Brief reportCigar/Cigarillo Surveillance: Limitations of the U.S. Department of Agriculture System
Introduction
Cigars of all sizes are addictive and cause early death and disability1, 2, 3 and, dangerously, consumers believe they are less harmful than cigarettes.4, 5 This is especially troubling given the increased sales of small cigars.6 Although much more work is needed, the best available evidence indicates that these cigarette-like cigars are inhaled,7, 8 and that they are as likely as cigarettes to cause lung cancer. Bofetta and colleagues2 found the risks of lung cancer from cigarettes (OR=14.9; 95% CI=12.3) and cigarillos (OR=12.7; 95% CI=6.9) to be equivalent.2
While the U.S. Department of Agriculture (USDA) formally recognizes three types of cigars: (1) little cigars (weighing less than 3 lbs. per thousand); (2) cigarillos (weighing 3–10 lbs. per thousand); and (3) large cigars (weighing more than 10 lbs. per thousand),9 they typically publish only a two-level categorization: (1) little cigars and (2) cigarillos and large cigars combined.10 This two-level system is the standard for cigar surveillance11, 12 in the U.S. and was featured prominently in the National Cancer Institute's monograph on cigars.1 This two-level scheme places little cigars, which are very similar in size to cigarettes, in a category by themselves. In contrast, cigarillos, which can be only slightly heavier than cigarettes, are placed in a category that also includes large cigars, which can be 34 times heavier than cigarettes.13 The current U.S. federal tax is $0.39 per 20 small cigarettes, $0.04 per 20 little cigars, and $0.05 per large cigar.10 When those federal taxes are combined with various states' sales taxes (typically much lower or non-existent for cigars), a pack of 20 cigarettes can cost almost double the price of a pack of 20 little cigars.11, 14
Although the increased sales of little cigars resulted primarily from the lower cost of cigars,10, 14, 15 other factors likely have influenced their use: increased advertising,5, 16 physical similarity to cigarettes (length, tobacco pH, burn-time, filters, and packaging [some are sold in units of 20]),17 and enticing flavors. These products attract smokers (including youth, women, and former smokers18) who are hoping to decrease the costs of smoking, to reduce disease risks, or to increase the convenience of cigar smoking. Industry market research has shown that consumers of little cigars and cigarillos are more similar to each other than to smokers of large cigars,19 and more recent research has shown that young consumers view little cigars and cigarillos as being both less expensive and more convenient (less time-consuming) than cigars.16, 20, 21
The present study evaluates the different trends in cigar sales as a function of the formal three-level classification and explores whether distortions in these trends arise from the USDA's two-level classification.
Section snippets
Methods
Descriptive statistics were used to analyze units of cigars sold from 1976 to 2006 using (1) the standard USDA two-level system and (2) data from the tobacco industry–informed Maxwell Report22 (i.e., a statistical survey of the tobacco industry) that provides information on cigarillos as a separate category. Pearson correlations were conducted to assess intercorrelations among sales of little cigars, cigarillos, and large cigars.
Results
Sales (in units) of cigars are depicted using the current two-level USDA classification system in Figure 1; each type of cigar is depicted separately in Figure 2. Sales of large cigars and cigarillos first declined by 58%, from 5.3 billion units in 1976 to 2.2 billion units in 1991, and then increased by 148%, from 2.1 billion units in 1993 to 5.3 billion units in 2006 (Figure 1). As shown in Figure 2, the rates of decline from 1976 to 1991 were similar for cigars (63% decrease) and cigarillos
Discussion
These findings provide evidence that over the past 30 years, the sales of cigarillos were more similar to the sales of little cigars than to the sales of large cigars. This increased consumption of cigarillos as well as little cigars merits public health attention, given the evidence that (1) smaller cigars (little cigars and cigarillos) may be as dangerous as cigarettes2 and (2) smaller cigars benefit from a tax break compared to cigarettes, and this seems to have enhanced their sales.10, 23,
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