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Cigars (eg, large manufactured cigars, cigarillos) are among the most used combustible tobacco products in the USA.1 2 Some of the popularity of cigars may be driven by the ability to modify them to smoke cannabis ‘blunts’ (ie, hollowed-out cigars filled with cannabis or a mixture of tobacco and cannabis).3–5 Smoking blunts could expose users to greater levels of carcinogens than smoking either cannabis or tobacco alone,6 and, among adolescents and young adults who smoke cigarettes and use cannabis, those who use blunts have greater dependence on nicotine and cannabis than those who use cannabis in forms other than blunts.7 8 Concerningly, blunt use is elevated among individuals who are young, black, or who have substance use disorders.8–10
Blunts can be made using blunt wraps—external wraps typically made of tobacco leaf. However, ‘tobacco-free blunt wraps’ are widely available (eg, convenience stores, tobacco retailers, online). These products do not contain nicotine or tobacco; they are made of products including hemp, banana leaves, palm leaves, and …
Twitter @gracekongphd, @DDavisPhD
Contributors Study conception and design: GK, MEM. Interpretation of results: GK, MEM, DD, KB, SK-S. Draft manuscript preparation/edits: GK, MEM, DD, KB, SK-S. All authors reviewed the results and approved the final version of the manuscript.
Funding This study is funded by Institute of Drug Abuse (NIDA) and the Food and Drug Administration’s Center for Tobacco Products (FDA CTP) grant U54DA036151 (SK-S). Support for authors is also provided by R01DA049878 (GK), K01DA065494 (DD) and R01DA054993 (KWB). The content of this paper is solely the responsibility of the authors and does not represent the official views of the NIH or the FDA.
Competing interests None declare.
Provenance and peer review Not commissioned; externally peer reviewed.
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