on the impact of tobacco regulatory policies.
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Affiliation(s)
- Tyler D Nighbor
- Vermont Center on Behavior and Health, United States of America
| | - Kaitlyn O Browning
- Vermont Center on Behavior and Health, United States of America; Department of Psychiatry, University of Vermont, United States of America
| | - Ellaina N Reed
- Vermont Center on Behavior and Health, United States of America
| | | | - Michael J DeSarno
- Vermont Center on Behavior and Health, United States of America; Department of Medical Biostatistics, University of Vermont, United States of America
| | - Allison N Kurti
- Vermont Center on Behavior and Health, United States of America
| | - Warren K Bickel
- Addiction Recovery Research Center, Virginia Tech Carillion Research Institute, United States of America
| | - Stephen T Higgins
- Vermont Center on Behavior and Health, United States of America; Department of Psychiatry, University of Vermont, United States of America; Department of Psychological Science, University of Vermont, United States of America.
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Chen-Sankey J, Elhabashy M, Ajith A, Jewett B, Hacker K, Phan L, Choi K. Correlates of behavior change intents in response to a hypothetical flavored cigar sales restriction among U.S. adult flavored cigar smokers. Prev Med 2022; 165:107128. [PMID: 35780974 PMCID: PMC9722503 DOI: 10.1016/j.ypmed.2022.107128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 06/15/2022] [Accepted: 06/27/2022] [Indexed: 10/17/2022]
Abstract
Flavored cigar sales restrictions (FCSRs) may reduce cigar smoking and protect public health. This study examined the correlates of behavior change intents in response to a hypothetical FCSR. Data were from a nationally representative sample of adult flavored cigar smokers (ages ≥21; n = 343) collected through an online survey in 2021. Respondents selected their behavior change intents in response to a hypothetical FCSR, including (1) quitting cigars altogether; (2) smoking plain or non-flavored cigars; (3) smoking other flavored tobacco products; (4) smoking cannabis; and (5) other options. Weighted logistic regressions were used to examine the associations of socio-demographic backgrounds, tobacco use history, and tobacco dependence with behavioral change intents. In response to an FCSR, 15.1% of respondents would quit smoking cigars altogether, 41.6% would smoke plain cigars without flavors, 33.4% would substitute flavored cigars with other flavored tobacco products, and 29.2% would substitute flavored cigars with cannabis. Large cigar smokers and blunt smokers were less likely to quit cigars altogether than non-smokers of those products; females and racial/ethnic minorities were more likely to substitute flavored cigars with other flavored tobacco and cannabis products, respectively, than males and non-Hispanic White respondents. Results suggest that FCSRs may reduce cigar smoking among a portion of U.S. flavored cigar smokers while leaving more continuing to smoke plain cigars or transitioning to use other flavored tobacco products or cannabis. Implementing FCSRs should be accompanied by comprehensive flavored tobacco sales restrictions, cessation programs, and educational messages aimed at reducing the use of cigars and other substances.
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Affiliation(s)
- Julia Chen-Sankey
- Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, United States of America; Rutgers School of Public Health, Rutgers University, Piscataway, NJ, United States of America.
| | - Maryam Elhabashy
- Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, United States of America
| | - Aniruddh Ajith
- University of Pittsburgh, School of Medicine, Pittsburgh, PA, United States of America
| | - Bambi Jewett
- National Institute on Minority Health and Health Disparities, Division of Intramural Research, Bethesda, MD, United States of America
| | - Kiana Hacker
- National Institute on Minority Health and Health Disparities, Division of Intramural Research, Bethesda, MD, United States of America
| | - Lilianna Phan
- National Institute on Minority Health and Health Disparities, Division of Intramural Research, Bethesda, MD, United States of America
| | - Kelvin Choi
- National Institute on Minority Health and Health Disparities, Division of Intramural Research, Bethesda, MD, United States of America
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Abeyesundere N, Osborn CC, Pike Moore S, Suratkal JP, Kaur M, Otieno C, Quisenberry AJ, Klein EG, Trapl ES. Substitution of flavored cigarillos with menthol cigarettes among young adults in the U.S. Drug Alcohol Depend 2022; 239:109603. [PMID: 35987085 PMCID: PMC10983117 DOI: 10.1016/j.drugalcdep.2022.109603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 08/08/2022] [Accepted: 08/11/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Young adult cigarillo users often cite flavor as a primary reason for initiating and sustaining product use and are more likely to concurrently use other tobacco products such as menthol cigarettes. This study examines substitution with menthol cigarettes among cigarillo users facing a hypothetical ban on flavored cigarillos. METHODS Current young adult (21-28 years) cigarillo users were recruited from October 2020 to April 2021 for an online survey about cigarillo and other tobacco use behaviors. Participants (n = 500) self-reported past or current menthol cigarette experience, and if they would switch to menthol cigarettes if they could not get flavored cigarillos. Logistic regression was used to test differences in switching behaviors by level of experience with menthol cigarettes. RESULTS Most young adult cigarillo users (76.8 %) had ever used a menthol cigarette and 46.6 % reported current use of menthol cigarettes. No participant who had never used menthol cigarettes reported they would switch to menthol cigarettes. Current users were 4.2 times as likely to say they would switch after controlling for demographic characteristics and nicotine dependence. CONCLUSION Most young adult cigarillo users reported they would not switch to menthol cigarettes if flavored cigarillos became unavailable. However, participants who currently use or have used menthol cigarettes were more likely to report their intention to switch products than those who had never used menthol cigarettes. There may be a subsequent increase in menthol cigarette use among past menthol cigarette users if policies restricting flavored tobacco products exclude menthol cigarettes, diluting these policies' intended population health impact.
