Short communication: Racial/ethnic disparities in cigar and cigarette exclusive, dual, and polyuse among adults

Despite documented racial/ethnic differences in cigar use, disparities in the context of dual and polyuse with cigarettes are unclear.

Using the Population Assessment of Tobacco and Health Study (2016-18), we examined prevalence and intensity of use patterns among adults (18+) who were Non-Hispanic (NH) Black, NH White, Hispanic, or another race/ethnicity: exclusive cigarillo, filtered cigar, traditional cigar, or cigarette use; dual use of each cigar product with cigarettes; dual or polyuse of cigars without cigarettes; and cigar and cigarette polyuse. We used multinomial logistic regression to compare odds of each pattern of use to non-use of cigars or cigarettes and quantile regression to assess differences in median products used per day.

In our sample (n = 33,424), NH Black adults were more likely to exclusively smoke cigarillos (1.8%), cigarillos and cigarettes (1.6%), and multiple cigar products with or without cigarettes than other racial/ethnic groups. In adjusted models, NH Black compared to NH White adults had higher odds of exclusive cigarillo use (aOR 5.24, 95% CI 3.74-7.34), exclusive filtered cigar use (aOR 2.40, 95% CI 1.33-4.35), cigarillo and cigarette dual use (aOR 2.19, 95% CI 1.60-3.00), and dual/polyuse of cigar products (aOR 2.03, 95% CI 1.22-3.38) compared to non-current use. However, NH White adults tended to smoke the most cigarettes and filtered cigars per day.

While the prevalence of cigar use was generally highest among NH Black adults, intensity of use was often highest among NH White users. These patterns may further explain racial/ethnic disparities in tobacco-related health outcomes.