A synthesis of local cigar pack policies in the US

Jensen, Jessica King; Delnevo, Cristine D.; Merten, Julie Williams; Torton, Brooke; Azagba, Sunday

doi:10.1016/j.pmedr.2022.101865

Cited by 4 publications

(3 citation statements)

References 25 publications

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“…This may indicate that switching from purchasing a 4-pack of cigars to a 5-pack of cigars may have minimal impact on health outcomes. That said, switching from purchasing singles to 10-packs or 20-packs, as some local US cigar pack quantity policies have set as the minimum pack quantity for sale, [ 14 ] could result in larger increases in smoking.…”

Section: Discussionmentioning

confidence: 99%

“…Adjusted models account for brand, other tobacco product use, flavor use, and price paid as these factors have been associated with pack quantity purchase and use [ 16 , 22 ]. Models also adjusted for residing in a state with local cigar minimum pack quantity or pricing regulations, which may influence cigar availability and price [ 14 ]. Price was winsorized for adults at above $500 for premium cigars ( n = 2) and large cigars ( n = 5), above $108.50 for cigarillos ( n = 17), and above $500.23 for filtered cigars ( n = 5).…”

Section: Methodsmentioning

confidence: 99%

“…To reduce youth cigarette use, the United States Food and Drug Administration (US FDA) mandated a minimum pack quantity of 20 for all cigarette products [ 13 ]. Some US municipalities have similarly enacted minimum pack quantity policies to reduce the availability of inexpensive cigars [ 14 ]. However, cigarette pack quantity is positively associated with consumption, with some consumers preferring to pay a premium for smaller packs to self-regulate their use [ 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

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Longitudinal analysis of cigar use patterns among US youth and adults, 2013–2019

Jensen,

Stoddard,

Delnevo

et al. 2023

BMC Public Health

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Background Cigars are available in a range of pack quantities, which contrasts regulations requiring cigarettes to be sold in packs of 20 or greater. Smaller packages may be associated with increases in initiation while larger packs may lead consumers to smoke more. The purpose of this study was to inform pack quantity regulations by examining whether usual cigar pack quantity purchased was associated with use, initiation, and discontinuation among youth and adults for four cigar types: premium cigars, large cigars, cigarillos, and filtered cigars. Methods We analyzed waves 1–5 (2013–2019) of the adult and waves 2–5 (2014–2019) of the youth Population Assessment of Tobacco and Health (PATH) Study. Samples included those responding to the item on pack quantity and providing data at all waves (adults: premium cigars [N = 536], large cigars [N = 1,272], cigarillos [N = 3,504], filtered cigars [N = 1,281]; youth: premium cigars [N = 55], large cigars [N = 217], cigarillos [N = 1514], filtered cigars [N = 266]). Generalized estimating equation models examined the population-averaged effects of pack quantity on cigar use, initiation, and discontinuation. Results Adult pack quantity was positively associated with the days used per month for premium cigars (b: 0.23, 95% CI: 0.11, 0.34), large cigars (b: 0.17, 95% CI: 0.08, 0.25), cigarillos (b: 0.12, 95% CI: 0.003, 0.24), and filtered cigars (b: 0.07, 95% CI: 0.04, 0.10), and positively associated with amount smoked per day for all cigar types. Youth pack quantity was positively associated with days used per month for premium cigars (b: 0.88, 95% CI: 0.33, 1.43), large cigars (b: 0.79, 95% CI: 0.43, 1.15), and cigarillos (b: 0.17, 95% CI: 0.01, 0.34). Adult initiation was associated with pack quantity for filtered cigars (b: -2.22, 95% CI: -4.29, -0.13), as those who initiated purchased smaller pack quantities compared to those who did not initiate that wave. Pack quantity was not associated with discontinuation for adults or youth. Conclusions Cigar use increased as usual pack quantity purchased increased across cigar types for youth and adults. Small increases in pack quantity (e.g., one additional cigar) are likely to result in consuming less than one additional day per month, though larger increases (e.g., 10 additional cigars per pack) may result in greater use.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Longitudinal analysis of cigar use patterns among US youth and adults, 2013–2019

Jensen,

Stoddard,

Delnevo

et al. 2023

BMC Public Health

Self Cite

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The impact of cigar pack size and pricing policies on youth and adult cigar use in the US

Jensen

Kim

et al. 2023

Drug and Alcohol Dependence

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Examining Cigar Pack Quantity Purchases by Cigar Type in the United States Between 2014 and 2017

Jensen

Ross

Rebentisch

et al. 2023

Nicotine and Tobacco Research

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Introduction We examined whether the proportion of cigar pack quantity usually purchased differed between 2014 and 2017 in the United States. Methods Data are from waves 1 and 4 of the Population Assessment of Tobacco and Health Study. The proportions of pack quantity purchases between waves for premium cigars, large cigars, cigarillos, and filtered cigars for 10-pack quantities (singles, 2-packs, 3-packs, 4-packs, 5-packs, 6–9-packs, 10-packs, 11–-19-packs, 20-packs, ≥21 packs) were compared using Z-tests. We used multivariable linear regressions to examine factors associated with pack quantity. Results For premium cigars, most adults purchased singles, with 84.4% in 2014 and 88.7% in 2017. For large cigars, single purchases increased from 46.2% to 62.7% (p < .00001). Two-packs also increased, 3.1% to 10.2% (p < .00001), while 5-packs, 6–9 packs, 10–19-packs, and 20-packs decreased. For cigarillos, singles purchases increased from 51.9% to 57.5% (p = .0002). Two-packs also increased, 8.8% to 19.6% (p < .00001), while 3-packs, 4-packs, 5-packs, and 20-packs decreased. For filtered cigars, the most prevalent pack quantity shifted from 20-packs in 2014 (62.6%) to singles in 2017 (36.7%). Singles, 2-packs, 3–4-packs, and 5-packs increased while 11–19-packs, 20-packs, and ≥21 packs decreased. Days used were positively associated with pack quantity purchase for all cigar types in 2017, while the price was positively associated with premium cigar purchase. Conclusions Between 2014 and 2017, the proportion of consumers who purchased singles remained at over 80% for premium cigars and increased for other cigars. Continued monitoring of use behaviors, including pack quantities by cigar type, is needed as the market and policy landscapes continue shifting. Implications Single cigar purchases are prominent across cigar types. Five-packs and 20-packs were the second most common pack quantities across cigar types, with relatively low proportions for other pack quantities. These findings suggest adults consuming premium cigars consistently prefer singles, a pattern that was found across cigar types. However, when considering purchases made online, premium cigars are widely purchased in larger pack quantities. Age and race were associated with purchase for some cigar types at some years, days used were associated with the purchase quantity in 2017 for all cigar types, and price was positively associated across time periods for only premium cigar purchases. Thus, the factors associated with cigar pack quantity purchase remain unclear. As the cigar policy landscape shifts, continued monitoring of the purchase behaviors by cigar type will be important to better inform future cigar policies.

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A synthesis of local cigar pack policies in the US

Cited by 4 publications

References 25 publications

Longitudinal analysis of cigar use patterns among US youth and adults, 2013–2019

Longitudinal analysis of cigar use patterns among US youth and adults, 2013–2019

The impact of cigar pack size and pricing policies on youth and adult cigar use in the US

Examining Cigar Pack Quantity Purchases by Cigar Type in the United States Between 2014 and 2017

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