Health Effects and Patterns of Use of Premium Cigars

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The early to mid-1990s saw a large surge in U.S. cigar consumption, including premium cigars. Based on recent import data, premium cigar use may be increasing, though they currently make up a small percent of the total U.S. cigar market. Premium cigars have also been the subject of legal and regulatory efforts for the past decade. In 1998, the National Cancer Institute undertook a comprehensive review of available knowledge about cigars - the only one to date. The resulting research recommendations have largely not been addressed, and many of the identified information gaps persist. Furthermore, there is no single, consistent definition of premium cigars, making research challenging.

In response, the Food and Drug Administration (FDA) and the National Institutes of Health commissioned the National Academies of Sciences, Engineering, and Medicine to convene a committee of experts to address this issue. The resulting report, Premium Cigars: Patterns of Use, Marketing, and Health Effects, includes 13 findings, 24 conclusions, and nine priority research recommendations and assesses the state of evidence on premium cigar characteristics, current patterns of use, marketing and perceptions of the product, and short- long-term health effects.

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522 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-09106-3
ISBN Ebook: 0-309-27480-X
DOI: https://doi.org/10.17226/26421

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National Academies of Sciences, Engineering, and Medicine. 2022. Premium Cigars: Patterns of Use, Marketing, and Health Effects. Washington, DC: The National Academies Press.

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Steven M. Teutsch

Steven M. Teutsch, M.D., M.P.H., is an adjunct professor at the UCLA Fielding School of Public Health and Senior Fellow at the Leonard D. Schaeffer Center for Health Policy and Economics at the University of Southern California. Until 2014, he was the Chief Science Officer, Los Angeles County Public Health where he continued his work on evidence-based public health and policy. Previously, Dr. Teutsch worked at Merck, where he was responsible for scientific leadership in developing evidence-based clinical management programs, conducting outcomes research studies, and improving outcomes measurement to enhance quality of care. Prior to joining Merck, he was Director of the Division of Prevention Research and Analytic Methods at the Centers for Disease Control and Prevention, where he was responsible for assessing the effectiveness, safety, and the cost-effectiveness of disease and injury prevention strategies. Dr. Teutsch has served as a member of the Community Preventive Services Task Force, the U.S. Preventive Services Task Force, Americas Health Information Community Personalized Health Care Workgroup, and the Evaluation of Genomic Applications in Prevention and Practice Workgroup. He chaired the Secretary's Advisory Committee on Genetics Health and Society, and has served on and has chaired several National Academies panels, Medicare’s Evidence Development and Coverage Advisory Committee, and on several subcommittees of the Secretary’s Advisory Committee on Healthy People 2020 and 2030. Dr. Teutsch has published over 200 articles and 8 books in a broad range of fields in epidemiology, including parasitic diseases, diabetes, technology assessment, health services research, and surveillance. He received his undergraduate degree in biochemical sciences at Harvard University, an M.P.H. in epidemiology from the University of North Carolina School of Public Health, and his M.D. from Duke University School of Medicine. He was certified by the American Board of Internal Medicine in 1977, the American Board of Preventive Medicine in 1995, and is a Fellow of the American College of Physicians and American College of Preventive Medicine.

Neal L. Benowitz

Neal Benowitz, M.D., is Emeritus Professor of Medicine, Division of Cardiology, at the University of California, San Francisco. Dr. Benowitz was Chief of the Division of Clinical Pharmacology at UCSF for more than 35 years. He is a leading authority on the human pharmacology of nicotine in relation to pathogenesis of and individual differences in vulnerability to tobacco-related disease, and the use of pharmacologic data as a basis for public health policies to prevent and reduce such disease. Dr. Benowitz has served on a number of national and international committees addressing issues in tobacco-related diseases and smoking cessation, including several with the National Academies. He has authored over 700 publications, including a state-of-the-art review on nicotine addiction in the New England Journal of Medicine. Dr. Benowitz is the former president of the Society for Research on Nicotine and Tobacco (SNRT) and the recipient of the Ove Ferno SRNT Award for Clinical Research on Nicotine and Tobacco, and is a former president of the American Society for Clincal Pharmacology and Therapeutics. He has been a contributing author or editor to six U.S. Surgeon General reports on tobacco. Dr. Benowitz is currently on retainer to serve as an expert witness for litigation related to cigarettes. He also serves on the DSMB for Achieve Health Sciences. He earned his M.D. from the University of Rochester.

Cristine D. Delnevo

Cristine D. Delnevo, Ph.D., M.P.H., FAAHB, is a professor in the Department of Health Behavior, Society, and Policy in the School of Public Health at Rutgers University. Dr. Delnevo is a scholar in tobacco control and the director of Rutgers’ Center for Tobacco Studies. Her work focuses on population-level patterns of tobacco use and tobacco control policy. Her tobacco research includes studying patterns of tobacco use, in particular non-cigarette products like electronic cigarettes and cigars; the impact of product characteristics, like menthol or flavoring in tobacco products, on patterns of use; and examining market trends. She was appointed to the Products Scientific Advisory Committee at FDA in March 2021. Dr. Delnevo holds a Ph.D. in health studies and a master’s in public health.

