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Surveillance of total nicotine and pH in Cigarette and Cigar Filler.
Abstract
Objective: We examined differences between nicotine concentrations and pH in cigarette and
cigar tobacco filler. Methods: Nicotine and pH levels for 50 cigarette and 75 cigar brands were
measured. Non-mentholated and mentholated cigarette products were included in the analysis
along with several cigar types as identified by the manufacturer: large cigars, pipe tobacco cigars,
cigarillos, mini-cigarillos, and little cigars. Results: There were significant differences found
between pH and nicotine for cigarette and cigar tobacco products. Mean nicotine concentrations
in cigarettes (19.2 mg/g) and large cigars (15.4 mg/g) were higher than the other cigars
types, especially the pipe tobacco cigars (8.79 mg/g). The mean pH for cigarettes was pH 5.46.
Large cigars had the highest mean pH value (pH 6.10) and pipe tobacco cigars had the lowest
(pH 5.05). Conclusions: Although cigarettes are the most common combustible tobacco product
used worldwide, cigar use remains popular. Our research provides a means to investigate the
possibility of distinguishing the 2 tobacco product types and offers information on nicotine and
pH across a wide range of cigarette and cigar varieties that may be beneficial to help establish
tobacco policies and regulations across product types.
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Background
Among U.S. youth overall, cigars are the most commonly used tobacco product after cigarettes. However, youth who identify their products by brand names, not general terms like “cigar,” may underreport use.
Purpose
To examine changes in reported cigar (cigar, cigarillo, or little cigar) smoking among students following inclusion of cigar brand examples on the National Youth Tobacco Survey (NYTS).
Methods
Data from the 2011 and 2012 NYTS and National Survey on Drug Use and Health (NSDUH) were analyzed in 2013 to estimate ever and current cigar smoking, overall and by race/ethnicity. The 2012 NYTS included cigar brand examples (Black and Mild, Swisher Sweets, Dutch Masters, White Owl, Phillies Blunt) in the survey instructions and ever use question, but the 2011 NYTS and 2011 and 2012 NSDUH did not.
Results
NYTS ever cigar smoking was higher in 2012 (27.8%) than 2011 (19.5%) among black students overall. Current cigar smoking was 60%–70% higher among black females and students aged ≥17 years, in 2012 than 2011. For black females, current cigar smoking (11.5%) was two times greater than that of white females (4.3%) in 2012, whereas the prevalence among these subgroups was comparable in 2011. Similar changes were not observed among these subgroups in the 2011–2012 NSDUH.
Conclusions
This study highlights the high burden of cigar use among U.S. youth and suggests that NYTS ascertainment of cigar smoking may have improved by including brands. Disparities in cigar smoking need to be addressed to prevent and reduce all youth tobacco use.
EARLY OBSERVATIONS The history of tobacco use includes accounts of cigar OF ADDICTIVE EFFECTS smoking by native Americans dating back more than 1000 years. In fact, when the term addiction was applied to describe the enslavement of some people to their tobacco in the late 1700's, the main forms of tobacco smoking were cigar and pipe smoking (Murray et al., 1991). The cigarette, which is now the most commonly used nicotine delivery device, did not make its appearance in common use until the 1840's (McKim, 1986). It has long been recognized that cigars contain and deliver psychoactive doses of nicotine. The concept that tobacco strain, growing conditions, and manipulation of the pH of nicotine preparations could greatly affect the amount of nicotine available from cigars was reported by Graham and Carr in 1924. In 1925, Mendenhall noted that the experiments in which a pipe or cigar was smoked were more likely to have subjects report feelings of being dizzy or sick than experiments in which subjects smoked cigarettes, presumably because the cigars and pipes delivered more nicotine than cigarettes. In 1931, Lewin reported on the psychoactive effects of cigars, noting the ceremonial use of cigars to produce a strong psychosis during which a young man can "see spirits which prophesy his future and endow him with strength, knowledge and happiness" (from Phantastica: Narcotic and Stimulating Drugs, Their Use and Abuse reprinted in English by E. P. Dutton and Company, 1964). Lewin concluded that the pharmacological effects of tobacco, smoked or unsmoked, were primarily due to the nicotine released from the tobacco and absorbed by the person. Other pharmacologic effects of cigar smoking, including tolerance, pleasure, and tranquilization were described by Gies et al. in 1921, who concluded that these effects contributed to the habitual use of cigars. Interestingly, Gies and colleagues (1921) listed cigars before cigarettes in the order of greatest to least degree of psychoactive and toxic potency.
