Cigar Warning Noticing and Demographic and Usage Correlates: Analysis from the United States Population Assessment of Tobacco and Health Study, Wave 5

• Published in: International journal of environmental research and public health Vol. 19; no. 6; p. 3221
• Main Authors: Gratale, Stefanie K., Teotia, Arjun, Chen-Sankey, Julia, Ganz, Ollie, Delnevo, Cristine D., Strasser, Andrew A., Wackowski, Olivia A.
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 09.03.2022; MDPI
• Subjects: Advertising; Cigarette industry; Compliance; Health risk assessment; Health risks; Hispanic Americans; Packaging; Population; Prevalence; Smoking; Smoking - epidemiology; Tobacco; Tobacco Products; Tobacco Use - epidemiology; United States - epidemiology; Young adults; United States; United States > US; survey methods; tobacco; warning labels; cigars
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph19063221

Although cigars pose health risks similar to cigarettes, their packaging/marketing is not subject to commensurate regulation in the US. In a 2000 agreement with the Federal Trade Commission, seven major manufacturers agreed to use some form of cigar warning. In 2016, the Food and Drug Administration passed a rule requiring larger standardized warnings, but the requirement was successfully challenged in court. Here, we examined U.S. population-level trends in noticing existing cigarillo, traditional and filtered cigar warnings. We analyzed Wave 5 Population Assessment of Tobacco and Health adult data to assess prevalence of past-30 day warning noticing and associations with socio-demographic and tobacco use variables. Noticing was higher among current users of cigarillos (27%), filtered (34%) and traditional cigars (21%), than non-users (8% for each product, p < 0.0001), and among every-day vs. some-day users, established vs. experimental users, and past-30 day users vs. those without past-30 day use. Results varied by product, but generally indicated lower noticing among non-Hispanic Whites and dual cigarette users, but higher noticing among those purchasing cigars by the box/pack (vs. not purchasing for themselves). Low overall noticing but higher prevalence among frequent users underscores a need for a stronger, uniform cigar warning label policy in the US.