The percentage of teens who smoked tobacco in the past 30 days increased by more than half when cigarillos — small cigars or little cigars — are included with regular cigarettes as a form of tobacco use.
The finding supports concerns in the public health community that cigarillos are attracting new youth to tobacco use.
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It comes from the 2015 nationwide Monitoring the Future study, which annually tracks trends in substance use among eighth-, 10th- and 12th-graders. The study surveys more than 40,000 students in about 400 secondary schools each year throughout the contiguous United States.
The survey asked youths whether they smoked a cigarillo or a regular cigarette in the past 30 days. For the three grades combined, the percentage that used tobacco increased to 11.2 percent from 6.7 percent when taking into account use of cigarillos, which is a 67-percent proportional increase in prevalence of tobacco smoking.
The size of this proportional increase was nearly three-quarters for eighth- and 10th-graders, and more than half for 12th-graders.
Specifically, taking into account flavored cigarillos increased the prevalence of smoking tobacco in the 30 days prior to the survey to 6.6 percent from 3.7 percent among eighth-graders, to 9.8 percent from 5.7 percent among 10th-graders, and to 17.8 percent from 11.1 percent among 12th-graders.
Cigarillos are tobacco products that are between a cigarette and a cigar both in terms of size and weight of tobacco. The outer wrapping consists of brown, dried tobacco leaves or brown paper. Cigarillos deliver combusted tobacco, which is the primary cause of the health hazards associated with cigarettes and cigars. There are many different flavors for cigarillos, including grape, cherry and strawberry.
“We find that more than 87 percent of adolescents who used cigarillos in the past 30 days used flavored cigarillos,” said professor Richard Miech, a senior investigator on the Monitoring the Future project and research professor at the Institute for Social Research. “This result suggests that flavoring is a major draw of cigarillos among youth. It also suggests the possibility that if cigarillos had no flavoring, then fewer youth would use them.”
The Food and Drug Administration prohibited the addition of flavoring to cigarettes (except menthol) in 2009 and is considering extending this prohibition to other tobacco products.
Many adolescents perceive that cigarillos are not as dangerous to health as cigarettes, which may contribute to the popularity of cigarillos, Miech said.
In all grades, the proportions of students who perceive great risk in regular use of cigarillos are about half the proportions who perceive great risk in smoking one or more packs of cigarettes a day. The percentages of adolescents who see great risk in regular cigarillo use were only 31 percent in eighth grade, 35 percent in 10th grade and 40 percent in 12th grade.
Cigarillos have the potential to recruit youth to cigarette smoking, Miech said. Overall, 27 percent of adolescents in the three grades combined who used cigarillos in the 30 days prior to the survey reported that they had never smoked a regular cigarette in their life.
“If these cigarillo users become addicted to nicotine and go on to become cigarette smokers, then the long-term and hard-fought decline in teen cigarette use may reverse,” Miech said.
“And even for those who do not transition to cigarette smoking, cigarillo use is already increasing the proportion of American young people being exposed to most of the smoked ingredients in cigarettes.”