Yields of tar, nicotine, and carbon monoxide were compared in selected Canadian brands of manufactured and hand-rolled cigarettes, and small and large cigars. To control for varying volumes of smoke delivery per cigarette or cigar, standardized comparisons in milligrams of toxic substance per liter of smoke were made. The mean deliveries per liter of smoke and tar, nicotine, and carbon monoxide were highest for small cigars, followed by hand-rolled and manufactured cigarettes; large cigars had the lowest deliveries. Five out of six brands of cigarettes handmade from fine-cut tobacco delivered significantly more tar, nicotine, and carbon monoxide per cigarette or per liter than did the identically named manufactured brand.
This article summarizes principal findings from a conference convened by the American Cancer Society in June 1998 to examine the health risks of cigar smoking. State-of-the-science reports were presented and 120 attendees (representing government and private agencies, academia, health educators, and tobacco control experts) participated in panels and summary development discussions. The following conclusions were reached by consensus: (1) rates of cigar smoking are rising among both adults and adolescents; (2) smoking cigars instead of cigarettes does not reduce the risk of nicotine addiction; (3) as the number of cigars smoked and the amount of smoke inhaled increases, the risk of death related to cigar smoking approaches that of cigarette smoking; (4) cigar smoke contains higher concentrations of toxic and carcinogenic compounds than cigarettes and is a major source of fine-particle and carbon monoxide indoor air pollution; and (5) cigar smoking is known to cause cancers of the lung and upper aerodigestive tract. JAMA. 2000;284:735-740
The present study examined characteristics relating to nicotine delivery of 17 cigar brands, which included small cigars, cigarillos, and large premium cigar brands. The cigars selected for analysis were intended to represent the range of cigar products currently available and in popular use. In addition to cigar characteristics previously studied such as size, nicotine content, and pH of their tobacco, the present study examined smoke pH on a puff-by-puff basis. The tobacco content of the cigars ranged in weight from 0.53 to 21.5 g. There was considerable variation in total nicotine content, which ranged from 5.9 to 335.2 mg per cigar. The aqueous pH of the tobacco from the cigars also varied widely with values ranging from 5.7 to 7.8. The smoke pH values of the smallest cigars was generally acidic, changed little across puffs, and more closely resembled the profiles previously reported for typical cigarettes. Interestingly, the smoke pH of smaller cigars and cigarillos became acidic after the first third of the cigar was consumed and then remained acidic thereafter, whereas larger cigars became acidic during the first third, then became quite alkaline during the last third. Because of wide variations in nicotine content of the tobacco across brands and of similarly wide variations in smoke pH, cigar size is not an accurate predictor of the nicotine delivery capacity of a particular cigar brand, although, in general, larger cigars are capable of providing larger total nicotine delivery with extraordinarily high delivery levels being possible from many of the large premium cigars. These results demonstrated that the popular cigars in this study contained enough nicotine for the development of dependence when smoking as few as one or two of the larger cigars per day.
The present study was conducted to determine whether smoking bidis, an additive-free cigarette, and conventional cigarettes caused similar biochemical, physiological and subjective effects. This was an open-label, within-subject design. In each session, subjects (n = 10) smoked a single cigarette: an unfiltered Natural American Spirit, an unfiltered Irie bidi, an unfiltered Sher bidi, or one of the participant's own brand. The presentation of the cigarettes was randomized. Before and up to 1 h after smoking, biochemical markers [plasma nicotine levels and exhaled carbon monoxide (CO)] and physiological effects of nicotine (heart rate and blood pressure) were measured. After smoking, subjects completed two standardized tests of cigarette liking and cigarette sensations. American Spirit (32.1 ng/ml) and Irie bidi (26.0 ng/ml) cigarettes increased plasma nicotine more than the participant's own brand (18.5 ng/ml). Subjects smoked longer and took more puffs to consume the American Spirit (452.8 s, 14 puffs) and Sher bidi (354.4 s, 14 puffs) than the participant's own brand (297.4 s, 10 puffs). In spite of differences in nicotine delivery, participants rated all cigarettes as similar in nicotine content. Overall, the results indicate that bidis and the additive-free cigarette delivered nicotine, CO and (presumably) other toxic components of tobacco smoke in equal or greater amounts than conventional cigarettes. These results do not support an emerging belief that bidi cigarettes are safer than conventional brands.
