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Updated: Jul 5, 2026

Comparing the Effects of Electronic Cigarette Vapor and Cigarette Smoke in a Novel In Vivo Exposure System
Published on: May 24, 2017
Cigars, cigarettes, and adolescents
Ashley Brooks1, Elizabeth M Gaier Larkin, Sonal Kishore
1University of North Carolina, Chapel Hill, NC 27599, USA. ashley.brooks@unc.edu
Objective:
To examine public health implications of adolescent use of cigars only, cigarettes only, and both cigarettes and cigars.
Methods:
A cross-sectional health risk survey was administered to a random sample of 4486 high school students in a Midwestern county.
Results:
More adolescents reported using both cigarettes and cigars (10.6%) than cigar-only (7.4%) or cigarette-only (6.4%). Product of initiation was associated with current product use. Dual use was associated with more frequent use of both products, high stress, and susceptibility to future cigarette use.
Conclusion:
Assessing cigarette use without examining cigar use overlooks a critical dimension of adolescent tobacco use.
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