"Phantom smokers": Young cigarillo users who do not identify as smokers

Area of Science:

• Public Health
• Tobacco Control
• Youth Health Behaviors

Background:

• Many young individuals consume non-cigarette tobacco products like cigarillos but do not identify as smokers.
• These "phantom smokers" often underestimate health risks and lack motivation to quit.
• Understanding this phenomenon is crucial for effective public health interventions.

Purpose of the Study:

• To determine the prevalence of phantom smoker status among young cigarillo users.
• To examine the characteristics associated with phantom smoker identity.
• To inform targeted tobacco control strategies for youth.

Main Methods:

• An online survey was administered to 1089 participants aged 14-28 who smoke at least two cigarillos weekly.
• Phantom smoker status was defined by self-identification (or lack thereof).
• Statistical analyses included chi-square tests, t-tests, and logistic regression to assess associations with smoking behaviors and quitting confidence.

Main Results:

• 22% of respondents (242 individuals) were identified as phantom smokers.
• Phantom smokers consumed fewer cigarillos weekly and were more likely to smoke only when sharing compared to identified smokers.
• Phantom smokers reported lower rates of concurrent cigarette use, less concern about addiction, and higher confidence in their ability to quit.

Conclusions:

• A significant proportion of young cigarillo users do not identify as smokers, posing a challenge for public health messaging.
• Cigarillo use, particularly non-daily and shared patterns, warrants routine assessment in youth.
• The underestimation of risks and overconfidence in quitting ability among phantom smokers necessitate tailored interventions beyond traditional smoking cessation approaches.