Tobacco manufacturers have recently introduced a proliferation of exotic brands featuring candylike flavors. We reviewed internal tobacco industry documents and patents to assess the role of flavored cigarettes in the targeting of young smokers. This research revealed the development of flavor delivery technologies hidden from consumers and public health professionals, including the use of a plastic pellet placed in the cigarette filter. These findings raise concerns as to the potential added health risks associated with using new flavored tobacco products, and they underscore the need for effective assessment and monitoring of tobacco products.
The recent availability of internal tobacco industry documents provides significant insight into industry knowledge and manipulation of tobacco smoke delivery. One critical area of research is the role of smoke chemistry in determining the absorption and effects of smoke constituents, especially harm producing or pharmacologically active compounds. Independent scientific research has suggested that the nicotine dosing characteristics, hence the addiction potential of cigarettes, may be determined in part by the amount of free-base nicotine in cigarette smoke and its effects on the location, route, and speed of absorption in the body and on the sensory perception effects of the inhaled smoke. Tobacco industry documents describe the use of a number of methods internally for measuring free-base nicotine delivery. These include the common use of cigarette “smoke pH” as a means to estimate the fraction of free-base nicotine in the particulate matter (PM) in cigarette smoke, as well as efforts to measure free-base nicotine directly. Although these methods do not provide accurate
Absolute
measures of free-base nicotine in smoke, consistencies observed in the findings across the various manufacturers indicate: (1) real
Relative
differences in the acid/base chemistry of the smoke from different brands of cigarettes; (2) a connection between differences in free-base levels and brand-dependent differences in sensory perception and smoke “impact”; and (3) levels of free-base nicotine that are greater than have typically been publicly discussed by the industry. Furthermore, the results of these methods are generally consistent with those of a recent study from the Centers for Disease Control and Prevention which directly measured the free-base fraction of nicotine across a range of cigarette types. Consideration of the likely fundamental importance of free-base nicotine levels in cigarette smoke, together with the efforts discussed in the tobacco industry documents to measure such levels, indicates that the public health community would benefit from additional research to assess directly the delivery of free-base nicotine in cigarette smoke across brands. This may be especially useful for those products (“light”, “ultralight”, “reduced carcinogen”, etc) that have been promoted, either explicitly or implicitly, as “harm reducing”.
Present-day consumption of little cigars rivals that of the early 1970s when sales of little cigars boomed. This boom was largely attributed to RJ Reynolds, and documents reveal how and why they became a powerful force in little cigar sales. RJ Reynolds designed a little cigar, Winchesters, for cigarette smokers and produced one as close to a cigarette as legally possible.
Initially, RJ Reynolds intended to capitalize on the cigarette advertising broadcast ban, but the price and tax structure was more critical to Winchester’s success. Today, the tobacco industry is fighting again to sustain its unique application of federal definitions for little cigars. Regulatory efforts are needed to close taxation loopholes for the little cigar.
Considerable evidence exists that little cigars are popular among African American adolescents and young adults who smoke. However, few studies have been published on the use of this tobacco product by young blacks in the United States. This research investigated little-cigar use among students at a historically black university in the southeastern United States.
As a follow-up to a survey on tobacco use among freshmen that revealed unexpectedly high rates of little-cigar use, 3 focus groups were conducted with current or former smokers of little cigars. Topics included preferred brands of little cigars, preference for little cigars over cigarettes, social contexts for smoking little cigars, perceived health risks of smoking little cigars relative to smoking cigarettes, and thoughts about quitting.
Focus group participants preferred little cigars to cigarettes for various reasons, among them taste, smell, a better "buzz," social purposes, status, and perceptions that smoking little cigars is less addictive and less harmful than smoking cigarettes. Opinions on health risks varied; some participants believed that health risks can be reduced by removing the inner liner of little cigars.
Use of little cigars should be addressed in tobacco research, use prevention, and use cessation efforts, targeting students at historically black colleges and perhaps other young African Americans. Results also suggest that clear distinctions should be made among cigarettes, little cigars, and cigars, and that tobacco use prevention and cessation programs should debunk myths that little cigars are a safe alternative to cigarettes. Study findings should be confirmed and elucidated through additional research.
