Ad lib Smoking of Black & Mild Cigarillos and Cigarettes

Abstract

Introduction: Over the past 20 years, there has been a tripling in the consumption of small cigars and cigarillos, with further increases expected because cigar products are not subject to Food and Drug Administration regulations. Acute toxin exposure from cigar smoking is difficult to assess because unlike cigarettes, cigars vary widely in size, design, composition, and in the smoking behavior of their consumers. For example, a recent practice among urban youth is to remove the paper liner (i.e., "freaking") of a small cigar in the belief that it is this paper liner that leads to addiction and cancer. Methods:We examined acute exposure (CO and nicotine boosts) and puffing behavior in 12 participants (10 men) who smoked (ad lib) their usual conventional cigarette, a Black & Mild cigar (B&M) and a B&M without the paper liner (i.e., "freaked" [B&Mf]).Results: All products (cigarettes, B&M, and B&Mf) significantly increased heart rate and CO with a trend for plasma nicotine. Nicotine boost was significantly higher after cigarette smoking than both B&M and B&Mf, while CO boost was significantly greater after B&M and B&Mf than cigarettes. The CO boost after B&M was larger than after B&Mf. Conclusions:These findings suggest that small cigar smoking is associated with smoke inhalation that leads to significant exposure to nicotine, CO, and presumably other components of tobacco smoke and that removing the inner liner does not substantially reduce toxin exposure.

Acute Effects of “Hyping” a Black&Mild Cigarillo

“…An analysis of YouTube videos depicting the practice of B&M modification supports this idea, as many users recommended removal of the "cancer paper" prior to smoking. 16 Results reported here and elsewhere 17 demonstrate that B&M smokers are exposed to less CO, but similar levels of nicotine, when they remove this inner binder. This reduction in CO exposure cannot be explained by differences in smoking topography, however.…”

“…Consequently, the average plasma nicotine levels reported here-11.8 ± 0.7 ng/mL for modified and 13.4 ± 0.9 ng/mL for original-approach those for ad libitum cigarette smoking (collapsed across bouts = 12.9 ± 0.6 ng/mL 21 ). Importantly, results add to the growing literature 17,20 that B&M smoking exposes users to pharmacologically active doses of nicotine, as well as relatively high levels of CO. B&M users are clearly inhaling the smoke when they puff on these products. Specifically, these levels of nicotine in plasma immediately after smoking are indicative of lung, rather than buccal, absorption.…”

“…Available work on this practice has reported only on use of the B&M brand. 13,[15][16][17] Either way, such beliefs for B&M cigarillos persist in the absence of any empirical evidence to support the notion that binder removal engenders these effects.…”

“…17 Smokers were required to have used B&M cigarillos in their lifetime, but were not required to report engagement in "hyping". Following the ad libitum smoking of their condition-assigned product, expired air carbon monoxide (CO) levels were significantly lower for modified, relative to original, B&M smoking.…”

“…These results suggest that removal of the inner binder may, in fact, reduce exposure to some toxicants. 17 On the other hand, participants may have changed the manner in which they smoke a B&M that is "hyped". That is, they may have taken fewer (number), smaller (volume), shorter (duration), and/or more frequent (inter-puff-interval [IPI]) puffs from the modified cigarillos.…”