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Affiliation(s)
- Nichele Abeyesundere
- Department of Population and Quantitative Health Sciences, Prevention Research Center for Healthy Neighborhoods at Case Western Reserve University, Cleveland, OH, the United States of America
| | - Catherine C Osborn
- Department of Population and Quantitative Health Sciences, Prevention Research Center for Healthy Neighborhoods at Case Western Reserve University, Cleveland, OH, the United States of America
| | - Stephanie Pike Moore
- Department of Population and Quantitative Health Sciences, Prevention Research Center for Healthy Neighborhoods at Case Western Reserve University, Cleveland, OH, the United States of America
| | - Jessica P Suratkal
- Department of Population and Quantitative Health Sciences, Prevention Research Center for Healthy Neighborhoods at Case Western Reserve University, Cleveland, OH, the United States of America
| | - Manpreet Kaur
- Department of Population and Quantitative Health Sciences, Prevention Research Center for Healthy Neighborhoods at Case Western Reserve University, Cleveland, OH, the United States of America
| | - Christopher Otieno
- Department of Population and Quantitative Health Sciences, Prevention Research Center for Healthy Neighborhoods at Case Western Reserve University, Cleveland, OH, the United States of America
| | - Amanda J Quisenberry
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, the United States of America
| | - Elizabeth G Klein
- Division of Health Behavior & Health Promotion, The Ohio State University College of Public Health, Columbus, OH, the United States of America
| | - Erika S Trapl
- Department of Population and Quantitative Health Sciences, Prevention Research Center for Healthy Neighborhoods at Case Western Reserve University, Cleveland, OH, the United States of America.
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Koopman Gonzalez SJ, Trapl ES, Albert EL, Ishler KJ, Cavallo DN, Lim R, Flocke SA. "I got a little addiction": Adolescent and young adult cigarillo users' self-perceptions of addiction. Drug Alcohol Depend 2022; 231:109235. [PMID: 35042154 DOI: 10.1016/j.drugalcdep.2021.109235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 11/30/2021] [Accepted: 12/03/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND While prior research has informed how cigarette smokers understand and apply the term addiction, little is known about how this term is used by cigarillo smokers. This is an important area of study given the decline in cigarette use and increase in cigar product consumption. PURPOSE/OBJECTIVES This paper examines how cigarillo smokers self-identify in terms of addiction and the association of this identification with tobacco use, quitting experiences, and level of nicotine dependence. METHODS Transcripts from semi-structured interviews conducted in 2015-2016 with 57 participants (aged 14-28) about cigarillo use and beliefs were analyzed using a phenomenological approach to examine themes around addiction and cessation experiences. Analyses were limited to participants endorsing having a habit. Quantitative analyses were conducted to assess associations with demographics, tobacco use, addiction, cessation, and nicotine dependence for two groups: participants endorsing having an addiction to cigarillos and those who did not. RESULTS All participants described the term addiction similarly. Participants with an addiction had significantly higher nicotine dependence and self-rating of addiction than those without an addiction. Although most quitting experiences did not differ between the two groups, participants who did not identify as addicted felt that they could quit smoking cigarillos at any time. CONCLUSIONS Variations in identification with addiction are not associated with differences in definitions, use and quit experiences. Understanding self-perceptions of addiction can inform targeted communication to encourage cessation and the use of cessation resources.
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Azagba S, King JL, Shan L. Characteristics differ based on usual cigar-type use among U.S. adults: Analysis from the tobacco use supplement to the current population survey. Prev Med Rep 2022; 24:101560. [PMID: 34976627 PMCID: PMC8683945 DOI: 10.1016/j.pmedr.2021.101560] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 09/08/2021] [Accepted: 09/12/2021] [Indexed: 12/15/2022] Open
Abstract
Significant demographic heterogeneity was found based on usual cigar type. Males were more likely to use all types of cigars relative to non-use. Males were less likely to use cigarillos and filtered cigars relative to large cigars. Black adults had greater odds for using all types of cigars relative to non-use. Education, income, and other tobacco use also varied according to cigar type.
