Association between purchasing behaviors and cigar use: A longitudinal analysis of Waves 1-3 of the Population Assessment of Tobacco and Health (PATH) Study

Abstract

Introduction Over 120 US jurisdictions have implemented policies mandating minimum cigar pack quantities, yet little empirical research exists on the relationship between pack quantity and use. We examined whether cigar use was associated with purchasing cigars by the box/pack or as singles, purchase quantity, and price paid per cigar. Methods Data are from Waves 1-3 (2013-2016) of the Population Assessment of Tobacco and Health (PATH) Study, analyzed in 2019. The sample included adults who reported current use of any type of cigars (cigarillos [N = 3,051], traditional cigars [N = 2,586], and filtered cigars [N = 1,295], including with marijuana) at Wave 1. For each cigar type, a generalized estimating equation model was used to examine the population-averaged effects of purchasing behavior on cigar use. Results Cigar users of each type who purchased by the box or pack smoked more per day than users who purchased singles (cigarillos: β = 1.02, p<0.0001; traditional cigars: β = 1.40, p<0.0001; filtered cigars: β = 2.55, p<0.01). Cigar users who purchased larger quantities smoked more per day (cigarillos: β = 0.16, p<0.0001; traditional cigars: β = 0.04, p<0.0001; filtered cigars: β = 0.24, p<0.0001). Higher price per cigar was significantly associated with smoking fewer traditional cigars (β =-0.12, p<0.01) and filtered cigars (β =-0.86, p = 0.02), but not cigarillos (β = 0.08, p = 0.62). Conclusions Smaller pack quantities and higher price per cigar were associated with smoking fewer cigars per day. Given the authority of the Food and Drug Administration and local

Associations between Black and Mild Cigar Pack Size and Demographics and Tobacco Use Behaviors among US Adults

“…These findings were consistent across two different definitions of smaller pack size; (1) singles and (2) singles and two to three packs. These findings align with King et al, who found in their longitudinal analysis of PATH data that larger pack size (box or pack vs. singles) was associated with smoking more cigarillos per day [15]. Similarly, in their review of previously secret tobacco industry documents aimed at examining how tobacco companies have used package quantity to target consumers, Persoskie et al found that larger tobacco pack sizes were designed for heavier users, while smaller pack sizes were designed for newer and lighter users [22].…”

“…On the other hand, while larger pack sizes are more expensive overall, they are cheaper per stick and consequently may have better value for more frequent and established smokers [ 15 , 16 ]. Indeed, we found that users of larger pack sizes consumed more cigars per day and were more likely to smoke within 30 min of waking; therefore, larger pack sizes may be more economical for their consumption patterns.…”

“…Second, since our analysis only focused on one cigar brand, Black and Mild, findings are not necessarily generalizable to other cigar brands. Due to Black and Mild’s product offerings, we also did not examine differences by cigar type (e.g., traditional cigars, cigarillos, filtered cigars), but future research should assess pack size preferences among users of various cigar types, which may be important when considering minimum pack size policies [ 15 , 22 ]. Lastly, sample size limitations prevented us from examining more granular categorizations of pack sizes, which may have masked differences between users of certain pack sizes (e.g., singles vs. two-packs).…”

“…Cigars often cost less than cigarettes in the United States, which increases their appeal among youth, young adults, and individuals with lower income levels [ 12 , 13 ]. Indeed, a pack of cigars generally costs less than USD 2 in the United States, whereas the average price of a pack of cigarettes is USD 7.22 [ 14 , 15 , 16 ]. There are two primary drivers of this stark price difference; first, the products are taxed differently, with lower state and federal excise taxes for cigars versus cigarettes.…”

“…It is widely acknowledged in the cigarette literature that smaller pack quantities reduce barriers to use, as they are easier to conceal and carry and are less expensive than larger packs [ 22 , 23 , 24 , 25 , 26 ]. However, there is limited research on cigar purchasing behaviors, although some data suggest that smaller pack sizes are cheaper per pack [ 15 , 16 ]. Further, trial or cigar experimentation is associated with smaller pack sizes.…”