All participants reported smoking cigarillos for use as a tobacco product, averaging 13 per week. Twenty-five (83%) also reported using cigarillos to smoke marijuana blunts. A preference for group smoking and product sharing, and the belief that cigarillos extend the high of marijuana were found to promote the co-use of these products. Cigarillos were also found to be used as a substitute for blunts when marijuana was unavailable or when its use was being restricted or monitored. Conclusions/Importance: This analysis of adolescent cigarillo and marijuana co-use demonstrates how marijuana use can initiate, increase, and reinforce tobacco use. These findings can be used to inform public health education campaigns and other programs and policies aimed at reducing cigarillo and marijuana use by youth.
IntroductionCigarettes and little cigars and cigarillos (LCCs) are the most prevalent dual-use tobacco combination; one-third of cigarette smokers use LCCs. Risk factors for multiple tobacco product use have been reported; however, there is little understanding of why some individuals transition to and maintain multiple product use. In this study, we examine narratives of tobacco product initiation and decision-making among LCC-only and LCC-cigarette smokers.MethodsWe audio-recorded in-depth interviews with 60 individuals, aged 14–28, who reported smoking more than or equal to 1 cigarillo per week; half also smoked cigarettes. Transcribed interviews were coded using a phenomenological approach to examine themes about smoking initiation, motivation, and product decision-making.ResultsAmong dual users, 60% began smoking LCCs before or at the same time as cigarettes, and 40% began smoking cigarettes first. Reasons for smoking cigarettes in addition to LCCs included easier access when experiencing craving and less time to smoke the product. Cigarette smokers reported first smoking LCCs in social contexts when sharing LCCs with other smokers, or when they could afford a single LCC but not a pack of cigarettes. LCC-only smokers reported not smoking cigarettes because of their expense, unpleasant taste and/or smell, and fear of becoming addicted.ConclusionsIn this sample of current LCC users, half also used cigarettes. Product initiation order was almost evenly split, but reasons for initiating the second product differed, with immediacy of reducing cravings as a key reason for LCC users to smoke a cigarette and social and financial reasons for cigarette users to smoke an LCC.ImplicationsUnderstanding how and why dual use is initiated and sustained can inform policies to help prevent increased nicotine dependence and initiation of additional tobacco products. This study demonstrates that the beliefs, perceptions, and practices of LCC-only and dual users inform their product selection. Our findings point to the need to apply the strategies that have been effective at decreasing cigarette consumption to LCCs.
When children tell stories, they gesture; their gestures can predict how their narrative abilities will progress. Five-year-olds who gestured from the point of view of a character (CVPT gesture) when telling stories produced better-structured narratives at later ages (Demir, Levine, & Goldin-Meadow, 2014). But does gesture just predict narrative structure, or can asking children to gesture in a particular way change their narratives? To explore this question, we instructed children to produce CVPT gestures and measured their narrative structure. Forty-four kindergarteners were asked to tell stories after being trained to produce CVPT gestures, gestures from an observer’s viewpoint (OVPT gestures), or after no instruction in gesture. Gestures were coded as CVPT or OVPT, and stories were scored for narrative structure. Children trained to produce CVPT gestures produced more of these gestures, and also had higher narrative structure scores compared to those who received the OVPT training. Children returned for a follow-up session one week later and narrated the stories again. The training received in the first session did not impact narrative structure or recall for the events of the stories. Overall, these results suggest a brief gestural intervention has the potential to enhance narrative structure. Due to the fact that stronger narrative abilities have been correlated with greater success in developing writing and reading skills at later ages, this research has important implications for literacy and education.
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