The tobacco products landscape is continually shifting, and there are concerns about the increased popularity of non-cigarette tobacco products, including cigars. This study examines characteristics associated with usual cigar-type use. Data are from the 2018–19 Tobacco Use Supplement to the Current Population Survey. Multinomial logistic regression was used to assess the association between sociodemographic characteristics and cigar-type use (i.e., large cigars, cigarillos, and little filtered cigars). Analyses also examined factors relative to large cigar use and further stratified by sex. Of 137,221 adults included in the study, 1467 used large cigars most often, 513 used cigarillos most often, 446 used little filtered cigars most often, and the remaining 134,795 did not use cigars. In adjusted models, males had greater odds for using all types of cigars relative to non-use. In contrast, males were less likely to use cigarillos (AOR 0.28, 95% CI 0.20–0.41) and filtered cigars (AOR 0.20, 95% CI 0.14–0.28) relative to large cigars. Black adults had greater odds of using all types of cigars relative to non-use, and cigarillos (AOR 3.55, 95% CI 2.47–5.08) and filtered cigars (AOR 2.50, 95% CI 1.70–3.68) relative to large cigars. Education, income, and other tobacco use also varied according to cigar type. Characteristics of those who usually use large cigars differed significantly from those who usually use cigarillos, little filtered cigars, or reported no cigar use.
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Affiliation(s)
- Sunday Azagba
- Ross and Carol Nese College of Nursing, The Pennsylvania State University, University Park, PA 16802, USA
- Corresponding author at: Ross and Carol Nese College of Nursing, The Pennsylvania State University, University Park, PA 16802, USA.
| | - Jessica L. King
- Department of Health & Kinesiology, University of Utah, Salt Lake City, UT, USA
| | - Lingpeng Shan
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH 43210, USA
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Phan L, McNeel TS, Choi K. Prevalence of current large cigar versus little cigar/cigarillo smoking among U.S. adults, 2018-2019. Prev Med Rep 2022; 24:101534. [PMID: 34976610 PMCID: PMC8683982 DOI: 10.1016/j.pmedr.2021.101534] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 08/19/2021] [Accepted: 08/22/2021] [Indexed: 11/29/2022] Open
Abstract
Prevalence of cigar use varied by type, age, and race/ethnicity in the U.S. Current large cigar smoking was more prevalent among non-Hispanic White adults. Little cigar/cigarillo (LCC) smoking was more common in non-Hispanic Black adults. LCC smoking varied significantly depending on both age and race/ethnicity. LCC smoking was most prevalent among non-Hispanic Black young adults (18–30 years).
Cigar smoking is increasing among non-Hispanic Black adults in the U.S. However, the prevalence of large and little cigar/cigarillo (LCC) smoking varying jointly by age and race/ethnicity has not been reported. We analyzed data from the 2018–2019 Tobacco Use Supplement to the Current Population Survey (n = 134,900) to fill this knowledge gap. Participants reported the type of cigar they used most often in the past 30 days (either large cigars, little cigars, or cigarillos). We estimated the prevalence of current large cigar and LCC smoking by sociodemographic characteristics. We then examined sociodemographic correlates of large cigar and LCC smoking in comparison to non-cigar smoking using a multivariable multinomial logistic regression model, and sociodemographic correlates of LCC smoking compared to large cigar smoking using a multivariable logistic regression model. Age*race/ethnicity interaction on cigar smoking was tested. Age-stratified multivariable multinomial logistic regression and logistic regression models were used to examine associations between race/ethnicity and large cigar and LCC smoking by age, adjusting for other sociodemographic variables. Overall, 1.1% and 0.8% of U.S. adults currently smoked large cigars and LCCs, with younger adults more likely to smoke both types of cigars and non-Hispanic Black adults more likely than non-Hispanic White adults to smoke LCCs. Prevalence of currently smoking LCCs varied greatly by age and race/ethnicity, with the highest prevalence of current LCC smoking being among 18–30 year-old non-Hispanic Black adults. Cigar smoking prevention and cessation efforts should prioritize non-Hispanic Black young adults who are most at risk for cigar smoking health effects.
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Affiliation(s)
- Lilianna Phan
- National Institute on Minority Health and Health Disparities Division of Intramural Research, 9000 Rockville Pike, Bethesda, MD 20892, USA
| | - Timothy S McNeel
- Information Management Services, Inc., 3901 Calverton Blvd., MD 20705, USA
| | - Kelvin Choi
- National Institute on Minority Health and Health Disparities Division of Intramural Research, 9000 Rockville Pike, Bethesda, MD 20892, USA
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Timberlake DS, Rhee J, Silver LD, Padon AA, Vos RO, Unger JB, Andersen-Rodgers E. Impact of California's tobacco and cannabis policies on the retail availability of little cigars/ cigarillos and blunt wraps. Drug Alcohol Depend 2021; 228:109064. [PMID: 34600261 DOI: 10.1016/j.drugalcdep.2021.109064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 08/30/2021] [Accepted: 09/01/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Recent changes in California's tobacco and cannabis policies could impact the retail availability of little cigars/cigarillos (LCCs) and blunt wraps that are used for blunt smoking. This study was intended to test whether tobacco flavor bans and minimum pack sizes of LCCs have reduced tobacco availability in California jurisdictions, whereas, permissive policies on sales and marketing of cannabis increased availability. METHODS Measures of retail availability of LCCs and blunt wraps were obtained from the 2016-2019 longitudinal sample of licensed tobacco retailers (LTRs, n = 4062) from California's Healthy Stores for Healthy Communities campaign. Additional data sources included the California Cannabis Local Laws database and geographic location of 1063 cannabis retailers used for constructing a spatial index of accessibility to the LTRs. Two-level generalized structural equation models were developed to assess effects of store- and jurisdiction-level predictors of change in tobacco availability (+, -, no change). RESULTS Neither permissive cannabis policies nor accessibility to cannabis retailers were associated with an increase in retail availability of the tobacco products. Enactment of a tobacco flavor ban, however, was associated with reduced availability of LCCs and blunt wraps, which was more pronounced in jurisdictions that had permissive cannabis policies (i.e. policy interaction). CONCLUSIONS A tobacco flavor ban may be an effective strategy to reduce retail availability of LCCs, blunt wraps and possibly other tobacco in California jurisdictions. This finding is of particular relevance as the tobacco industry has successfully petitioned for a referendum vote on California's statewide flavor ban in the 2022 election.
