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Nicotine Tob Res. 2019 Apr 23. pii: ntz060. doi: 10.1093/ntr/ntz060. [Epub ahead of print]

Trends in Cigar Use in the United States, 2002 to 2016: Diverging Trends by Race/Ethnicity.

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Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY USA.
Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY USA.
Center for Tobacco Studies, School of Public Health, Rutgers University, Piscataway, NJ USA.
Institute for Implementation Science in Population Health, The City University of New York, New York, NY USA.
Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY USA.
Department of Clinical Psychology, Teachers College, Columbia University, New York, NY USA.
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY USA.



While there are racial/ethnic differences in cigarette use, little is known about how non-cigarette tobacco use differs among racial/ethnic groups. The current study investigated trends in cigar use from 2002 to 2016, by racial/ethnic group, in nationally representative United States (US) data.


Data were drawn from the 2002-2016 National Survey on Drug Use and Health (NSDUH) public use data files (total analytic sample n=630,547 including 54,060 past-month cigar users). Linear time trends of past-month cigar use were examined by racial/ethnic group (Non-Hispanic [NH] White, NH Black, Hispanic, NH Other/Mixed Race/Ethnicity) using logistic regression models.


In 2016, the prevalence of past-month cigar use was significantly higher among NH Black respondents than among other racial/ethnic groups (ps<0.001). Cigar use was also higher among NH White respondents than among Hispanic and NH Other/Mixed Race/Ethnicity respondents. The year by racial/ethnic group interaction was significant (p<0.001). Past-month cigar use decreased significantly from 2002 to 2016 among NH White and Hispanic respondents (ps=0.001), while no change in prevalence was observed among NH Black (p=0.779) and NH Other/Mixed Race/Ethnicity respondents (p=0.152). Cigar use decreased for NH White men (p<0.001) and did not change for NH White women (p=0.884). Conversely, cigar use increased for NH Black women (p<0.001) and did not change for NH Black men (p=0.546).


Cigar use remains significantly more common among NH Black individuals in the US and is not declining among NH Black and NH Other/Mixed Race/Ethnicity individuals over time, in contrast to declines among NH White and Hispanic individuals.


This study identified racial/ethnic differences in trends in past-month cigar use over 15 years among annual cross-sectional samples of United States individuals. The highest prevalence of cigar use in 2016 was found among non-Hispanic (NH) Black individuals. In addition, cigar use prevalence did not decline from 2002 to 2016 among NH Black and NH Other/Mixed Race/Ethnicity groups over time, in contrast to NH White and Hispanic groups. Further, cigar use increased over time for NH Black women. Targeted public health and clinical efforts may be needed to decrease the prevalence of cigar use, especially for NH Black individuals.


NSDUH; cigars; epidemiology; ethnicity; race; tobacco


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