Pebbles Fagan

Pebbles Fagan, Ph.D., M.P.H., is a professor in the Department of Health Behavior and Health Education, and the Director of the Center for the Study of Tobacco at the Fay W. Boozman College of Public Health at the University of Arkansas for Medical Sciences. She is also the Director of Research in the Office of Health Initiatives and Disparities Research, Department of Surgery, College of Medicine. Dr. Fagan is a behavioral scientist and has over 25 years of experience in conducting research that aims to increase knowledge on how to reduce tobacco- and cancer-related health disparities in racial/ethnic, socially disadvantaged, and marginalized communities. She uses team-based science to examine social, behavioral, and biobehavioral factors associated with health disparities. Formerly, she was a Health Scientist at the Tobacco Control Research Branch at the National Cancer Institute. There she co-founded the Tobacco Research Network on Disparities (TReND), the first national research network designed to stimulate novel collaborative research in tobacco related health disparities. In 2011, Dr. Fagan began serving as an Associate Professor and Program Director for the Cancer Prevention and Control Program at the University of Hawaii Cancer Center. In 2016, she joined the faculty at the Fay W. Boozman College of Public Health as a Professor and Director of the Center for the Study of Tobacco. Dr. Fagan was instrumental in advancing a series of papers that informed the content of several reports that describe the impact of menthol cigarettes on the public’s health. Dr. Fagan earned her Ph.D. in Health Education and Community Health from Texas A&M University, and her M.P.H. from the Tulane University School of Public Health and Tropical Medicine.

Maciej Goniewicz

Maciej Goniewicz, Ph.D., Pharm.D., is a full member of the Department of Health Behavior, Division of Cancer Prevention and Population Sciences at Roswell Park Comprehensive Cancer Center. Dr. Goniewicz’s primary research area is in nicotine pharmacology and toxicology, with a focus on nicotine dependence and smoking cessation. He has research experience in smoking cessation behavioral treatment, pharmacotherapy, and pharmacokinetics in both clinical and community-based settings. He has authored over 170 scientific papers on topics related to tobacco control, biomarkers, and nicotine-containing products. Dr. Goniewicz is a member of the Society for Research on Nicotine and Tobacco, Society of Toxicology, and the American Association for Cancer Research. He was a member of the National Academies committee on the Public Health Consequences of E-Cigarettes. He earned his Pharm.D. and Ph.D. from the Medical University of Silesia, Poland. He completed his postdoctoral fellowships at the University of California, San Francisco and Queen Mary University of London, UK.

Stephen S. Hecht

Stephen S. Hecht, Ph.D., is the Wallin Land Grant Professor of Cancer Prevention in the Department of Laboratory Medicine and Pathology at the University of Minnesota Medical School and a professor at the Masonic Cancer Center at the University of Minnesota. Dr. Hecht’s research is focused on understanding the ways tobacco smoke constituents cause cancer. His research focuses on carcinogens such as tobacco-specific nitrosamines, polycyclic aromatic hydrocarbons, and certain volatiles such as formaldehyde, acetaldehyde, and acrolein. He is a fellow of the American Association for the Advancement of Science and the American Chemical Society. Dr. Hecht has received the Joseph Cullen Award from the American Society of Preventive Oncology, the Merit Award from the National Cancer Institute, and the Award for Excellence in Cancer Prevention Research from the American Association for Cancer Research. Dr. Hecht was a member of the National Academies committee on scientific standards for studies on modified risk tobacco products. He earned his Ph.D. from the Massachusetts Institute of Technology.

Miranda R. Jones

Miranda R. Jones, Ph.D., is an assistant professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health. Dr. Jones is an epidemiologist whose research focuses on environmental and social determinants of chronic diseases. She is specifically interested in the health impacts of environmental exposures, including tobacco, secondhand smoke, air pollution, and arsenic, and the role of these exposures to racial/ethnic disparities in cancer and cardiovascular disease. Dr. Jones earned her M.H.S. and Ph.D. from Johns Hopkins Bloomberg School of Public Health.

Grace Kong

Grace Kong, Ph.D., is an assistant professor in the Department of Psychiatry at Yale School of Medicine. Dr. Kong’s current research interests include understanding substance use health disparities among youth, the use of social media for tobacco marketing, novel tobacco use behaviors among youth, and developing innovative adolescent tobacco/cessation interventions for youth. Dr. Kong received her Ph.D. in Clinical Psychology (Child and Adolescent Track) at St. John’s University in 2009 and completed her NIDA T32 postdoctoral fellowship focused on adolescent addictions in the Division of Substance Abuse at Yale School of Medicine in 2012.

