Premium Cigars Patterns of Use, Marketing, and Health Effects (2022) / Chapter Skim
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2 Characteristics of Cigars
2 Characteristics of Cigars
Pages 59-102
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From page 59... ...
" or "cigars in general" are used in this report, they refer to all cigar types (filtered cigars, little cigars, cigarillos, and large/traditional cigars [which include premium cigars]
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From page 60... ...
. Exceptions to this are some little cigars, which tend to use some flue-cured and/or Turkish tobacco, presumably to be more appealing to cigarette users (Delnevo and Hrywna, 2007)
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From page 61... ...
The cigar marketplace is highly diverse, including little/filtered cigars, cigarillos, large nonpremium cigars, and premium cigars (see Figure 2-1)
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From page 62... ...
difference in weight between little cigars and large filtered cigars (Caruso et al., 2015)
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From page 63... ...
measured 21 cigarillos (including what they refer to as "mini" cigarillos) and reported a mean pH of tobacco in aqueous solution of 5.7; the two cigarillos with the highest pH were determined by the committee to be premium cigars.
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From page 64... ...
. Several of the remaining "large cigars" were premium cigar brands and matched the committee's definition of a premium cigar.
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From page 65... ...
study, one of the large cigars was premium: a Romeo y Julieta 1875 Churchill, which weighed 17.60 grams. Recent testing commissioned by the committee of 66 premium cigars from several top premium cigar brands highlights that these products are quite large and considerably exceed 6 pounds per 1,000 units (Yassin et al., 2021)
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From page 66... ...
CIGAR CHEMISTRY Introduction All cigar tobaccos, like all cigarette and smokeless tobaccos, contain the highly addictive compound nicotine and carcinogenic tobacco-specific nitrosamines (NCI, 1998)
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From page 67... ...
Overview of Chemistry and Toxicology Findings from 1998 NCI Monograph on Cigars Chapter 3 of the 1998 NCI monograph, on chemistry and toxicology, compared selected components of cigar tobacco (including some premium cigars) and types of cigarette tobacco; relevant data are discussed here.
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From page 68... ...
have been found in all tobacco types of little cigars, nonfilter cigars, filter cigarettes, and nonfilter cigarettes (NCI, 1998)
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From page 69... ...
FIGURE 2-3 pH of total mainstream smoke of various tobacco products. NOTE: 1 = little cigar I; 2 = little cigar II; 3 = cigar; 4 = Kentucky reference cigarette; 5 = blended filter-tipped cigarette (85 mm)
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From page 70... ...
This free nicotine is readily absorbed across the oral mucosa, and may explain why cigar smokers are less likely to inhale than cigarette smokers." No new evidence in the current literature would significantly alter these conclusions. Studies Published After the 1998 NCI Monograph on Cigars Constituents of Cigar Tobacco The studies reported here investigated constituents of cigar tobacco.
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From page 71... ...
Fresquez and colleagues (2015) developed a validated method for the high-throughput determination of mercury in tobacco and mainstream smoke from little cigars.
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From page 72... ...
They are all made from cigar tobacco (with the exception of little cigars, which can include tobacco blends [Delnevo and Hrywna, 2007]
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From page 73... ...
developed a validated method to determine mercury in tobacco and mainstream smoke from little cigars. Mercury levels in little cigar smoke under International Organization for Standardization/U.S.
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From page 74... ...
Hamad and colleagues (2017) compared levels of nicotine and certain harmful and potentially harmful constituents in mainstream, standard 3R4F reference cigarette smoke with those in the mainstream smoke of four popular little cigars under standardized smoking conditions.
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From page 75... ...
Little cigars produced higher mainstream smoke yields than cigarettes under both smoking regimens, and little cigar smoke contained higher amounts of these compounds than cigarette smoke when amounts were adjusted for the mass of tobacco. Edwards and colleagues (2021)
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From page 76... ...
While there is insufficient evidence on the pH of premium cigar smoke, the pH of large cigar smoke is generally higher than cigarette smoke, which can decrease depth of inhalation and increase nicotine absorption through the oral mucosa. There is insufficient evidence on the relationship between the pH of premium cigar tobacco and smoke.
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All subjects inhaled the cigar smoke to varying degrees, independent of whether they were also current or past cigarette users or exclusive cigar users. The 1999–2012 National Health and Nutrition Examination Survey (NHANES)
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From page 78... ...
examined smoking topography and toxicant exposure (plasma nicotine and exhaled CO) in three groups of study participants who smoked both cigarettes and filtered little cigars, cigarillos, or large cigars (Phillies Blunt)
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0.6 (SD = 0.5) plasma nicotine (ng/mL)
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b Cmax (Cmax normalized by the amount of tobacco smoked [i.e., ng/ mL/g tobacco]
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between primary and secondary cigar smokers. # = statistically significant differences (p < .05)
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Time (min) FIGURE 2-4 Plasma nicotine levels during ad libitum cigar smoking session.