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Affiliation(s)
- David S Timberlake
- Program in Public Health, College of Health Sciences, University of California, Irvine, Anteater Instruction & Research Building, Irvine, CA 92697, United States.
| | - Joshua Rhee
- Program in Public Health, College of Health Sciences, University of California, Irvine, Anteater Instruction & Research Building, Irvine, CA 92697, United States
| | | | | | - Robert O Vos
- Spatial Sciences Institute, University of Southern California, Los Angeles, CA, United States
| | - Jennifer B Unger
- Preventive Medicine, University of Southern California, Los Angeles, CA, United States
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Dunn DS, Johnson AL, Sterling KL, Cohn AM. Differences in reasons for little cigar/cigarillo use across white and black/African American young adult users. Addict Behav 2021; 118:106884. [PMID: 33744620 DOI: 10.1016/j.addbeh.2021.106884] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 02/15/2021] [Accepted: 02/16/2021] [Indexed: 10/22/2022]
Abstract
INTRODUCTION The prevalence of little cigar and cigarillo (LCC) use among young adults is high. Research shows there are racial/ethnic differences in this prevalence, with Black/African American users more likely to report current LCC use. Given these discrepancies in LCC use, the present study aimed to assess potential differences in reasons for LCC use between White and Black/African American young adult ever and past 30-day users. METHODS Participants were White (n = 2150), and Black/African American (n = 308) young adults (aged 18 to 24) recruited from Amazon Mechanical Turk who completed an online survey of tobacco use (December 2018-January 2019). LCC users were asked eight reasons for using LCCs. RESULTS Flavoring was cited as the most popular reason for LCC use among White ever users while affordability was the most popular among Black/African American ever users. Adjusted logistic regressions among ever users revealed that Black/African American respondents (vs White) were more likely to use LCCs because of their affordability, the perception that LCCs are less harmful than cigarettes, and because of LCC advertising appeal. Among past 30-day users, adjusted logistic regression models showed that Black/African American respondents (vs White) were more likely to use LCCs because of their affordability. CONCLUSIONS Findings align with previous studies showing that LLCs are more heavily marketed in predominantly Black/African American communities. Prevention efforts should account for racial differences in reasons for use in message development.
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Zhu Y, Pasch KE, Loukas A, Sterling KL, Perry CL. Exposure to cigar Point-of-Sale marketing and use of cigars and cigarettes among young adults. Addict Behav 2021; 116:106821. [PMID: 33482429 DOI: 10.1016/j.addbeh.2021.106821] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 12/16/2020] [Accepted: 01/05/2021] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Few studies examine the impact of objective exposure to point-of-sale (POS) marketing for cigars including little cigars and cigarillos (LCCs) on tobacco use. The present study aimed to examine the relationship between exposure to LCC marketing at the POS and current and future use of LCCs and cigarettes among young adult college students. METHOD Data on LCC and cigarette use from 4201 young adult students (mean age = 22.8 [SD = 2.3]; 35.9% non-Hispanic whites) attending 24 Texas colleges was linked to objective assessments of POS marketing at 220 tobacco retail outlets within one mile of the colleges. Multilevel logistic regression analyses examined the impact of LCC marketing at the POS on use of LCCs and cigarettes currently and 6-months later. RESULTS Participants were, on average, exposed to 43 LCC marketing materials per week. Results from cross-sectional analyses indicated that exposure to LCC POS marketing was associated with higher odds of current use of LCCs (AOR = 1.003, 95% CI = 1.0002, 1.0053) and cigarettes (AOR = 1.006, 95% CI = 1.0050, 1.0075). The relationship between LCC POS marketing exposure and LCC use was not significant in longitudinal models; however, exposure to LCC POS marketing at baseline did predict current cigarette use at 6-month follow-up (AOR = 1.004, 95% CI = 1.0021, 1.0052). CONCLUSION Findings suggest a substantial influence of LCC marketing exposure at the POS. Regulations on LCC marketing at the POS, especially around college campuses, should be considered.
