Background: Single cigarette use and its implications have rarely been studied among adults.
Objective: Assess perceptions, prevalence and correlates of single cigarette purchase behavior and its relationship to harm reduction.
Design: Focus group transcripts and cross-sectional data were analyzed. Setting and participants: Focus groups among convenience samples of adult smokers in two Mexican cities and a population-based sample of 1079 adult smokers from the International Tobacco Control Policy Evaluation Project in four Mexican cities.
Main outcome measures: Purchase of single cigarettes last time cigarettes were bought, frequency of purchasing singles in the previous month and intention to quit in the next six months.
Results: Focus group data indicated that smokers bought singles as a harm reduction strategy. Survey data indicated that 38% of participants purchased singles in the last month and 10% purchased them the last time they bought cigarettes, with more frequent consumption among young adults and those with lower income. Purchasing singles was independently associated with the frequency of using singles to reduce consumption and, less consistently, with the frequency of being cued to smoke due to seeing singles for sale. Using singles to reduce consumption was positively associated with quit intention, whereas being cued to smoke by singles was negatively associated with quit intention.
Conclusions: Study results suggests that some adult Mexican smokers purchase single cigarettes as a method to limit, cut down on and even quit smoking. Nevertheless, promotion of singles availability as a harm reduction strategy could provide additional smoking cues that undermine quit attempts and promote youth smoking.
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