Flavored cigar smoking among African American young adult dual users: An ecological momentary assessment

Julia Cen Chen-Sankey, Kelvin Choi, Thomas Kirchner, Robert H. Feldman, James Butler, Erin L. Mead

Research output: Contribution to journalArticle

Abstract

Background: Flavored cigar sales have increased in recent years in the U.S. African American young adults (AAYAs) have high prevalence of smoking flavored cigars and dual use with cigarettes, but the predictors of use are unclear. We examined the predictors of flavored cigar smoking among AAYA dual users. Methods: We analyzed data from an Ecological Momentary Assessment (EMA) study that captured near real-time affect, smoking cues, and tobacco smoking from eight text-messaging surveys per day over two weeks. Sixty-three AAYA (ages 18–29) dual users of cigarettes and cigars recorded 1205 cigar smoking moments. Multivariable Generalized Estimating Equations were used to assess the predictors of smoking cigars with flavors and specific flavor types. Results: Half of the participants were women (49.2%) and aged between 18–24 (46.7%). Over the two-weeks, almost all (98.4%) participants smoked flavored cigars, and 64.2% of the cigars smoked were flavored. Alcohol (34.4%) was the most frequently smoked flavor type followed by sweet (23.4%) and mint (5.7%). Feeling stressed (AOR = 1.07) and bored (AOR = 1.10) predicted smoking alcohol flavors. Blunt smoking positively predicted smoking sweet flavors (AOR = 4.79), but negatively predicted smoking alcohol flavors (AOR = 0.40). Conclusions: Smoking flavored cigars, especially alcohol-flavored cigars, was prevalent among AAYA dual users in this study. This group might use specific flavors for different purposes including smoking blunts and boosting mood. Efforts to reduce cigar use need to tackle these risk factors and the increased marketing and low-cost pricing of cigars. A federal ban of cigar flavors might reduce the appeal of cigar products.

Original languageEnglish (US)
Pages (from-to)79-85
Number of pages7
JournalDrug and Alcohol Dependence
Volume196
DOIs
StatePublished - Mar 1 2019

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Tobacco Products
African Americans
Young Adult
Smoking
Flavors
Alcohols
Ecological Momentary Assessment
Text Messaging
Mentha
Costs and Cost Analysis
Mints
Text messaging
Marketing
Cues
Tobacco
Emotions
Costs
Sales

Keywords

  • Cigars
  • Craving
  • Dual use
  • Ecological momentary assessment
  • Flavored cigars
  • Flavored tobacco
  • Health disparities
  • Mood
  • Smoking cues
  • Young adults

ASJC Scopus subject areas

  • Toxicology
  • Pharmacology
  • Psychiatry and Mental health
  • Pharmacology (medical)

Cite this

Flavored cigar smoking among African American young adult dual users : An ecological momentary assessment. / Chen-Sankey, Julia Cen; Choi, Kelvin; Kirchner, Thomas; Feldman, Robert H.; Butler, James; Mead, Erin L.

In: Drug and Alcohol Dependence, Vol. 196, 01.03.2019, p. 79-85.

Research output: Contribution to journalArticle

Chen-Sankey, Julia Cen ; Choi, Kelvin ; Kirchner, Thomas ; Feldman, Robert H. ; Butler, James ; Mead, Erin L. / Flavored cigar smoking among African American young adult dual users : An ecological momentary assessment. In: Drug and Alcohol Dependence. 2019 ; Vol. 196. pp. 79-85.
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abstract = "Background: Flavored cigar sales have increased in recent years in the U.S. African American young adults (AAYAs) have high prevalence of smoking flavored cigars and dual use with cigarettes, but the predictors of use are unclear. We examined the predictors of flavored cigar smoking among AAYA dual users. Methods: We analyzed data from an Ecological Momentary Assessment (EMA) study that captured near real-time affect, smoking cues, and tobacco smoking from eight text-messaging surveys per day over two weeks. Sixty-three AAYA (ages 18–29) dual users of cigarettes and cigars recorded 1205 cigar smoking moments. Multivariable Generalized Estimating Equations were used to assess the predictors of smoking cigars with flavors and specific flavor types. Results: Half of the participants were women (49.2{\%}) and aged between 18–24 (46.7{\%}). Over the two-weeks, almost all (98.4{\%}) participants smoked flavored cigars, and 64.2{\%} of the cigars smoked were flavored. Alcohol (34.4{\%}) was the most frequently smoked flavor type followed by sweet (23.4{\%}) and mint (5.7{\%}). Feeling stressed (AOR = 1.07) and bored (AOR = 1.10) predicted smoking alcohol flavors. Blunt smoking positively predicted smoking sweet flavors (AOR = 4.79), but negatively predicted smoking alcohol flavors (AOR = 0.40). Conclusions: Smoking flavored cigars, especially alcohol-flavored cigars, was prevalent among AAYA dual users in this study. This group might use specific flavors for different purposes including smoking blunts and boosting mood. Efforts to reduce cigar use need to tackle these risk factors and the increased marketing and low-cost pricing of cigars. A federal ban of cigar flavors might reduce the appeal of cigar products.",
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T1 - Flavored cigar smoking among African American young adult dual users

