Cigars

A cigar is defined as a roll of tobacco wrapped in leaf tobacco or in a substance that contains tobacco.^1,2

Cigars differ from cigarettes in that cigarettes are a roll of tobacco wrapped in paper or in a substance that does not contain tobacco.

The three major types of cigars sold in the United States are large cigars, cigarillos, and little cigars.^1,2

The use of flavorings in some cigar brands and the fact that they are commonly sold as a single stick has raised concerns that these products may be especially appealing to youth.^3,4,5,6

In 2014, among middle and high school students who used cigars in the past 30 days, 63.5% reported using a flavored cigar during that time.⁶

Little cigars are the same size and shape as cigarettes, often include a filter, and are packaged in a similar way, but they are taxed differently than cigarettes. Rather than reduce consumption, cost-conscious smokers might switch from cigarettes to less costly little cigars.^2,5,7

Historically, cigar smoking in the United States has been a behavior of older men, but the industry’s increased marketing of these products to targeted groups in the 1990s increased the prevalence of use among adolescents.³

Cigar use is higher among youth who use other tobacco products or other drugs (e.g., alcohol, marijuana, and inhalants) than among youth who do not use these products.³

Health Effects

Current Cigar Use

Adults*

Percentage of U.S. adults who were current cigar smokers^† in 2013:⁹

• 5.0% of  all adults
  

• 8.2% of  adult males
• 2.0% of  adult females
  

• 7.5% of  African American adults
• 6.7% of  American Indian/Alaska Native adults
• 2.1% of  Asian American adults
• 4.0% of  Hispanic adults
• 5.0% of  White adults

High School Students

Percentage of U.S. high school students who were current smokers^† in 2014:¹⁰

• 8.2% of all students in grades 9–12
•   5.5% of female students in grades 9–12
• 10.8% of male students in grades 9–12
  

• Current (past 30 days) cigar use among high school males (10.8%) is almost double that of high school females (5.5%) and similar to cigarette use among high school males (10.6%).¹⁰

Middle School Students

Percentage of U.S. middle school students who were current cigar smokers^† in 2014:¹⁰

• 1.9% of all U.S. students in grades 6–8
• 1.4% of female students in grades 6–8
• 2.4% of male students in grades 6–8
  

Overall

• In 2013, an estimated 12.4 million people in the United States aged 12 years or older (or 5.2%) were current cigar smokers.⁹

*Adults are defined as persons 18 years of age or older.
^†Current cigar use is defined as smoking cigars on 1 or more of the 30 days before participation in a survey about this topic.

Marketing Information

Marketing efforts promote cigars as symbols of a luxury and successful lifestyle. The following strategies can contribute to the increased acceptability of cigar smoking:^1,3

• Endorsements by celebrities
• Development of cigar-friendly magazines (e.g., Cigar Aficionado)
• Images of highly visible women smoking cigars
• Product placement in movies

In 2001, the Federal Trade Commission mandated that cigar packaging and advertisements must display one of the following five "SURGEON GENERAL WARNING" text-only labels on a rotating basis:¹¹

• Cigar Smoking Can Cause Cancers Of The Mouth And Throat, Even If You Do Not Inhale.
• Cigar Smoking Can Cause Lung Cancer And Heart Disease.
• Tobacco Use Increases The Risk Of Infertility, Stillbirth, And Low Birth Weight.
• Cigars Are Not A Safe Alternative To Cigarettes.
• Tobacco Smoke Increases The Risk Of Lung Cancer And Heart Disease, Even In Nonsmokers.

References

1. National Cancer Institute. Cigars: Health Effects and Trends. Smoking and Tobacco Control Monograph No. 9. Smoking and Tobacco Control Monograph No. 9. Bethesda (MD): National Institutes of Health, National Cancer Institute, 1998 [accessed 2015 Oct 19].
2. American Cancer Society. Cigar Smoking. Atlanta: American Cancer Society [accessed 2015 Oct 19].
3. U.S. Department of Health and Human Services. Preventing Tobacco Use Among Youth and Young Adults: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Office on Smoking and Health, 2012 [accessed 2015 Oct 19].
4. Campaign for Tobacco-Free Kids. The Rise of Cigars and Cigar-Smoking Harms[PDF–144 KB] Washington: Campaign for Tobacco-Free Kids [accessed 2015 Oct 19].
5. King BA, Tynan MA, Dube SR, Arrazola R. Flavored-Little-Cigar and Flavored-Cigarette Use Among U.S. Middle and High School Students. Journal of Adolescent Health 2013;54(1):40–6 [accessed 2015 Oct 19].
6. Centers for Disease Control and Prevention. Flavored Tobacco Product Use Among Middle and High School Students—United States, 2014. Morbidity and Mortality Weekly Report 2015;64(38):1066–70 [accessed 2015 Oct 19].
7. Gammon DG, Loomis BR, Dench DL, King BA, Fulmer EB, Rogers T. Effect of Price Changes in Little Cigars and Cigarettes on Little Cigar Sales; USA, Q4 2011-Q4 2013. Tobacco Control 2015 (doi:10.1136/tobaccocontrol-2015-052343) [cited 2015 Oct 19].
8. The Maxwell Report: Cigar Industry in 2014. Richmond (VA): John C. Maxwell, Jr., 2015 [cited 2015 Oct 19].
9. Substance Abuse and Mental Health Services Administration. Results from the 2013 National Survey on Drug Use and Health: Detailed Tables, Table 2.36B. Rockville, MD: Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality, 2015 [accessed 2015 Oct 19].
10. Centers for Disease Control and Prevention. Tobacco Product Use Among Middle and High School Students–United States, 2011-2014. Morbidity and Mortality Weekly Report 2015;64(14):381-5 [accessed 2015 Oct 19].
11. Federal Trade Commission. Nationwide Labeling Rules for Cigar Packaging and Ads Take Effect Today. Washington: Federal Trade Commission, 2001 [accessed 2015 Oct 19].