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Cigar smoking among young adults: formative research

Institution: California State University, Long Beach Foundation
Investigator(s): Fen Rhodes, Ph.D.
Award Cycle: 1997 (Cycle 6) Grant #: 6RT-0426 Award: $292,920
Subject Area: Tobacco-Use Prevention and Cessation
Award Type: Research Project Awards

Initial Award Abstract
The proposed research project is designed to investigate the nature and scope of the recent rise in popularity of cigar smoking among young adults. This proposal is inspired by the recent visible trend in cigar smoking and the absence of objective information on the reasons for and the extent of cigar smoking among young adults. The specific objectives that will be accomplished include the following:

1. The salient factors influencing cigar smoking among young adults will be identified through a combination of qualitative and quantitative methods. We hypothesize that cigar smoking will be related to beliefs about the health effects of cigar smoking, attitudes toward cigar smoking, expectations of others in the social network regarding cigar smoking, and exposure to information about cigar smoking in the media.

2. Following identification of factors influencing cigar smoking among young adults, a group of young adults will be followed for two years in order to compare the relative importance of these various influencing factors as predictors of cigar smoking behavior.

The underlying assumptions of this study are that the public health impact of cigar smoking among young adults has been underestimated and that cigar smoking needs to be addressed as a health risk behavior separate from yet related to cigarette smoking. Confirmation of our hypothesis that cigar smoking is increasingly common within this population should direct more attention and resources to the prevention and cessation of cigar smoking among young adults. Existing research shows that cigar smoking does indeed pose a serious health risk, especially among ex-smokers who switch to cigars. Surprisingly, cigars seem to be growing in popularity at the same time that cigarettes are becoming less fashionable. It seems apparent, then, that individuals evaluate these behaviors differently, and may attribute less of a health risk to cigar smoking as compared to cigarette smoking. In addition, social norms projected through the media may be encouraging cigar smoking at the same time as they move toward discouraging cigarette smoking. Our research will highlight these differences in the way that young adults view the two behaviors, and will yield information that will be useful in designing individual and community approaches to reducing the prevalence of cigar smoking among young adults.

Final Report
Cigar use in California nearly doubled during the 1990s, and the most dramatic increase occurred within the 18- to 24year old population (Gilpin & Pierce, 1999). This project investigated the nature and scope of the rise in popularity of cigar smoking among young adults, and sought to identify factors influencing their cigar-smoking behavior. Accordingly, the project had 3 specific aims. First, an initial pilot study sought to identify how beliefs about cigars, as well as perceived obstacles and facilitators to smoking, influence cigar-smoking behaviors among young adults. Informed by the qualitative data obtained from the pilot study, a second, longitudinal study was designed to achieve the second and third aims. Due to the increased promotional activities for cigars that coincided with the upsurge in their use (U.S. Department of Health and Human Services, 1998), the project's second aim was to analyze the ways in which beliefs about smoking and exposure to tobacco-related media are related to cigar-smoking behavior in young adults. Finally, the project sought to examine how positive and negative portrayals of smoking in the media, in addition to beliefs, attitudes, and social norms, are related to cigar smoking behaviors in this population.

The longitudinal study extends the results from the pilot study by documenting cigar use in a non-cigar-smoking sample of approximately 300 first- and second-year college students over the course of two years. Results suggest differences in the frequency of occasional and regular cigar use by gender, race/ethnicity, and cigarette-smoking history. First, men were more likely than women to report having tried cigars. African-Americans were the most likely to become regular cigar smokers; ironically, they were less likely than their peers to report regular cigarette use. Regular cigarette smokers were more likely than non-smokers to have experimented with cigars during the two years of the study. In addition, occasional and regular cigar smokers differed in terms of their beliefs regarding cigars. Beliefs regarding the pleasure enhancement aspect of cigars were most strongly associated with regular cigar smoking, while beliefs regarding the social benefits were most strongly associated with occasional cigar smoking. In addition, participants who had smoked a cigar in the previous 12 months were more likely to report exposure to cigar-related media in movies, magazines, and posters. Moreover, a significantly greater proportion of those who reported that they were presented with a positive image of cigars in these three media types were more likely to report having smoked a cigar in the previous 12 months.

The results of this project have several implications for intervention efforts aimed at curbing the cigar use of young adults. The present findings corroborate the results of previous studies (e.g., Centers for Disease Control and Prevention, 1997, 2000) that African-Americans appear to be the most vulnerable population for regular cigar use, and particular emphasis should be placed on this group for preventive efforts focused on encouraging the cessation of regular cigar use. Also, since there was a positive correlation between experimentation with cigars and positive images of cigars in the media, media emphasizing the possible negative social consequences of cigar smoking, such as others not wanting to be around cigar smokers because of the smell, and the unsightly staining of teeth and hands, may help to discourage young adults from experimenting with cigars. In addition, the strong association between cigar experimentation and regular cigarette smoking highlights the importance of efforts aimed at preventing tobacco use in general within this population. Finally, as suggested by the U.S. Department of Health and Human Services, (1998), efforts aimed at encouraging cigar makers to adhere to the same marketing code utilized by cigarette makers, in which the use of sex and celebrity is forbidden, may help to reduce cigar use among young adults.