Flavored cigar smoking among African American young adult dual users: An ecological momentary assessment

Abstract

Background-Flavored cigar sales have increased in recent years in the U.S. African American young adults (AAYAs) have high prevalence of smoking flavored cigars and dual use with cigarettes, but the predictors of use are unclear. We examined the predictors of flavored cigar smoking among AAYA dual users. Methods-We analyzed data from an Ecological Momentary Assessment (EMA) study that captured near real-time affect, smoking cues, and tobacco smoking from eight text-messaging surveys per day over two weeks. Sixty-three AAYA (ages 18-29) dual users of cigarettes and cigars recorded 1,205 cigar smoking moments. Multivariable Generalized Estimating Equations were used to assess the predictors of smoking cigars with flavors and specific flavor types. Results-Half of the participants were women (49.2%) and aged between 18-24 (46.7%). Over the two-weeks, almost all (98.4%) participants smoked flavored cigars, and 64.2% of the cigars smoked were flavored. Alcohol (34.4%) was the most frequently smoked flavor type followed by sweet (23.4%) and mint (5.7%). Feeling stressed (AOR=1.07) and bored (AOR=1.10) predicted smoking alcohol flavors. Blunt smoking positively predicted smoking sweet flavors (AOR=4.79) but negatively predicted smoking alcohol flavors (AOR=0.40). Conclusions-Smoking flavored cigars, especially alcohol-flavored cigars, is prevalent among AAYA dual users in this study. This group might use specific flavors for different purposes including smoking blunts and boosting mood. Efforts to reduce cigar use need to tackle these risk

Substance Use among Economically Disadvantaged African American Older Adults; Objective and Subjective Socioeconomic Status

“…Individuals with low SES have worse emotion regulation and may use less healthy coping strategies to deal with their stressors [50]. Individuals with lower SES live in closer proximity to outlets and shops that sell tobacco products and alcoholic beverages [85] and have a higher risk of exposure to point-of-sale advertisements, coupons, and discounts [86,87]. In addition, low-SES individuals may be specially targeted by the tobacco industry through predatory marketing, including but not limited to flavoring [87,88].…”

“…Individuals with lower SES live in closer proximity to outlets and shops that sell tobacco products and alcoholic beverages [85] and have a higher risk of exposure to point-of-sale advertisements, coupons, and discounts [86,87]. In addition, low-SES individuals may be specially targeted by the tobacco industry through predatory marketing, including but not limited to flavoring [87,88]. Finally, low-SES individuals are more likely to live in areas with less restrictive tobacco policies, defined as lower age for tobacco and alcohol purchase, lower cigarette taxes, and no smoke-free laws [89].…”

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

“…Most of the participants resided in the Washington, D.C., area. Eligibility criteria were (1) self-identifying as non-Hispanic African American or non-Hispanic Black; (2) 21 to 29 years old; (3) being a current cigar smoker, defined as smoking large cigars, cigarillos, or filtered cigars at least 4 times in the past 2 weeks [ 9 , 22 ]; and (4) able to read and speak English. Participants were screened through a self-administered eligibility screening survey online, followed by a brief phone call to further confirm eligibility.…”

“…Cigar products are disproportionately smoked by Black individuals [ 9 , 10 , 11 ] and young adults [ 12 , 13 ]. Increased cigar smoking is a consequence of the tobacco industry’s targeted marketing strategies for selling and promoting cigar products among Black communities [ 14 ].…”

Exploring changes in cigar smoking patterns and motivations to quit cigars among black young adults in the time of COVID-19

“…The social media posts predominantly targeted participants residing in the Washington D.C. metropolitan area. Eligibility criteria were: (1) self-identified as non-Hispanic Black or African American; (2) 21 to 29 years old; (3) a current cigar smoker (defined as smoking premium cigars, cigarillos, or little cigars ≥ 4 times in the last 2 weeks) ( Chen-Sankey et al, 2019 , Mead et al, 2018 ); and (4) able to read and speak English. The research team members screened the interested individuals through the phone and emailed eligible participants a link to an online survey.…”