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

Abstract

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’s < 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.

The Landscape of Cigar Marketing in Print Magazines from 2018–2021: Content, Expenditures, Volume, Placement and Reach

“…These findings suggest that the company was aware of the new FDA warning guidelines and capable of implementing them, but was not interested in doing so if not required. This underscores the need for cigar-specific research on warning label effectiveness to support relevant future policy and implementation efforts [ 53 , 54 , 55 , 56 ].…”

Young adults’ cigarillo risk perceptions, attention to warning labels and perceptions of proposed pictorial warnings: a focus group study

“…Recent survey research has found high cigarillo harm perceptions among users who more frequently noticed warnings, 13 but relatively low levels of noticing cigarillo warnings. 35 Despite overall inattention to warnings, participants across groups supported the use of PWLs on cigarillo packaging, even stating they were drawn to PWLs they previously encountered. Consistent with broader PWL research, participants perceived PWLs as more attention getting and better able to elicit emotional/cognitive reactions than text warnings.…”

“…Recent survey research has found high cigarillo harm perceptions among users who more frequently noticed warnings, 13 but relatively low levels of noticing cigarillo warnings. 35 …”

“…Many of these issues around warning noticeability could also apply to cigarette and other tobacco packaging, yet in this context, they highlight concerns about the inconsistent application of cigar warnings and the need for uniform regulations like those applied to cigarettes. Recent survey research has found high cigarillo harm perceptions among users who more frequently noticed warnings,13 but relatively low levels of noticing cigarillo warnings 35…”