BACKGROUND:
There has been an increase in the use of cigarillos in the US. People who smoke cigarillos typically also regularly smoke cigarettes (dual users).
METHODS:
We compared puffing topography, biomarkers of acute exposure [exhaled carbon monoxide (COex) and plasma nicotine] and physiologic effects from usual brand cigarette and Black & Mild cigarillo smoking in dual users (N=23) in two laboratory sessions.
RESULTS:
Participants (21 men) smoked an average of 17.5cigarettes/day. Cigarillo consumption varied widely from as few as 1/week to daily. Participants were highly nicotine dependent (average FTND score: 6.3). There were statistically significant differences in smoking behavior between cigarette and cigarillo smoking in time to smoke, number of puffs, and total puff volume (all P<0.001). Average puff duration, interpuff interval average puff volume, and puff velocity did not differ between cigarettes and cigarillos. Nicotine boost was similar after both cigarettes and cigarillos. COex boost was significantly greater after cigarillo smoking compared to cigarette smoking (P<0.001).
CONCLUSIONS:
The smoking pattern and exposure profile indicate that dual users inhale cigarillo smoke just as they inhale cigarette smoke thereby exposing themselves to considerable amounts of nicotine and other components of tobacco smoke. COex exposure results imply that cigarillo smoking may be associated with higher exposure to smoke-delivered volatile components of mainstream cigarillo smoke including carcinogens when compared to cigarettes.
IMPACT:
The findings that cigarillos and cigarettes are smoked similarly in dual users are relevant to health and regulatory considerations on cigar products.
Copyright © 2015. Published by Elsevier Inc.
Introduction:
Although cigar use and sales have increased in the United States over the past decade, little is known about how these products are promoted. Direct-to-consumer (DTC) advertising is a common method used to promote tobacco products and may be a potential channel through which cigars are advertised.
Methods:
Comperemedia (Mintel) was used to acquire opt-in direct mail and email advertising for the top 10 cigar brands in the United States between January 2013 and July 2014. The advertisement and corresponding data on brand, advertising spend, and mail volume were downloaded and summarized. Promotions such as coupons, giveaways, and sweepstakes were also examined.
Results:
A total of 92 unique advertisements met the search criteria and included two brands: Black & Mild (n = 77) and Swisher Sweets (n = 15). Expenditures on direct mail advertising during this period totaled $12 809 630. Black & Mild encompassed 80% of total direct mail volume and 78% of direct mail advertising expenditures. Almost all advertisements contained at least one promotion (88%) and included a URL to the product website (85%).
Conclusions:
The results suggest that Black & Mild and Swisher Sweets are the primary cigar brands using DTC advertising. Promotional offers were nearly ubiquitous among the advertisements, which may appeal to price-sensitive populations. Future studies should continue to examine cigar advertising via direct mail and email, in addition to other channels, such as the point-of-sale.
Implications:
Although cigar use and sales have increased in the United States over the past decade, there is limited data on cigar advertising. This article provides a snapshot of expenditures, volume, and promotional content of DTC cigar advertising in the United States between January 2013 and July 2014.
The mainstream smoke yields of 14 polycyclic aromatic hydrocarbons (PAHs) were determined for 50 commercial U.S. cigarettes using a validated GC/MS method with the International Organization of Standardization (ISO) and Canadian Intense (CI) smoking machine regimens. PAH mainstream smoke deliveries vary widely among the commercial cigarettes with theISO smoking regimen primarily because of differing filter ventilation. The more abundant, lower molecular weight PAHs such as naphthalene, fluorene, and phenanthrene predominantly comprise the total PAH yields. In contrast, delivery yields of high molecular weight PAHs such as benzo[b]fluoranthene, benzo[e]pyrene, benzo[k]fluoranthene, and benzo[a]pyrene (BaP) are much lower. Comparative analysis of PAHs deliveries shows brand specific differences. Correlation analysis shows strong positive associations between BaP and most of the other PAHs as well as total PAHs. The results suggest that BaP may be a representative marker for other PAH constituents in cigarette smoke generated from similarly blended tobacco, particularly those PAHs with similar molecular weights and chemical structures.
