Characteristics of Past 30–Day Cigar Smoking, U.S. Adolescents, 2020

Published:September 05, 2021DOI:


      Data from the 2019 National Youth Tobacco Survey indicated that cigars were the most commonly used combustible tobacco product in the past 30 days among youth. This study uses 2020 National Youth Tobacco Survey data to report the prevalence estimates and characteristics of current cigar use, overall and by cigar type, among middle- and high-school students in the U.S.


      Weighted prevalence estimates and 95% CIs were calculated in 2020 for overall cigar use and by cigar type.


      In 2020, current cigar smoking was reported by 3.5% of students (1.5% middle school and 5.0% high school). Cigarillos (44.1%) were the most reported cigar type smoked, followed by regular (33.1%) and little (22.6%) cigars; 21.8% did not know the cigar type. Most cigar smokers were in high school (81.2%) and were male (52.4%), and 42.3% were non-Hispanic White. More than half of cigar smokers reported smoking flavored cigars (58.3%), with fruit (61.5%), candy/desserts/other sweets (34.0%), and mint (30.4%) as the most frequently reported flavor categories. Approximately 1 in 5 current cigar smokers (18.4%) smoked on ≥20 days in the past 30 days, and 78.8% reported multiple tobacco product use.


      Cigar smoking was highest among non-Hispanic Black and Hispanic youth. More than half of youth cigar smokers reported using flavored cigars, and most were also currently using other tobacco products. Cigarillos were the most reported cigar type used by youth, followed by regular cigars. These findings highlight the continued importance of youth tobacco use reduction strategies and can inform policy development.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to American Journal of Preventive Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Wang TW
        • Gentzke AS
        • Creamer MR
        • et al.
        Tobacco product use and associated factors among middle and high school students-United States, 2019.
        MMWR Surveill Summ. 2019; 68: 1-22
        • Kostygina G
        • Glantz SA
        • Ling PM.
        Tobacco industry use of flavours to recruit new users of little cigars and cigarillos.
        Tob Control. 2016; 25: 66-74
        • Delnevo CD
        • Giovenco DP
        • Miller Lo EJ
        Changes in the mass-merchandise cigar market since the Tobacco Control Act.
        Tob Regul Sci. 2017; 3: S8-S16 1).2
        • Lindblom EN
        • Mays D
        • Schroth KRJ
        • Delnevo C.
        Has FDA abandoned its efforts to make fake-cigar cigarettes comply with federal tobacco control laws that apply to cigarettes but not cigars?.
        Tob Control. 2020; 29: 606-611
      1. National Youth Tobacco Survey (NYTS). Centers for Disease Control and Prevention. Updated June 2020. Accessed July 27, 2020.

        • Gentzke AS
        • Wang TW
        • Jamal A
        • et al.
        Tobacco product use among middle and high school students - United States, 2020.
        MMWR Morb Mortal Wkly Rep. 2020; 69: 1881-1888
        • Chen B
        • Sterling KL
        • Bluestein MA
        • et al.
        Age of initiation of cigarillos, filtered cigars and/or traditional cigars among youth: findings from the Population Assessment of Tobacco and Health (PATH) study, 2013–2017.
        PLoS One. 2020; 15e0243372
        • Chen-Sankey JC
        • EL Mead-Morse
        • Le D
        • et al.
        Cigar-smoking patterns by race/ethnicity and cigar type: a nationally representative survey among U.S. adults.
        Am J Prev Med. 2021; 60: 87-94
        • Edwards KC
        • Sharma E
        • Halenar MJ
        • et al.
        Longitudinal pathways of exclusive and polytobacco cigar use among youth, young adults and adults in the USA: findings from the PATH Study Waves.
        Tob Control. 2020; 29 (1–3 (2013–2016)): s163-s169
        • Rostron BL
        • Cheng YC
        • Gardner LD
        • Ambrose BK.
        Prevalence and reasons for use of flavored cigars and ENDS among U.S. youth and adults: estimates from Wave 4 of the PATH Study, 2016-2017.
        Am J Health Behav. 2020; 44: 76-81
        • Kong G
        • Creamer MR
        • Simon P
        • et al.
        Systematic review of cigars, cigarillos, and little cigars among adolescents: setting research agenda to inform tobacco control policy.
        Addict Behav. 2019; 96: 192-197
        • Gomez Y
        • Creamer M
        • Trivers KF
        • et al.
        Patterns of tobacco use and nicotine dependence among youth, United States, 2017-2018.
        Prev Med. 2020; 141106284
        • Sawdey MD
        • Anic GM
        • Rostron BL
        • Cullen KA.
        Characteristics of Past 30-Day Cigar Smoking Among U.S. Middle and High School Students—National Youth Tobacco Survey, 2019.
        February 2020 (Paper presented at: Society for Research on Nicotine and Tobacco, 11–14, 2020. New Orleans, LA)
        • Chang CM
        • Corey CG
        • Rostron BL
        • Apelberg BJ.
        Systematic review of cigar smoking and all cause and smoking related mortality.
        BMC Public Health. 2015; 15: 390