| NEW YORK
NEW YORK (Reuters Health) - Young people are smoking fewer cigarettes these days, but their cigar use is rising, which may partly be due to the popularity of flavored cigars, according to a new study.
"The cigar market is the most heavily flavored of all tobacco products," said Cristine D. Delnevo, who led the research. "For decades, tobacco industry internal documents have highlighted that flavors appeal to youth and young people."
Delnevo, who directs the Center for Tobacco Surveillance & Evaluation Research at Rutgers Cancer Institute of New Jersey in New Brunswick, and colleagues from the National Institutes of Health investigated recent market and survey data on flavored cigar use among young people.
Delnevo and her coauthors analyzed an annual survey of drug and alcohol use among Americans ages 12 and up. For this study, the researchers selected the 6,700 survey responders in 2010 and 2011 who reported smoking cigars in the previous month and had noted their usual brand.
They found that 8 percent of men and 2 percent of women said they had smoked a cigar in the past 30 days, but 11 percent of people between ages 18 and 25 years old had smoked a cigar - more than any other age group.
Three quarters of cigar smokers reported a usual brand that offers flavored varieties, according to the results published in the journal Tobacco Control.
People who smoked cigarettes or those who smoked cigars daily were more likely to report using a flavored brand. Flavored varieties were also more popular among females, African Americans and people under age 35.
By 2011, flavored cigars made up almost half of all cigar sales from convenience stores, according to Nielsen market scanner data. Between 2008 and 2011, revenue from cigar sales went up by 30 percent, driven largely by flavored cigar sales, which increased by 53 percent.
Flavored cigars increased from 42 percent of the cigar market in 2008 to 50 percent of the cigar market in 2011.
"It is important to remember that youth experiment with multiple tobacco products, not just cigarettes," Delnevo told Reuters Health by email. "In fact, the most recent data from the National Youth Tobacco Survey show that rates of current cigarette and cigar use do not differ among adolescent males."
Public health messaging in the past largely focused on cigarettes, she said.
Cigars have been flavored for decades, but may be appealing to youth more now as a substitute for cigarettes, Centers for Disease Control and Prevention epidemiologist Brian King told Reuters Health.
King is the senior scientific advisor to the CDC's Office on Smoking and Health in Atlanta.
"Little cigars and cigarillos are the same size and shape and have similar filters as cigarettes," he said. "They are essentially cigarettes in disguise."
The Food and Drug Administration has banned flavorings other than menthol in cigarettes, but that restriction does not apply to cigars.
"A lot of times they're bubble gum or chocolate or candy flavored, and in many cases the packages are also framed in a manner to appeal to kids," King said.
They are also less expensive than cigarettes because they are not subject to the same taxes, all of which combines to give cigars a "glaring loophole" in tobacco regulation, he said.
"In many states these products can be purchased for mere pocket change," he said.
The price differential could potentially encourage cigarette smokers to switch to a cheaper alternative when they might otherwise have quit, Delnevo said.
It's important for parents and schools to remember that cigars contain the same carcinogens as cigarettes, and they are not a safe alternative, King said.
"We should use the same public health messaging for cigarettes and cigars," he said.
SOURCE: bit.ly/1l8jX4X Tobacco Control, online April 10, 2014.