Cigars remain a widely used tobacco product among adolescent and adult populations. The appeal of a certain type of cigar, the cigarillo, may be enhanced by users' beliefs that their harm potential can be reduced by removing the inner tobacco liner before use (a.k.a. "hyping"). The purpose of this within-subject study was to compare the acute effects of smoking an original cigarillo, a modified ("hyped") cigarillo, and an unlit cigarillo.
Twenty smokers (19 males, 1 female; 19 non-Hispanic African Americans, 1 Hispanic "other") of ≥ 7 Black&Mild cigarillos/week and ≤5 cigarettes/day completed the study. All participants reported hyping their cigarillos at least occasionally. Primary outcomes, assessed over two, 30-min smoking bouts, included plasma nicotine, expired air CO concentration, subjective ratings (product effects, nicotine abstinence symptoms), and puff topography.
Mean plasma nicotine concentration increased significantly within (pre- to post-bouts), but not between, original and modified B&M conditions. Mean CO concentration was significantly lower for modified, relative to original, B&M smoking at all post-administration timepoints. Both smoked conditions significantly increased ratings of positive product effects (satisfaction, pleasant) and decreased abstinence symptom magnitude; however, ratings generally did not differ between these conditions. Overall, topography outcomes did not differ between modified and original B&M smoking.
Results are consistent with a previous report in that "hyping" may decrease users' CO, but not nicotine, exposure. While these data collectively suggest reduced exposure to CO acutely with engagement in "hyping", longer-term assessments are needed to determine the impact on individual and public health.
© The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Despite the increasing consumption of little cigars and cigarillos (LCCs), few studies have examined unique predictors and correlates of LCC use among adult cigarette smokers. This study explored differences between cigarette smokers with and without a history of LCC use on harm perceptions, use of other tobacco products (chewing tobacco, snus, e-cigarettes, and dissolvables), cigarette smoking/cessation-related behaviors/cognitions, and mental health and substance use disorder symptoms.
A geographically diverse sample of current cigarette smokers were included in analyses (n=1,270). Frequencies of LCC use, awareness, purchase, and harm perceptions were examined and logistic regression models investigated differences between LCC ever and never users on a variety of factors, controlling for demographics.
Bivariate analyses showed that LCC users were more likely to be male, younger, have lower income, have tried other tobacco products, perceive LCCs as less harmful than cigarettes, and endorse lifetime substance disorder symptoms. Menthol and other tobacco product trial were the only significant correlates of LCC use in logistic regression models. Post-hoc analyses showed that other tobacco product use partially mediated an association between substance use disorder symptoms and LCC use.
A third of the sample had tried LCCs, and LCC users were more likely to have experimented with other tobacco products and used menthol. The high degree of co-use of cigarette smoking and LCCs with other tobacco products and its association to substance use suggests that these users have unique risk factors and deserve specific targeting in public health campaigns.
© The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Cigars were one form of Native American tobacco use observed by Columbus and early European settlers. A long, thick bundle of twisted tobacco leaves wrapped in a dried palm or maize leaf was used by Native Americans as a primitive cigar. Smoking of cigars is recorded on artifacts of the Mayas of the Yucatan region of Mexico, and the Mayan verb "sikar," meaning to smoke, became the Spanish noun "cigarro." Among early English colonists of the 1600's, tobacco was used predominantly in the form of smokeless tobacco or smoked in pipes, although tobacco was also smoked as cigars at this time. Records dating from the late 1700's suggest that most cigars were imported from the West Indies and Cuba during the Colonial period. The first U.S. cigar factory was established in Connecticut in 1810. Cigar manufacturing spread to other parts of the U.S. as cigar use slowly gained in popularity. Through the 1880's and early 1900's, cigars remained a popular form of tobacco use, with most cigars made of locally grown tobacco and marketed locally. By 1900, tobacco used in the form of cigars accounted for 2.0 of the 7.5 pounds of tobacco consumed per adult in the U.S., second only to chewing tobacco's 3.5 pounds per adult (USDA 1997, Burns et al 1997). However, the amount of tobacco consumed as cigars declined as the popularity of cigarettes increased around the time of World War I.
While cigarette consumption in the USA continues to decline, cigar consumption has increased. Tobacco-trade publications suggest that flavoured cigars are driving the recent growth in cigar consumption. Limited survey data exist to explore flavoured cigar preferences among youth and adults.
