Cigar-Smoking-Cessation Interest and Experience among Black Young Adults: A Semi-Structured In-Depth Interview Investigation

Abstract

Although Black/African American populations have high cigar-smoking prevalence, little is known about cigar-smoking cessation among this group. This study explored the perceptions and experiences of cigar-smoking cessation and assistance received from healthcare providers among forty Black young-adult cigar smokers (ages 21–29). Semi-structured in-depth phone interviews were transcribed and coded. Qualitative data were analyzed by using thematic analysis. Participants mostly smoked cigarillos, large cigars, and blunts. Overall, many regular cigarillo smokers reported interest in quitting eventually, while large-cigar and blunt smokers shared less interest in quitting because they perceived low harm from smoking these products. The reasons for cigar-smoking cessation were health concerns and financial constraints. Most of the participants who attempted to quit cigars did not use any cessation aids. The reasons for relapse included nicotine withdrawal, stress, and easy access. Additionally, most participants reported their healthcare providers did not ask whether they smoked cigars, and even when they knew, little assistance for cigar-smoking cessation was provided. Informing Black cigar smokers of the harm of cigar smoking and encouraging healthcare providers to screen for and assist with cigar-smoking cessation may alleviate the health burden of cigar smoking in this population.

Exploring the Experiences and Perceptions of Cigar Craving and Addiction among Young Adult Black Cigar Smokers

“…We found that perceived addiction to cigar products may be the lowest among blunt smokers, which builds on previous research that found that blunt smokers have low perceptions of harm from cigar smoking and little interest in quitting smoking [ 29 ]. Together, our findings indicate a lack of knowledge among our participants that smoking blunts may result in harm and have risks associated with smoking combustible tobacco products as well as cannabis [ 18 , 42 ].…”

“…Furthermore, our finding that more than half of predominant cigarillo smokers identified themselves as addicted to cigar products is consistent with a recent study exploring self-perceptions of addiction among adolescent and young adult cigarillo smokers [ 41 ]. Black young adults who predominantly smoked cigarillos were also more likely to report interests and motivations in quitting cigar products than smokers of other cigar and blunt products [ 29 ]. Therefore, interventions for treating cigar addiction and cessation can first target cigarillo smokers who may already be aware of their addiction to the products and are interested in quitting smoking.…”

“…For recruitment, the research team generated posts on social media platforms such as Facebook and Instagram. These posts targeted residents in Washington D.C. who met the following eligibility criteria: (1) self-identified as non-Hispanic Black or African American; (2) between the ages of 21 and 29 years old; (3) current cigar smokers (as defined by smoking premium cigars, cigarillos, or little cigars ≥ 4 times within the preceding 2 weeks) [ 16 , 29 , 30 ]; and (4) proficient in reading and speaking the English language.…”

“…The percentage agreement of the codes used for this analysis was moderate to high (84–92%), demonstrating satisfactory inter-coder reliability [ 33 ]. Reporting of themes and subthemes was based on the frequencies of relevant content discussed by the participants using the following words: “all” (100%), “most” (70–99%), “more than half” (51–69%), “half” (50%), “some” (20–49%), “a few” (1–19%), and “none” (0%) [ 16 , 29 , 34 , 35 ]. Due to the limited amount of interview data specific to filtered cigar-smoking, themes specific to filtered cigars were not generated or reported.…”

“…To date, however, little is known about how Black young adults perceive and experience cigar addiction. Moreover, interest in quitting appears to be low among Black young adult cigar smokers, highlighting the importance of understanding their experiences with addiction to inform interventions [ 29 ]. Investigating Black young adult cigar smokers’ perceived addiction to blunt smoking is also critical to understanding their overall experiences with cigar and cannabis addiction since these two products are often used together by cigar smokers [ 16 ].…”