Dual Use of Cigarettes, Little Cigars, Cigarillos, and Large Cigars: Smoking Topography and Toxicant Exposure

Abstract

Objective-Smoking topography variables and toxicant exposure (plasma nicotine and exhaled CO) were examined in 3 groups of study participants that smoked both cigarettes and either filtered little cigars (Winchester), cigarillos (Black & Mild), or large cigars (Phillies Blunt).Methods-Laboratory ad lib smoking of the cigar products was collected with a smoking puff analyzer; plasma levels of nicotine and exhaled CO were collected before and after smoking.Results-Although there were no statistically significant differences in demographic and cigarette smoking topography among the groups, there were significant differences in how the different cigar products were smoked. Plasma nicotine boost was similar after all products but exhaled CO was greater after the cigarillo and large cigar than the little cigar. Some of the differences were due to the differences in article size but other differences were apparent even after adjustment for the amount of tobacco burned or the mouth intake (puff volume).Conclusions-The topography findings of differences among products challenge the practice of grouping cigars as a single entity in surveys, regulatory decisions, and discussions of toxicant exposure. The results add to the discussion of distinctions among products in the scientific assessment of public health risk and regulatory decisions.Keywords little cigars; cigarillos; large cigars; tobacco; smoking; topography; toxicant exposure Correspondence Dr Pickworth; pickworthw@battelle.org. Human Subjects StatementThis study was approved by Battelle Memorial Institute's Institutional Review Board. Conflict of Interest StatementThe authors have no conflicts of interest. HHS Public AccessAuthor manuscript Tob Regul Sci. Author manuscript; available in PMC 2018 April 01. Author Manuscript Author ManuscriptAuthor Manuscript Author ManuscriptThe way smokers consume combustible tobacco products is individualized. 1,2 Two smokers of the same tobacco product may take different number of puffs, with various volume, velocity, and duration. Because of that unique product-user interaction, smokers may be potentially exposed to various levels of tobacco smoke constituents, even while smoking the same tobacco product. Many published studies show that measuring smoking behavior (topography) provides a valid and reliable index of smoking and an indirect measure of smoke exposure. [3][4][5][6] Smoking topography is also a useful tool for assessing harm related to smoking, or even can be used to predict abstinence after using nicotine replacement therapy. 7Smoking topography is well described in the literature for combustible cigarettes. Data show that smoking topography may depend on many different factors including: sex, 8,9 age, 9 race, nicotine metabolism ratio, CYP2A6 genotype, 8 or health status. 10,11 However, to date, data available on smoking topography of other tobacco products (particularly cigars) is limited.Assessing cigar smoking topography is challenging because there are multiple types of cigars available in the United...

Biomarkers of Exposure among U.S. Adult Cigar Smokers: Population Assessment of Tobacco and Health (PATH) Study Wave 1 (2013–2014)

“…Our findings may also be explained by differences in nicotine delivery. For example, a recent study found higher levels of plasma nicotine per unit of consumption from little cigar smoking compared with cigarillo or large cigar smoking (31). We observed that TNE-2 concentrations in every day exclusive filtered cigar smokers were comparable to those of every day exclusive cigarette smokers.…”

Polytobacco product use among current cigarette smokers in Hong Kong, China: results from population surveys (2015–17)

“…This suggested EC was less popular for PTU. Dual use of cigar and cigarette was associated with less negative perception toward cigarette use and quit attempts [ 27 ], tobacco intervention program specific to this subgroup of smokers is warranted to prevent the growth of this type of PTU. The trend changes in overall prevalence of number of tobacco product use with cigarette varied in 3 years, this suggested these smoking behaviors had not been routinized.…”

Polytobacco product use among current cigarette smokers in Hong Kong, China: results from population surveys (2015-17)

“…This suggested EC was less popular for PTU and those who used EC were more likely to be exclusive EC users. Dual use of cigar and cigarette was associated with less negative perception toward cigarette use and quit attempts, 27 tobacco intervention program speci c to this subgroup of smokers is warranted to prevent the growth of this type of PTU. The trend changes in overall prevalence of number of tobacco product use with cigarette varied in three years, this suggested these smoking behaviors had not been routinized.…”