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Addict Behav. 2016 Feb;53:206-9. doi: 10.1016/j.addbeh.2015.06.035. Epub 2015 Jun 23.

Reporting of cigar use among adolescent tobacco smokers.

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Division of Adolescent Medicine, University of California, San Francisco, San Francisco, CA, United States.
Stanford Prevention Research Center in the Department of Medicine at Stanford University, Stanford, CA, United States.
Division of Adolescent Medicine, University of California, San Francisco, San Francisco, CA, United States. Electronic address:



With the changing landscape of tobacco products, the divide between cigarettes and cigars is obscured, so understanding adolescent reporting of cigar use is needed to improve best practices for surveillance, screening, and prevention/intervention. This study examined adolescents' reported cigar use and correlates of use.


Participants (N=186) were 13-17year old tobacco users participating in a prospective study of adolescent smoking behaviors. Measurement occurred at baseline and 24-months, and included demographics, nicotine dependence, tobacco use, and quit attempts. Cigar use was assessed as, "have you smoked a cigar in the last 30days" and by brand specific use in the past 30days.


Cigar use was reported by 51 adolescents (27%), and increased to 76 (41%) when identifying by brand name. African Americans (32%) were more likely to smoke cigars than whites (10%, p<.01), Asian/Pacific Islanders (3%, p=.04), and multiracial participants (24%, p=.05). Cigarette-only users smoked more per day (p=.04) and had higher cotinine levels (p=.05) than cigar users. Number of prior quit attempts (p=.84) did not differ by group. Group differences in addiction were found between cigar users and cigarette only users (p<.01). At 24months, more baseline cigar users were tobacco abstinent than cigarette only users (16% versus 7%, p<0.01, respectively).


Assessment of brand-specific cigars nearly doubled the reporting among adolescent users. Cigar users differed from cigarette-only users in consumption and likelihood of abstinence at 24-months. For more accurate surveillance and to inform treatment considerations, surveys of adolescent tobacco use should include cigars, including brand names, in the assessment strategy.


Adolescent; Black & Mild; Cigar use; Tobacco

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