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Affiliation(s)
- Yenan Zhu
- Department of Kinesiology and Health Education, The University of Texas at Austin, 2109 San Jacinto D3700, Austin, TX 78712, USA
| | - Keryn E Pasch
- Department of Kinesiology and Health Education, The University of Texas at Austin, 2109 San Jacinto D3700, Austin, TX 78712, USA.
| | - Alexandra Loukas
- Department of Kinesiology and Health Education, The University of Texas at Austin, 2109 San Jacinto D3700, Austin, TX 78712, USA
| | - Kimberle L Sterling
- School of Public Health, The University of Texas Health Science Center at Houston Dallas Campus, 6011 Harry Hines Blvd V8.112, Dallas, TX 75235, USA
| | - Cheryl L Perry
- School of Public Health, The University of Texas Health Science Center at Houston Austin Campus 1616 Guadalupe Street, Suite 6.300, Austin, TX 78701, USA
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Cornacchione Ross J, Sutfin EL, Suerken C, Walker S, Wolfson M, Reboussin BA. Longitudinal associations between marijuana and cigar use in young adults. Drug Alcohol Depend 2020; 211:107964. [PMID: 32251920 PMCID: PMC7508868 DOI: 10.1016/j.drugalcdep.2020.107964] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 03/12/2020] [Accepted: 03/13/2020] [Indexed: 01/20/2023]
Abstract
BACKGROUND We assess the longitudinal associations between marijuana and cigar (little cigars and cigarillos [LCCs] and large cigars) use on subsequent initiation of marijuana and cigar use. METHODS Data are from a cohort study of 2189 young adults recruited in fall 2010 from 11 colleges in the Southeast. We used discrete-time survival analysis to examine whether ever use of marijuana at baseline (spring 2011, freshman year) predicted initiation of LCCs and large cigars and whether ever use of these cigar products predicted initiation of marijuana use across 10 waves of data collection (2011-2018). RESULTS The sample was 65.3 % female, 83.6 % White, 5.9 % Hispanic, and 61.8 % had college-educated mothers. At baseline, 70 % reported never using LCCs, 71 % reported never using large cigars, and 74 % reported never using marijuana. Ever use of marijuana at baseline was associated with an increased risk of LCC initiation (Incident rate ratio [IRR] = 1.6, 95 %CI = 1.0, 2.5) but not large cigar initiation. Ever use of LCCs (IRR = 1.4, 95 %CI = 1.1, 1.8) and ever use of large cigars (IRR = 1.3, 95 %CI = 1.1, 1.8) at baseline both predicted initiation of marijuana use. CONCLUSIONS Our findings support growing evidence that marijuana and LCCs are strongly associated and use of one substance predicts use of the other. In contrast to studies of adults, we also found that young adults who have tried large cigars may be at increased risk for subsequent marijuana use. These findings highlight the need to consider each product as a potential gateway of the other when developing interventions for young adults.
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Affiliation(s)
- Jennifer Cornacchione Ross
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston Salem, NC, 27157, USA.
| | - Erin L Sutfin
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston Salem, NC, 27157, USA
| | - Cynthia Suerken
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston Salem, NC, 27157, USA
| | - Stephannie Walker
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston Salem, NC, 27157, USA
| | - Mark Wolfson
- Department of Social Medicine, Population and Public Health, School of Medicine, University of California, Riverside, 3333 14(th)Street, Riverside, CA, 92501, USA
| | - Beth A Reboussin
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston Salem, NC, 27157, USA
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Kong G, Creamer MR, Simon P, Cavallo DA, Ross JC, Hinds JT, Fishbein H, Gutierrez K. Systematic review of cigars, cigarillos, and little cigars among adolescents: Setting research agenda to inform tobacco control policy. Addict Behav 2019; 96:192-197. [PMID: 31125939 PMCID: PMC6645397 DOI: 10.1016/j.addbeh.2019.04.032] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 04/01/2019] [Accepted: 04/28/2019] [Indexed: 01/06/2023]
Abstract
INTRODUCTION We conducted a systematic review of the literature on cigar research on youth to identify potential future research agenda to generate evidence to inform cigar regulations to prevent cigar use among youth. METHODS We searched articles on Medline, EMBASE, and PsycINFO in April 2017 to identify articles relevant to cigars and adolescents. Two independent coders examined 48 articles to determine eligibility: (1) published between 2000-April 2017; (2) published in English; (3) conducted in the United States; (4) published in a peer-review journal; (5) examined cigars, cigarillos, or little cigars; (6) included youth (12-18 years old); and (7) included empirical data. Three independent coders reviewed the included articles (n = 48) to identify whether the studies addressed FDA's Research Priorities. RESULTS The studies addressed FDA's Research Priorities of "behavior" (n = 48), "communications" (n = 4), "marketing influences" (n = 1), and "impact analysis" (n = 1). Studies on "behavior" underscored the need for improvements in measurement, such as using brand names and distinguishing cigar products. The review revealed the need for restrictions on cigar flavors, development of media campaigns and interventions, increasing the cost (via taxation), and evaluating the impact of cigar policies. CONCLUSIONS The studies mostly focused on surveillance of behaviors and use patterns, which revealed cigar specific issues to address in policies to decrease cigar use among youth. The lack of studies addressing other FDA's research priorities highlighted the critical need for future studies that inform prevention of youth cigar use.