This study used the 2010-2011 National Survey on Drug Use and Health (NSDUH) and Nielsen market scanner data. The NSDUH sample consisted of 6678 past 30-day cigar smokers who reported smoking a usual brand of cigars. NSDUH contains a measure on usual cigar brand smoked and was merged with Nielsen data to estimate the per cent of each cigar brand's market share that is flavoured.
Multivariate analyses indicate that youth, young adults, females, blacks, cigarette smokers, blunt users and daily cigar smokers are significantly more likely to report a usual cigar brand that is flavoured. Preference for a usual brand that produces flavoured cigars decreases significantly with age.
This study finds recent growth in flavoured cigar consumption and preference among youth and young adults for cigar brands that are flavoured. These findings underscore the need to expand monitoring of product attributes as well as individual-level cigar use behaviours captured through population surveillance.
Objectives:
We have documented little cigar and cigarillo (LCC) availability, advertising, and price in the point-of-sale environment and examined associations with neighborhood demographics.
Methods:
We used a multimodal real-time surveillance system to survey LCCs in 750 licensed tobacco retail outlets that sold tobacco products in Washington, DC. Using multivariate models, we examined the odds of LCC availability, the number of storefront exterior advertisements, and the price per cigarillo for Black & Mild packs in relation to neighborhood demographics.
Results:
The odds of LCC availability and price per cigarillo decreased significantly in nearly a dose-response manner with each quartile increase in proportion of African Americans. Prices were also lower in some young adult neighborhoods. Having a higher proportion of African American and young adult residents was associated with more exterior LCC advertising.
Conclusions:
Higher availability of LCCs in African American communities and lower prices and greater outdoor advertising in minority and young adult neighborhoods may establish environmental triggers to smoke among groups susceptible to initiation, addiction, and long-term negative health consequences.
In recent years, there has been a rapid proliferation of smokeless products with a wide range of nicotine content and flavoring formulations that may appeal to new users and existing cigarette smokers. The CDC nicotine method, which employs gas chromatography–flame ionization detection (GC–FID), provides a robust means for measuring nicotine in smokeless tobacco. However, several compounds, identified in a few flavored smokeless products, interfere with nicotine quantification using GC–FID. In response, the standard nicotine method (26.7 min run time) was modified to use faster GC ramping (3.7 min run time) and detection with mass spectrometry (GC–MS) in selected ion-monitoring mode to reduce signal interferences that can bias nicotine values. Seven conventional smokeless samples (n = 12) and blank tobacco samples spiked at three nicotine concentration levels (n = 5) were analyzed using the GC–FID and GC–MS methods and found to be in excellent agreement. However, only the GC–MS method provided confirmation of chromatographic peak purity in certain highly flavored products. The GC–MS method is not intended to replace the GC–FID method but to provide a method versatile enough to analyze a wide range of nicotine values in domestic and international samples of varying complexity. Accurate nicotine quantification is important for determining total nicotine content in tobacco and in subsequent calculations of un-protonated nicotine content.
Introduction:
Under its authority to regulate tobacco products, the U.S. Food and Drug Administration prohibited certain characterizing flavors in cigarettes in September 2009; however, flavored cigars are still permitted to be manufactured, distributed, and sold. This study assessed the prevalence and correlates of flavored cigar smoking among U.S. adults.
Methods:
Data were obtained from the 2009-2010 National Adult Tobacco Survey, a national landline and cell phone survey of adults aged ≥ 18 years old residing in the 50 U.S. states and the District of Columbia. National and state estimates of flavored cigar use were calculated overall and among current cigar smokers; national estimates were calculated by sex, age, race/ethnicity, educational attainment, annual household income, U.S. Census Region, and sexual orientation.
Results:
The national prevalence of flavored cigar smoking was 2.8% (95% confidence interval [CI] = 2.6%-3.1%; state range: 0.6%-5.7%) and was greater among those who were male, younger in age, non-Hispanic Other race, less educated, less wealthy, and lesbian, gay, bisexual, or transgendered (LGBT). Nationally, the prevalence of flavored cigar use among cigar smokers was 42.9% (95% CI = 40.1%-45.7%; state range: 11.1%-71.6%) and was greater among those who were female, younger in age, Hispanic, non-Hispanic Other race, less educated, less wealthy, and LGBT.