T2 - An ecological momentary assessment

AU - Chen-Sankey, Julia Cen

AU - Choi, Kelvin

AU - Kirchner, Thomas

AU - Feldman, Robert H.

AU - Butler, James

AU - Mead, Erin L.

PY - 2019/3/1

Y1 - 2019/3/1

N2 - Background: Flavored cigar sales have increased in recent years in the U.S. African American young adults (AAYAs) have high prevalence of smoking flavored cigars and dual use with cigarettes, but the predictors of use are unclear. We examined the predictors of flavored cigar smoking among AAYA dual users. Methods: We analyzed data from an Ecological Momentary Assessment (EMA) study that captured near real-time affect, smoking cues, and tobacco smoking from eight text-messaging surveys per day over two weeks. Sixty-three AAYA (ages 18–29) dual users of cigarettes and cigars recorded 1205 cigar smoking moments. Multivariable Generalized Estimating Equations were used to assess the predictors of smoking cigars with flavors and specific flavor types. Results: Half of the participants were women (49.2%) and aged between 18–24 (46.7%). Over the two-weeks, almost all (98.4%) participants smoked flavored cigars, and 64.2% of the cigars smoked were flavored. Alcohol (34.4%) was the most frequently smoked flavor type followed by sweet (23.4%) and mint (5.7%). Feeling stressed (AOR = 1.07) and bored (AOR = 1.10) predicted smoking alcohol flavors. Blunt smoking positively predicted smoking sweet flavors (AOR = 4.79), but negatively predicted smoking alcohol flavors (AOR = 0.40). Conclusions: Smoking flavored cigars, especially alcohol-flavored cigars, was prevalent among AAYA dual users in this study. This group might use specific flavors for different purposes including smoking blunts and boosting mood. Efforts to reduce cigar use need to tackle these risk factors and the increased marketing and low-cost pricing of cigars. A federal ban of cigar flavors might reduce the appeal of cigar products.

AB - Background: Flavored cigar sales have increased in recent years in the U.S. African American young adults (AAYAs) have high prevalence of smoking flavored cigars and dual use with cigarettes, but the predictors of use are unclear. We examined the predictors of flavored cigar smoking among AAYA dual users. Methods: We analyzed data from an Ecological Momentary Assessment (EMA) study that captured near real-time affect, smoking cues, and tobacco smoking from eight text-messaging surveys per day over two weeks. Sixty-three AAYA (ages 18–29) dual users of cigarettes and cigars recorded 1205 cigar smoking moments. Multivariable Generalized Estimating Equations were used to assess the predictors of smoking cigars with flavors and specific flavor types. Results: Half of the participants were women (49.2%) and aged between 18–24 (46.7%). Over the two-weeks, almost all (98.4%) participants smoked flavored cigars, and 64.2% of the cigars smoked were flavored. Alcohol (34.4%) was the most frequently smoked flavor type followed by sweet (23.4%) and mint (5.7%). Feeling stressed (AOR = 1.07) and bored (AOR = 1.10) predicted smoking alcohol flavors. Blunt smoking positively predicted smoking sweet flavors (AOR = 4.79), but negatively predicted smoking alcohol flavors (AOR = 0.40). Conclusions: Smoking flavored cigars, especially alcohol-flavored cigars, was prevalent among AAYA dual users in this study. This group might use specific flavors for different purposes including smoking blunts and boosting mood. Efforts to reduce cigar use need to tackle these risk factors and the increased marketing and low-cost pricing of cigars. A federal ban of cigar flavors might reduce the appeal of cigar products.

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KW - Craving

KW - Dual use

KW - Ecological momentary assessment

KW - Flavored cigars

KW - Flavored tobacco

KW - Health disparities

KW - Mood

KW - Smoking cues

KW - Young adults

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