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Affiliation(s)
- Grace Kong
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06519, United States of America.
| | - MeLisa R Creamer
- UTHealth The University of Texas Health Science Center at Houston School of Public Health in Austin, Austin, TX 78701, United States of America
| | - Patricia Simon
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06519, United States of America
| | - Dana A Cavallo
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06519, United States of America
| | - Jennifer Cornacchione Ross
- Wake Forest School of Medicine, Department of Social Sciences & Health Policy, Winston Salem, NC 27101, United States of America
| | - Josephine T Hinds
- The University of Texas at Austin, Department of Kinesiology & Health Education, Austin, TX 78712, United States of America
| | | | - Kevin Gutierrez
- Yale School of Medicine, Department of Psychiatry, New Haven, CT 06519, United States of America
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Schiavon S, Hodgin K, Sellers A, Hendricks PS, Gaggar A, Scarinci I, Cropsey KL. Differences among cigarette-only smokers compared to dual users of cigarettes and little cigars/ cigarillos in the criminal justice population. Addict Behav 2019; 90:236-240. [PMID: 30458372 DOI: 10.1016/j.addbeh.2018.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 10/31/2018] [Accepted: 11/05/2018] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The FDA has restrictions on cigarettes; however, little cigars and cigarillos (LCCs) remain largely absent from these regulations. Due to their low prices and flavoring, many engage in dual use of both LCCs and cigarettes. Dual use is particularly prevalent among low income racial/ethnic minority groups. The purpose of this study was to (U.S. Department of Health and Human Services, 2014) conduct an exploratory examination among cigarette users compared to dual users on smoking characteristics; and (Centers for Disease Control and Prevention, 2016) to examine racial differences (White and Black) among cigarette users compared to dual users. METHODS Participants (N = 500) were recruited from community corrections (i.e., parole/probation) and categorized as either cigarette-only (66.4%) or dual users (33.6%) if they used little cigars or cigarillos over a one-year period during a smoking cessation clinical trial. RESULTS Dual users were more likely to be younger, Black, males with lower educational attainment compared to cigarette-only smokers. Smokers with increased nicotine dependence were 17% more likely to be cigarette-only smokers compared to dual users. Racial differences revealed that White/cigarette-only smokers were more likely to report non-menthol use and higher cigarette consumption at the end of treatment compared to Black/cigarette-only or Black/dual users. CONCLUSIONS This study contributes to our understanding of dual use among a disenfranchised group of smokers. Overall, dual users were more likely to be younger, Black, and male with lower reported nicotine dependence compared to cigarette-only users. Racial differences revealed that non-menthol smokers as well as smokers with greater cigarettes smoked at the end of treatment were more likely White/cigarette-only smokers.
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Affiliation(s)
- Samantha Schiavon
- Department of Psychiatry and Behavioral Neurobiology, Sparks Center 1016, 1720 2(nd) Ave. South, Birmingham, AL 35294, USA.
| | - Kathleen Hodgin
- Department of Psychiatry and Behavioral Neurobiology, Sparks Center 1016, 1720 2(nd) Ave. South, Birmingham, AL 35294, USA.
| | - Aaron Sellers
- Department of Psychiatry and Behavioral Neurobiology, Sparks Center 1016, 1720 2(nd) Ave. South, Birmingham, AL 35294, USA.
| | | | - Amit Gaggar
- Department of Medicine, Division of Pulmonary, Allergy, and Critical Care, USA.
| | - Isabel Scarinci
- Department of Medicine, Division of Preventative Medicine, USA.
| | - Karen L Cropsey
- Department of Psychiatry and Behavioral Neurobiology, Sparks Center 1016, 1720 2(nd) Ave. South, Birmingham, AL 35294, USA.
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14
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Majeed BA, Nyman A, Sterling KL, Slovic P. Little cigars and cigarillos: Affect and perceived relative harm among U.S. adults, 2015. Addict Behav 2018; 85:107-112. [PMID: 29886248 DOI: 10.1016/j.addbeh.2018.05.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 05/22/2018] [Accepted: 05/24/2018] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Similar to cigarette smoking, consumption of cigars delivers nicotine and byproducts of tobacco combustion and elevates the risk of addiction, illness, and premature death. This study examined the relationship of affect, perceived relative harm, and LCC smoking behavior among U.S. adults. METHODS Data were from Tobacco Products and Risk Perceptions Survey conducted in 2015. The study included a probability based sample of 6051 adults (18+) drawn from an online research panel. A current LCC smoker was defined as having ever smoked LCCs and was currently smoking LCCs every day, somedays, or rarely. Participants were asked whether smoking LCCs was less harmful, had about the same level of harm, or was more harmful than smoking regular cigarettes. Feelings about LCCs were collected using word association technique. Descriptive and multinomial logistic regression analyses were conducted. RESULTS About 7% of the study participants were current LCC smokers. Adults with positive feelings had four-fold the adjusted odds to be current LCC smokers. Perceiving LCCs to be less harmful had 2.7 higher adjusted odds of being current LCC smokers. CONCLUSIONS Compared to cigarettes, LCCs evoked more positive feelings among adults and these positive feelings were strongly associated with both perceiving LCCs as less harmful than cigarettes and with current LCC smoking. Cessation and prevention interventions would benefit from applying the principles of social marketing in which information is provided not only to inform consumers but also to evoke negative feelings and associations with LCC smoking.