Conclusions:
More than two fifths of current cigar smokers report using flavored cigars. Disparities in flavored cigar use also exist across states and subpopulations. Efforts to curb flavored cigar smoking have the potential to reduce the prevalence of overall cigar smoking among U.S. adults, particularly among subpopulations with the greatest burden.
Nicotine is the principal alkaloid in both commercial and homemade products (e.g., cigarettes, smokeless tobacco, bidis, waterpipes) followed by nornicotine, anabasine, anatabine, and many other basic substances that contain a cyclic nitrogenous nucleus. Tobacco types, leaf position on the plant, agricultural practices, fertilizer treatment, and degree of ripening are among some prominent factors that determine the levels of alkaloids in tobacco leaf. From a random examination of 152 cultivated varieties of Nicotiana tabacum, a range of alkaloid variation between 0.17 and 4.93% was determined. In fact, every step in tobacco production that affects plant metabolism will influence the level of alkaloid content to a certain degree. Depending on blending recipe, type and amount of additives, and product design, all types of tobacco products contain a very wide range of nicotine concentration. However, the ultimate emission of nicotine to the user, exposure, and psychophar-macological effects depend not only on the content and emission, but also on the relationship between the product and the user.
There is relatively little information available about the chemical constituents of tobacco and individual toxic emissions from cigarettes and other tobacco products.
To characterise 21 constituents in whole tobacco and 41 constituents in the smoke emissions of Canadian cigarettes, as well as to compare differences between domestic and imported brands.
All data were released as part of Canada's Tobacco Reporting Regulations. Data are reported for 247 brands tested in 2004.
The results indicate significant differences in the constituent levels of domestic and imported cigarette tobacco. Levels of ammonia compounds were significantly higher in imported "US blended" tobacco compared to domestically manufactured brands. Toxic emissions for tobacco-specific nitrosamines were significantly higher for imported cigarettes under both the ISO and Canadian Intense testing methods; however domestic cigarettes had higher levels of other toxic constituents, including benzo[a]pyrene. The findings also highlight the extent to which nicotine, heavy metals and tobacco-specific nitrosamines are "transferred" from the whole tobacco to the smoke.
The findings illustrate important differences between domestically manufactured Virginia flue-cured cigarettes and imported US blended cigarettes. Although the findings suggest that domestic cigarettes had lower levels of constituents such as ammonia, which are associated with increased "additives", Canadian cigarettes were by no means "additive-free." Overall, these findings provide important benchmarks for making historical and international comparisons across brands on key constituents.
The risk of lung cancer is greater in cigarette smokers than in cigar or pipe smokers. In Great Britain, which has a very high lung-cancer death rate, cigarette tobacco (flue-cured) has a high sugar content (up to 20%) while cigar tobacco (aircured) has a low sugar content (0.5—2%). Determinations of the sugar content of the tobacco and the pH of the smoke of cigarettes from more than 30 countries, and of a number of cigar and pipe tobaccos, have been carried out. The main differences found between the characteristics of cigarette and cigar and pipe tobaccos are:
Since the satisfaction derived from smoking is mainly due to the pharmacological effects of nicotine, it is suggested that the lower lung cancer incidence in cigar and pipe smokers may be related to the fact that nicotine is more readily absorbed in the form of the free base, at alkaline pH, than in the form of a stable salt, at acid pH. To obtain the same degree of “nicotine satisfaction” as in smoking a pipe or cigar, the smoker of cigarettes giving an acid smoke would tend to smoke more, and to encourage more prolonged and extensive contact of the smoke with the mouth and bronchus, and to take the smoke into his lungs, which would thus suffer greater exposure to the “carcinogenic” effects of the smoke than would be the case with cigar or pipe smokers.
In preliminary attempts to devise a “safer” cigarette, the addition of substances which give rise to an alkaline vapour at the usual temperature of combustion of cigarettes has been shown to reverse the character of the smoke of high sugar (fluecured) tobacco cigarettes so that it then resembles that of cigars and pipes in becoming progressively more alkaline during the course of smoking.
