Premium and Non-Premium Cigar Use Among a Nationally Representative Sample of Reproductive Age Women: Findings from the 2010–2019 National Survey on Drug Use and Health

Abstract

Abstract Introduction Little is known about cigar use among women of reproductive age, especially potential differences relating to the use of premium versus non-premium cigars. Aims and Methods Using 2010–2019 data from the National Survey on Drug Use and Health, rates and trends in premium and non-premium cigar use were determined among women of reproductive age (18–49; n = 5651). Weighted sociodemographic characteristics, substance co-use, patterns of use, and health indicators were compared between women using premium versus non-premium cigars. Results Among reproductive-aged women who smoked cigars in the past 30 days, 4.9% reported use of premium cigar brands. The most commonly used premium brands were Romeo y Julieta, Cohiba, and Macanudos. Women who used premium versus non-premium cigars were less likely to identify as non-Hispanic black (16.5% vs. 35.5%), more likely to have household income >$50 000 (54.2% vs. 26.6%), and less likely to report past 30-day marijuana (28.7% vs. 55.7%) or blunt use (26.0% vs. 53.9%; ps < .001). Women who used premium cigars also reported later age of onset of cigar use (24.1 vs. 20.3 years; p < .001) and smoked fewer cigars in the last 30 days (9.8 vs. 2.3 days; p < .001). Trend analysis revealed that although rates of past 30-day premium cigar use remained consistent from 2010 (4.7%) to 2019 (4.9%), prevalence decreased from 6.6% in 2017 to 2.8% in 2018 before increasing to 4.9% in 2019. Conclusions Understanding premium and non-premium cigar use among reproductive-age women, an understudied vulnerable population, will provide critical data to the Food and Drug Administration to inform policy and regulatory decisions. Implications The current study revealed prevalence of ~5% premium cigar use among women of reproductive age who smoke cigars, and evidence for consistency in women’s rates of premium cigar use across time. Women who used premium versus non-premium cigars were more likely to identify as non-Hispanic white, older, and of higher socioeconomic status were in better health and less likely to co-use cigarettes and marijuana, but more likely to co-use alcohol. Consideration of reproductive age and pregnant women as uniquely vulnerable populations is warranted in the development of regulations regarding premium and non-premium cigars. Comprehensive regulation of cigars (both premium and non-premium) may offer the potential to positively impact women’s health.