Tobacco Whack-A-Mole: A Consumption Taxonomy of Cigar & Other Combustible Tobacco Products among a Nationally Representative Sample of Young Adults

Kymberle Landrum Sterling (), Katherine Masyn, Stephanie Pike Moore, Craig S. Fryer, Erika Trapl, Ce Shang and Douglas Gunzler
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Kymberle Landrum Sterling: Department of Health Promotion & Behavioral Sciences, School of Public Health, University of Texas Health Sciences Center, Dallas, TX 75207, USA
Katherine Masyn: Department of Epidemiology and Biostatistics, School of Public Health, Georgia State University, Atlanta, GA 30302, USA
Stephanie Pike Moore: Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH 44106, USA
Craig S. Fryer: Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD 20742, USA
Erika Trapl: Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH 44106, USA
Ce Shang: Department of Internal Medicine, Wexner Medical Center, Ohio State University, Columbus, OH 43210, USA
Douglas Gunzler: Department of Medicine, The MetroHealth System, Case Western Reserve University, Cleveland, OH 44106, USA

IJERPH, 2022, vol. 19, issue 22, 1-15

Abstract: Introduction: Little filtered cigars and cigarillos (LCCs) are consumed infrequently, co-administered with marijuana, and concurrently used with other tobacco products. Reliance on the past 30-day use estimate, a marker of tobacco user status, may underestimate the dynamic nature of intermittent LCC and other tobacco product use. We developed a framework to capture the intermittent nature of exclusive LCC use and dual/poly use with cigarettes and large cigars using broader timing of last product use categories and product use modality (e.g., with marijuana). Methods: Data come from the baseline C’RILLOS study, a U.S. nationally representative sample of young adults aged 18–34 ( n = 1063) collected in October 2019. We developed a consumption taxonomy framework that accounted for respondents’ modality of LCC use (i.e., use with tobacco, LCC-T, or use with marijuana as blunts, LCC-B), the exclusive use of LCCs and other tobacco products (i.e., cigarettes, and large cigars) or their co-use and the timing of last product use (i.e., ever and past 30 days, past 3 months, past 6 months, greater than 6 months). Results: Seventy-five percent of our sample reported ever use of any combustible tobacco product, including LCCs. The most common ever use pattern was poly use of LCC-T + LCC-B + cigarettes (16%). Our consumption taxonomy framework demonstrated the fluid nature of combustible tobacco product use among LCC users. For instance, among past 30-day cigarette users, 48% reported using LCC-T, 39% reported using LCC-B, and 32% reported using large cigars in the past 3 months or more. Discussion: The tobacco use field currently classifies ‘tobacco users’ based on the product they smoked in the past 30 days. Any tobacco product use beyond the past 30-day period is considered ‘discontinued use’ and not the focus of intervention or tobacco regulatory science decisions. We documented the substantial proportion of young adult LCC, cigarette, and large cigar users who either exclusively or dual/poly used these combustible products in recent (e.g., past 3 months) periods. To prevent underestimation of use, surveillance measures should assess the use modality, timing of last product use, and exclusive/multiple product use to more accurately identify the smoking status of young adult LCC users.

Keywords: cigarillo; little filtered cigar; cigarette; large cigar; tobacco use; young adults (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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