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Nicotine is recognized to be the major inducer of tobacco dependence. The smoking of cigarettes as an advantageous delivery system for nicotine, accelerates and aggravates cardiovascular disease, and is causally associated with increased risks for chronic obstructive lung disease, cancer of the lung and of the upper aerodigestive system, and cancer of the pancreas, renal pelvis, and urinary bladder. It is also associated with cancer of the liver, cancer of the uterine cervix, cancer of the nasal cavity, and myeloid leukemia. In 1950, the first large-scale epidemiological studies documented that cigarette smoking induces lung cancer and described a dose-response relationship between number of cigarettes smoked and the risk for developing lung cancer. In the following decades these observations were not only confirmed by several hundreds of prospective and case-control studies but the plausibility of this causal association was also supported by bioassays and by the identification of carcinogens in cigarette smoke. Whole smoke induces lung tumors in mice and tumors in the upper respiratory tract of hamsters. The particulate matter of the smoke elicits benign and malignant tumors on the skin of mice and rabbits, sarcoma in the connective tissue of rats, and carcinoma in the lungs of rats upon intratracheal instillation. More than 50 carcinogens have been identified, including the following classes of compounds: polynuclear aromatic hydrocarbons (PAH), aromatic amines, and N-nitrosamines. Among the latter, the tobacco-specific N-nitrosamines (TSNA) have been shown to be of special significance. Since 1950, the makeup of cigarettes and the composition of cigarette smoke have gradually changed. In the United States, the sales-weighted average "tar" and nicotine yields have declined from a high of 38 mg "tar" and 2.7 mg nicotine in 1954 to 12 mg and 0.95 mg in 1992, respectively. In the United Kingdom, the decline was from about 32 mg "tar" and 2.2 mg nicotine to less than 12 mg "tar" and 1.0 mg nicotine per cigarette. During the same time, other smoke constituents changed correspondingly. These reductions of smoke yields were primarily achieved by the introduction of filter tips, with and without perforation, selection of tobacco types and varieties, utilization of highly porous cigarette paper, and incorporation into the tobacco blend of reconstituted tobacco, opened and cut ribs, and "expanded tobacco." In most countries where tobacco blends with air-cured (burley) tobacco are used, the nitrate content of the cigarette tobacco increased. In the United States nitrate levels in cigarette tobacco rose from 0.3-0.5% to 0.6-1.35%, thereby enhancing the combustion of the tobacco. More complete combustion decreases the carcinogenic PAH, yet the increased generation of nitrogen oxides enhances the formation of the carcinogenic N-nitrosamines, especially the TSNA in the smoke. However, all analytical measures of the smoke components have been established on the basis of standardized machine smoking conditions, such as those introduced by the Federal Trade Commission, that call for 1 puff to be taken once a minute over a 2-s period with a volume of 35 ml. These smoking parameters may have simulated the way in which people used to smoke the high-yield cigarettes; however, they no longer reflect the parameters applicable to contemporary smokers, and especially not those applicable to the smoking of low- and ultra-low-yield filter cigarettes. Recent smoking assays have demonstrated that most smokers of cigarettes with low nicotine yield take between 2 and 4 puffs per minute with volumes up to 55 ml to satisfy their demands for nicotine. The overview also discusses further needs for reducing the toxicity and carcinogenicity of cigarette smoke. From a public health perspective, nicotine in the smoke needs to be lowered to a level at which there is no induction of dependence on tobacco.
The U.S. Department of Agriculture (USDA) reports data on cigar sales in two categories: little cigars (weighing less than 3 lbs. per thousand) and large cigars and cigarillos (weighing more than 10 lbs. per thousand). A rise in the sales of little cigars in recent years is a cause for concern. The capacious second category could be obscuring the growth of sales in cigarillos.
Trends in cigar use were analyzed in May 2007 using (1) the standard USDA two-level system and (2) data from the Maxwell Report that provides information on cigarillos as a separate category. The intercorrelations among cigar use trends in the three areas were also explored.
From 1993 to 2006, unit sales of little cigars increased from 37% to 47% of the cigar market, cigarillos increased from 25% to 32%, and large cigars dropped from 37% to 22%. From 1976 to 2006, cigarillo sales were strongly related to sales of little cigars (r=0.93; 95% CI=0.86-0.97), while sales of large cigars and cigarillos were modestly related (r=0.42; 95% CI=0.08-0.57).
Analyses show strong correlations between cigarillo and little cigar sales and argue for more detailed reporting of cigar sales as a function of cigar size. Tobacco surveillance should at minimum be watching the same trends as the tobacco industry. The sales of little cigars, cigarillos, and large cigars should be monitored, and the measuring of cigarillo sales in 3-5 subcategories according to size is encouraged.
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