Cigarillo use increases estimates of teen smoking rates by half
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. It comes from the 2015 nationwide Monitoring the Future study, which annually tracks trends in substance use among 8th-, 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 youth whether they smoked a cigarillo or a regular cigarette in the past 30 days. For the three grades combined, the percentage who 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 8th- 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 8th-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. "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 8th 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."
Monitoring the Future has been funded under a series of competing, investigator-initiated research grants from the National Institute on Drug Abuse, one of the National Institutes of Health. The lead investigators are Lloyd Johnston (principal investigator), Patrick O'Malley, Jerald Bachman, John Schulenberg and Richard Miech—all research professors at the University of Michigan's Institute for Social Research.
Surveys of nationally representative samples of American high school seniors were begun in 1975, making the class of 2015 the 41st such class surveyed. Surveys of 8th- and 10th-graders were added to the design in 1991, making the 2015 nationally representative samples the 25th such classes surveyed. The 2015 samples total 44,892 students located in 382 secondary schools. The samples are drawn separately at each grade level to be representative of students in that grade in public and private secondary schools across the coterminous United States.
The findings summarized here will be published in January in a forthcoming volume: Johnston, L. D., O'Malley, P. M., Miech, R.A., Bachman, J. G., & Schulenberg, J. E. (2016). Monitoring the Future national results on adolescent drug use: Overview of key findings, 2015. Ann Arbor, Mich.: Institute for Social Research, the University of Michigan. The content presented here is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Drug Abuse, or the National Institutes of Health.