Skip Navigation
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.


The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Your Environment. Your Health.

Publication Detail

Title: Longitudinal associations between use and co-use of cigars and cigarettes: A pooled analysis of three adolescent cohorts.

Authors: Kong, Grace; Mayer, Margaret E; Barrington-Trimis, Jessica L; McConnell, Rob; Leventhal, Adam M; Krishnan-Sarin, Suchitra

Published In Drug Alcohol Depend, (2019 08 01)

Abstract: INTRODUCTION: Patterns of adolescent tobacco product use are evolving rapidly and need examination. We assessed whether ever use of cigars (i.e., lifetime use) was related to an increased risk of subsequent cigarette initiation and dual use of cigars and cigarettes. METHODS: Leveraging data from three prospective cohort studies of adolescents (n = 6258), we assessed the odds of initiating cigarettes at one-year follow-up among ever cigar users at baseline, relative to never cigar users, after adjusting for demographics and e-cigarette use. We also assessed patterns of transition between exclusive use of cigars, exclusive use of cigarettes, and dual use of both cigars and cigarettes between baseline and follow-up and whether these associations differed by e-cigarette use. RESULTS: Among never cigarette smokers (n = 4876; 79.3% of the total sample), 3.4% reported ever cigar use by baseline. Ever cigar use by baseline was associated with higher likelihood of initiating cigarettes by follow-up (31.3%) relative to never cigar use at baseline (8.4%; adjusted odds ratio = 2.26, 95% confidence interval: 1.52, 3.35). Effect estimates were stronger if e-cigarette was used by baseline. Furthermore, exclusive ever cigar use by baseline was associated with a 2-4-fold increase in the odds of transition to exclusive cigar, exclusive cigarette, and dual use at follow-up relative to non-users of either product by baseline. CONCLUSIONS: Comprehensive tobacco regulations and early prevention efforts focused on reducing youth appeal of cigars may be warranted, as cigar use may place youth at risk for subsequent cigarette use as well as dual use of cigars and cigarettes.

PubMed ID: 31181436 Exiting the NIEHS site

MeSH Terms: Adolescent; Female; Humans; Longitudinal Studies; Male; Odds Ratio; Prospective Studies; Tobacco Products/statistics & numerical data*; Tobacco Use/epidemiology*; Vaping/epidemiology

to Top