Risk Perceptions of Little Cigar and Cigarillo Smoking Among Adult Current Cigarette Smokers

Introduction Few studies have examined the perceptions of risk of little cigar and cigarillo (LCC) smoking among cigarette smokers, which is important for expanding regulatory policies and developing prevention programs. We examined current cigarette smokers' perceived harm of LCC smoking, and determined whether these perceptions were associated with susceptibility and intention to continue smoking LCCs. Methods Data were from the 2014 Tobacco Products and Risk Perceptions Survey of a probability sample of 5717 US adults. Data were analyzed for a subsample of 1191 current cigarette smokers who were stratified into three groups: (1) dual current cigarette smokers who had ever used LCCs, (2) current smokers susceptible to LCC smoking, and (3) current smokers who were not susceptible to LCC smoking. Results Overall, 47.2% of participants were dual smokers, 12.7% were susceptible to LCC smoking, and 40.1% were not susceptible. Perceptions of risk of LCCs varied across the groups. Dual smokers were more likely to perceive that daily LCC smoking is "very risky" (OR = 1.64, 95% CI = 1.08, 2.41) while occasional LCC smoking is only "somewhat risky" (OR = 1.71, 95% CI = 1.02, 2.87). Of the dual smokers, 20.7% intended to continue smoking LCCs in the future. Perceptions of addiction and risk of daily LCC smoking significantly predicted intention to continue LCC smoking. Addiction perceptions also significantly predicted susceptibility to initiate LCC smoking. Conclusions Perceptions about harms from and addiction to LCCs could predict future LCC smoking. Health communication campaigns need to address the harms of LCCs. Implications Our data suggest that perceptions of risk about the addictiveness of LCCs and frequency of use are important determinants of the LCC smoking susceptibility among some cigarette smokers and intended continued use among cigarette smokers with a history of LCC use. Health communication campaigns should address misperceptions related to LCCs.

[1]  P. Fagan,et al.  The Most Natural Tobacco Used: A Qualitative Investigation of Young Adult Smokers' Risk Perceptions of Flavored Little Cigars and Cigarillos. , 2016, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[2]  K. A. Holmes,et al.  Results of a National Survey , 2016 .

[3]  Amy M. Cohn,et al.  The Other Combustible Products: Prevalence and Correlates of Little Cigar/Cigarillo Use Among Cigarette Smokers. , 2015, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[4]  T. Pechacek,et al.  Use of electronic nicotine delivery systems and other tobacco products among USA adults, 2014: results from a national survey , 2015, International Journal of Public Health.

[5]  D. Strong,et al.  Trends in use of little cigars or cigarillos and cigarettes among U.S. smokers, 2002-2011. , 2015, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[6]  Brian L. Rostron,et al.  Biomarkers of Exposure among U.S. Cigar Smokers: An Analysis of 1999–2012 National Health and Nutrition Examination Survey (NHANES) Data , 2014, Cancer Epidemiology, Biomarkers & Prevention.

[7]  Brian A. King,et al.  Little Filtered Cigar, Cigarillo, and Premium Cigar Smoking Among Adults — United States, 2012–2013 , 2014, MMWR. Morbidity and mortality weekly report.

[8]  Brian A. King,et al.  Tobacco Product Use Among Adults — United States, 2012–2013 , 2014, MMWR. Morbidity and mortality weekly report.

[9]  A. Loukas,et al.  Prevalence and harm perceptions of various tobacco products among college students. , 2014, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[10]  K. Conway,et al.  Preference for flavoured cigar brands among youth, young adults and adults in the USA , 2014, Tobacco Control.

[11]  Jennifer L Pearson,et al.  Marketing little cigars and cigarillos: advertising, price, and associations with neighborhood demographics. , 2013, American journal of public health.

[12]  H. Morgenstern,et al.  Systematic Reviews and Meta- and Pooled Analyses Cigarette, Cigar, and Pipe Smoking and the Risk of Head and Neck Cancers: Pooled Analysis in the International Head and Neck Cancer Epidemiology Consortium , 2013 .

[13]  E. Perez-stable,et al.  An empirical analysis of cigarette demand in Argentina , 2013, Tobacco Control.

[14]  Brian A. King,et al.  Flavored cigar smoking among U.S. adults: findings from the 2009-2010 National Adult Tobacco Survey. , 2013, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[15]  D. Vallone,et al.  Primary and dual users of cigars and cigarettes: profiles, tobacco use patterns and relevance to policy. , 2012, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[16]  A. Joyce,et al.  Reducing the Environmental Impact of Dietary Choice: Perspectives from a Behavioural and Social Change Approach , 2012, Journal of environmental and public health.

[17]  D. Abrams,et al.  Patterns of Tobacco Use and Dual Use in US Young Adults: The Missing Link between Youth Prevention and Adult Cessation , 2012, Journal of environmental and public health.

[18]  S. Vijaykumar,et al.  Young adults' perceptions about established and emerging tobacco products: results from eight focus groups. , 2012, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[19]  R. Barr,et al.  The Association of Pipe and Cigar Use With Cotinine Levels, Lung Function, and Airflow Obstruction , 2010, Annals of Internal Medicine.

[20]  P. Richter,et al.  Exploring Use of Nontraditional Tobacco Products Through Focus Groups with Young Adult Smokers, 2002 , 2008, Preventing chronic disease.

[21]  David H. Jolly Exploring the Use of Little Cigars by Students at a Historically Black University , 2008, Preventing chronic disease.

[22]  P. Richter,et al.  Young adult smoker risk perceptions of traditional cigarettes and nontraditional tobacco products. , 2006, American journal of health behavior.

[23]  S. Evans,et al.  Cigars, Cigarillos, and Youth , 2004 .

[24]  L. Biener,et al.  Trends in cigar smoking and perceptions of health risks among Massachusetts adults , 2002, Tobacco control.

[25]  R. Malone,et al.  Cigar risk perceptions in focus groups of urban African American youth. , 2001, Journal of substance abuse.

[26]  M. Denniston,et al.  Risk perception and cigar smoking behavior. , 2001, American journal of health behavior.

[27]  P. Slovic Smoking : risk, perception & policy , 2001 .

[28]  James L. Repace,et al.  Health risks associated with cigar smoking. , 2000, JAMA.

[29]  G. Pershagen,et al.  Risk of lung cancer from exposure to environmental tobacco smoke from cigars, cigarillos and pipes , 1999, International Journal of Cancer.

[30]  C. Iribarren,et al.  Effect of cigar smoking on the risk of cardiovascular disease, chronic obstructive pulmonary disease, and cancer in men. , 1999, The New England journal of medicine.

[31]  E. Gilpin,et al.  Validation of susceptibility as a predictor of which adolescents take up smoking in the United States. , 1996, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[32]  E. Wynder,et al.  Smoke of Cigarettes and Little Cigars: An Analytical Comparison , 1972, Science.