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Affiliation(s)
- Ban A Majeed
- Division of Epidemiology, Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA.
| | - Amy Nyman
- Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, GA, USA
| | | | - Paul Slovic
- Decision Research, Eugene, OR, USA; Department of Psychology, University of Oregon, Eugene, OR, USA
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15
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Giovenco DP, Spillane TE, Mauro CM, Martins SS. Cigarillo sales in legalized marijuana markets in the U.S. Drug Alcohol Depend 2018; 185:347-350. [PMID: 29500953 PMCID: PMC5997459 DOI: 10.1016/j.drugalcdep.2017.12.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 12/13/2017] [Accepted: 12/14/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Nearly half of marijuana users in the United States also smoke cigarillos, with many using the products as marijuana "blunts." The relationship between marijuana legalization and tobacco retail has not yet been examined. This study uses tobacco sales data to compare the cigarillo marketplace in states with legalized recreational marijuana to the overall U.S. marketplace in 2016. METHODS Cigarillo sales data from 2016 were obtained from the Nielsen Research Company in the following market regions: Denver, CO; Seattle, WA; Portland, OR; and the overall U.S. Descriptive statistics highlighted differences in the market share of various product features (e.g., flavors, brand, pack size) across regions. RESULTS Characteristics such as fruit flavors, single sticks, and 2-3 packs were more popular in legal marijuana regions compared to the overall U.S. Black & Mild, a brand not traditionally used for blunts, was the top brand nationally (32.8% market share), but Swisher was the top brand in legal marijuana regions. In Seattle and Portland, for example, over half of cigarillo sales were for Swisher products (59.1% and 52.1%, respectively). Cigarillo wraps (i.e., no tobacco filler) were particularly popular in Denver, constituting 11.4% all cigarillo sales versus 2.8% nationally. CONCLUSIONS Cigarillo product characteristics traditionally associated with blunt use may shape the tobacco market in legal marijuana regions. As more states continue to legalize recreational marijuana, state and local governments should anticipate the potential impact on the tobacco marketplace and implement tobacco control policies (e.g., flavor bans, minimum pack sizes) that discourage product use.
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Affiliation(s)
- Daniel P. Giovenco
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, 722 W 168th Street, New York, NY 10032, United States
| | - Torra E. Spillane
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, 722 W 168th Street, New York, NY 10032, United States,Corresponding author: Torra E. Spillane, Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, 722 W 168th Street, New York, NY 10032, United States, Phone: 212-342-0616,
| | - Christine M. Mauro
- Department of Biostatistics, Columbia University Mailman School of Public Health, 722 W 168th Street, New York, NY 10032, United States
| | - Silvia S. Martins
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W 168th Street, New York, NY 10032, United States
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Cohn A, Johnson A, Pearson J, Rose S, Ehlke S, Ganz O, Niaura R. Determining non-cigarette tobacco, alcohol, and substance use typologies across menthol and non-menthol smokers using latent class analysis. Tob Induc Dis 2017; 15:5. [PMID: 28105000 PMCID: PMC5240208 DOI: 10.1186/s12971-017-0111-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 01/04/2017] [Indexed: 12/04/2022] Open
Abstract
Background Substance use and mental health are robustly associated with smoking and poor cessation outcomes, but not often examined in combination with menthol cigarette smoking, which is also associated with lower quit rates. This study identified classes of Black and White menthol and non-menthol cigarette smokers based on demographics, alcohol, drug, and other tobacco use behaviors. Methods Using screening data from two studies, latent class analysis (LCA) was conducted to classify n = 1177 menthol and non-menthol cigarette smokers on demographic characteristics, heavy smoking, alcohol and drug use, desire to quit smoking, other tobacco product use, and use of psychotropic medication. Results Three latent classes were identified that differentiated smokers on substance use, menthol cigarette smoking, and other tobacco use behavior. One class consisted primarily of young adults who used a wide array of other tobacco products, reported the highest prevalence of other drug use, and showed the lowest desire to quit smoking cigarettes in the next 6-months. Class 2 comprised primarily of Black male menthol smokers, all of whom used cigarillos in addition to cigarettes, and who displayed moderate drug use. The third class was categorized as primarily older cigarette smokers, who engaged in very little other tobacco use or drug use, but who were most likely to self-report being prescribed psychotropic medication. Conclusions LCA allowed for the identification of distinct classes of smokers based on factors related to poor cessation outcomes, including menthol use, that have not previously been examined in combination. Interventions should target specific groups of smokers, rather than take a “one size fits all” approach.