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From page 83... ...
Based on the measurement of urinary biomarkers of nicotine and toxicants and carcinogens in the large NHANES and PATH studies and several smaller controlled clinical studies examining different products, such as small and large cigars, cigar users are exposed to significant amounts of nicotine and harmful and potentially harmful constituents. While levels of some urinary biomarkers were higher in every day exclusive cigarette smokers, the PATH study found that, for other biomarkers, concentrations in every day exclusive traditional cigar smokers were comparable to those of every day exclusive cigarette smokers. This indicates similar exposure and uptake of nicotine, toxicants, and carcinogens.
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From page 84... ...
84 TABLE 2-4 Comparison of Selected Urinary Biomarkers in Every Day Exclusive Traditional Cigar Smokers and in Other Smokers and Never-Tobacco Users Biomarker Every Day Exclusive Tra- Some Day Exclusive Tradi- Every Day Exclusive Urinary Biomarker Source ditional Cigar Smokers tional Cigar Smokers Cigarette Smokers Never-Tobacco Users Total nicotine equiv- nicotine 24.05 (range = 12.85–45.00) 0.16 (range = 0.07–0.33)
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From page 85... ...
. Finally, alternative approaches to studying puffing topography, including direct observation by trained observers and video recordings, have not been commonly used to analyze inhalation patterns of premium cigar users.
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. The order of tobacco products was randomized.
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From page 87... ...
(Rosenberry et al., 2018) ; the immediate increase implies significant large cigar smoke inhalation.
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From page 88... ...
, it is reasonably expected that increased alkalinity of a premium cigar could also promote oral nicotine absorption, even if emitted smoke is not inhaled. The observation that dual users of cigars and cigarettes may be more likely to inhale deeply than exclusive users of cigars is also seen in differences in perceived level of inhalation reported by participants in the Cancer Prevention Study I of the American Cancer Society, conducted between 1959 and 1972.
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From page 89... ...
TABLE 2-6 2x2 rANOVA Models of Outcome Measures Mean (SD) Product Time Product x Time Interaction Large Cigar Outcome Measure Cigarette Smoking Smoking F Value p Value F Value p Value F Value p Value Plasma nicotine (ng/mL)
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From page 90... ...
For example, in PATH Wave 4, only about one-third (33.7 percent) of current premium cigar users were never-cigarette users; 25.7 and 40.6 percent were current or former cigarette users, respectively (Jeon and Mok, 2022)
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From page 91... ...
FIGURE 2-6 Levels of inhalation from CPS-1 study. NOTE: CPS = Cancer Prevention Study.
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From page 92... ...
Conclusion 2-5: There is strongly suggestive evidence that the inhalation patterns of cigar smokers in general significantly affect their exposure to nicotine and harmful and potentially harmful constituents. At present, the extent to which premium cigar users who do not inhale have sys temic exposure to nicotine and harmful and potentially harmful constitu ents remains unknown.
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From page 93... ...
Additionally, FDA and NIH asked the committee a research question about the potential effects of added flavors, which are an important consideration because they could influence the constituent profile and use of tobacco products like premium cigars. Manufacturing of Flavored Cigars Cigars vary by not only size but also added, characterizing flavors (Corey et al., 2014)
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From page 94... ...
CONCLUDING OBSERVATIONS Despite the many different types of cigars in the U.S. market, including premium cigars, all cigar tobaccos contain the highly addictive compound nicotine, as well as toxicants and carcinogenic tobacco-specific nitrosamines.
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From page 95... ...
Data on premium cigar smoke inhalation topography are limited; however, past or concurrent users of other combustible tobacco products appear to puff more intensely on cigars compared to those users who only smoke cigars. Methods are available for the analysis of premium cigar tobacco for hazardous and potentially hazardous compounds, but developing standardized conditions for quantitation of constituents of premium cigar smoke is a research priority; CORESTA may be well placed to develop these reproducible methods.
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From page 96... ...
found that some cigar users who were former cigarette users switched to cigars after flavors were banned from cigarettes. 1 Public Law 111–31.
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From page 97... ...
• Comparative biomarker studies of premium, traditional, and other cigar users. • Studies to assess how pH of premium cigar smoke affects puffing topogra phy, as well as sites and extent of nicotine absorption.
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From page 98... ...
2014. Little filtered cigar, cigarillo, and premium cigar smoking among adults -- United States, 2012–2013.
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From page 99... ...
2021. Tobacco-specific nitrosamines in the to bacco and mainstream smoke of commercial little cigars.
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2017. Smoking behavior and smoke constituents from cigarillos and little cigars.
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From page 101... ...
2017b. Dual use of cigarettes, little cigars, cigarillos, and large cigars: Smoking topography and toxicant exposure.
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From page 102... ...
2018. Little cigars, filtered cigars, and their carbonyl delivery relative to cigarettes.
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