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Affiliation(s)
- Amy Cohn
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, 900 G Street, NW, 4th Floor, Washington, DC USA ; Department of Oncology, Georgetown University Medical Center, 3970 Reservoir Road, NW, Washington, DC USA
| | - Amanda Johnson
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, 900 G Street, NW, 4th Floor, Washington, DC USA
| | - Jennifer Pearson
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, 900 G Street, NW, 4th Floor, Washington, DC USA ; Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway Street, Baltimore, MD USA
| | - Shyanika Rose
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, 900 G Street, NW, 4th Floor, Washington, DC USA
| | - Sarah Ehlke
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, 900 G Street, NW, 4th Floor, Washington, DC USA
| | - Ollie Ganz
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, 900 G Street, NW, 4th Floor, Washington, DC USA
| | - Raymond Niaura
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, 900 G Street, NW, 4th Floor, Washington, DC USA ; Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway Street, Baltimore, MD USA
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Roberts ME, Berman ML, Slater MD, Hinton A, Ferketich AK. Point-of-sale tobacco marketing in rural and urban Ohio: Could the new landscape of Tobacco products widen inequalities? Prev Med 2015; 81:232-5. [PMID: 26363447 PMCID: PMC4679669 DOI: 10.1016/j.ypmed.2015.08.024] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 08/28/2015] [Accepted: 08/31/2015] [Indexed: 11/17/2022]
Abstract
Considerable research has examined how cigarette point-of-sale advertising is closely related to smoking-related disparities across communities. Yet few studies have examined marketing of alternative tobacco products (e.g., e-cigarettes). The goal of the present study was to examine external point-of-sale marketing of various tobacco products and determine its association with community-level demographics (population density, economic-disadvantage, race/ethnicity) in urban and rural regions of Ohio. During the summer of 2014, fieldworkers collected comprehensive tobacco marketing data from 199 stores in Ohio (99 in Appalachia, 100 in Columbus), including information on external features. The address of each store was geocoded to its census tract, providing information about the community in which the store was located. Results indicated that promotions for e-cigarettes and advertising for menthol cigarettes, cigarillos, and cigars were more prevalent in communities with a higher percentage of African Americans. Cigarillos advertising was more likely in high-disadvantage and urban communities. A greater variety of products were also advertised outside retailers in urban, high-disadvantage, African American communities. Findings provide evidence of differential tobacco marketing at the external point-of-sale, which disproportionately targets urban, economically-disadvantaged, and African American communities. There is a need for tobacco control policies that will help improve equity and reduce health disparities.
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Affiliation(s)
- Megan E Roberts
- College of Public Health, The Ohio State University, 1841 Neil Avenue, Columbus, OH 43210, United States.
| | - Micah L Berman
- College of Public Health, The Ohio State University, 1841 Neil Avenue, Columbus, OH 43210, United States; Moritz College of Law, Ohio State University, 55 W 12th Ave, Columbus, OH 43210, United States
| | - Michael D Slater
- School of Communication, The Ohio State University, 154 North Oval Mall, Columbus, OH 43210, United States
| | - Alice Hinton
- College of Public Health, The Ohio State University, 1841 Neil Avenue, Columbus, OH 43210, United States
| | - Amy K Ferketich
- College of Public Health, The Ohio State University, 1841 Neil Avenue, Columbus, OH 43210, United States
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Koszowski B, Rosenberry ZR, Kanu A, Viray LC, Potts JL, Pickworth WB. Nicotine and carbon monoxide exposure from inhalation of cigarillo smoke. Pharmacol Biochem Behav 2015; 139:7-14. [PMID: 26459155 DOI: 10.1016/j.pbb.2015.10.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Revised: 09/24/2015] [Accepted: 10/08/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND There has been an increase in the use of cigarillos in the US. People who smoke cigarillos typically also regularly smoke cigarettes (dual users). METHODS We compared puffing topography, biomarkers of acute exposure [exhaled carbon monoxide (COex) and plasma nicotine] and physiologic effects from usual brand cigarette and Black & Mild cigarillo smoking in dual users (N=23) in two laboratory sessions. RESULTS Participants (21 men) smoked an average of 17.5cigarettes/day. Cigarillo consumption varied widely from as few as 1/week to daily. Participants were highly nicotine dependent (average FTND score: 6.3). There were statistically significant differences in smoking behavior between cigarette and cigarillo smoking in time to smoke, number of puffs, and total puff volume (all P<0.001). Average puff duration, interpuff interval average puff volume, and puff velocity did not differ between cigarettes and cigarillos. Nicotine boost was similar after both cigarettes and cigarillos. COex boost was significantly greater after cigarillo smoking compared to cigarette smoking (P<0.001). CONCLUSIONS The smoking pattern and exposure profile indicate that dual users inhale cigarillo smoke just as they inhale cigarette smoke thereby exposing themselves to considerable amounts of nicotine and other components of tobacco smoke. COex exposure results imply that cigarillo smoking may be associated with higher exposure to smoke-delivered volatile components of mainstream cigarillo smoke including carcinogens when compared to cigarettes. IMPACT The findings that cigarillos and cigarettes are smoked similarly in dual users are relevant to health and regulatory considerations on cigar products.
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Affiliation(s)
- Bartosz Koszowski
- Battelle Memorial Institute, Battelle Public Health Center for Tobacco Research, Baltimore, MD, United States.
| | - Zachary R Rosenberry
- Battelle Memorial Institute, Battelle Public Health Center for Tobacco Research, Baltimore, MD, United States
| | - Alieu Kanu
- Battelle Memorial Institute, Battelle Public Health Center for Tobacco Research, Baltimore, MD, United States
| | - Lauren C Viray
- Battelle Memorial Institute, Battelle Public Health Center for Tobacco Research, Baltimore, MD, United States
| | - Jennifer L Potts
- Battelle Memorial Institute, Battelle Public Health Center for Tobacco Research, Baltimore, MD, United States
| | - Wallace B Pickworth
- Battelle Memorial Institute, Battelle Public Health Center for Tobacco Research, Baltimore, MD, United States
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