Adam Leventhal

Adam Leventhal, Ph.D., Professor within the Keck School of Medicine of the University of Southern California (USC), is a clinical psychologist and public health scientist who aims to understand and prevent addiction. He is Founding Director of the USC Institute for Addiction Science, which supports transdisciplinary collaborative addiction research and education, including 63 faculty members across 8 schools within the university. Having been awarded more than $40M in grant funding from the NIH and other agencies, his laboratory’s current areas of focus are: (1) adolescent and young adult tobacco, cannabis, and opioid use; (2) addiction among populations with mental illness, from racial/ethnic minority backgrounds, with socioeconomic disadvantage, and other groups subject to health disparities; (3) the development of medications to treat nicotine addiction; (4) science to inform public policies for regulating tobacco and other addictive consumer products; and (5) cancer and cardiovascular disease prevention. Dr. Leventhal has authored over 250 peer-reviewed scientific articles, including publications in JAMA, New England Journal of Medicine, and other journals. His work has been covered the Associated Press, NBC Nightly News, New York Times, and other media outlets. Dr. Leventhal has served on expert panels on the health effects of tobacco products for the National Academy of Sciences, Engineering, and Medicine, the US Food and Drug Administration, and the US Surgeon General. He is currently a member of the Tobacco Products Scientific Advisory Committee at FDA. He is an elected fellow of the American Academy of Health Behavior and American Psychological Association and recipient of awards for contributions to addiction science and mentoring.

Darren Mays

Darren Mays, Ph.D., M.P.H., is as an associate professor in the Division of Medical Oncology at The Ohio State University College of Medicine. Dr. Mays is a behavioral scientist with more than 10 years of experience in behavioral cancer prevention and control research, with a major emphasis on tobacco prevention and cessation. Dr. Mays’ research investigates the uptake and progression of tobacco use among young people, risk factors for tobacco use, and behavioral prevention and cessation interventions. Dr. Mays’ research also focuses on tobacco policy and regulation, such as policies targeting tobacco packaging, labeling and advertising. Dr. Mays has published more than 100 peer-reviewed research articles and he has presented his research widely. Dr. Mays is a longstanding member of several professional organizations, including the Society for Research on Nicotine & Tobacco, the Society of Behavioral Medicine, and the American Public Health Association. Dr. Mays received his M.P.H. from the Rollins School of Public Health at Emory University and his Ph.D. from the Rollins School of Public Health & James T. Laney School of Graduate Studies at Emory University.

Rafael Meza

Rafael Meza, Ph.D., is Associate Professor and Associate Chair in the Department of Epidemiology at the University of Michigan, and co-Leader of the Cancer Epidemiology and Prevention Program at the UM Rogel Cancer Center. Dr. Meza is Principal Investigator of the UM/Georgetown TCORS Center for the Assessment of Tobacco Regulations (CAsToR) and Coordinating Principal Investigator of the Cancer intervention and Surveillance Modeling Network (CISNET) lung cancer working group. Dr. Meza's research focuses on the use of simulation modeling and quantitative methods to assess the impact of disease prevention and control interventions, particularly of tobacco control and lung cancer prevention interventions. Dr. Meza received his B.Sc. in applied mathematics from the Instituto Tecnologico Autonomo de Mexico (ITAM), and his Ph.D. in applied mathematics from the University of Washington. After receiving his Ph.D., Dr. Meza completed a two-year postdoctoral fellowship at the Fred Hutchinson Cancer Research Center and a three-year fellowship at the University of British Columbia Centre for Disease Control.

Kymberle L. Sterling

Kymberle Landrum Sterling, Ph.D., M.P.H., is an associate professor of health promotion and behavioral sciences at the University of Texas (UT) Health School of Public Health, Dallas Regional Campus. Dr. Sterling is a tobacco control behavioral scientist, with expertise in youth and young adult cigarette and novel tobacco product use, tobacco-related health disparities, and smoking cessation. She has served as the principal investigator of two Food and Drug Administration (FDA)/NIH-funded tobacco control regulatory sciences research grants that assessed flavored cigar smoking and identified risk perceptions for flavored cigar use among racially/ethnically diverse young adults. Her research has informed federal tobacco control policies, specifically the FDA’s expansion of its regulatory authority to cigars. Currently, she is the principal investigator of an FDA/NIH tobacco regulatory sciences research grant that is examining the effects of implied modified risk statements on flavored cigar advertising on cigar use behaviors among young adults. An important methodological feature of her research is the use of community-based research principles to engage with vulnerable communities to assess their health needs and develop culturally-tailored, evidence-based interventions to optimize their health behavior outcomes and mitigate health disparities. She also has methodological expertise in mixed-methods (survey and qualitative research) and experimental study designs and latent variable modeling. Dr. Sterling was trained as a Cell and Molecular Biologist at Tulane University in New Orleans, Louisiana, before receiving her doctorate in Health Promotion and Behavioral Sciences at the University of Texas (UT) Health School of Public Health in Houston, Texas.

Andrea Villanti

Andrea Villanti, Ph.D., M.P.H., is an associate professor of psychiatry and psychology at the University of Vermont. Her primary research focus is on young adult tobacco use, including predictors and patterns of use and interventions to reduce tobacco use in young adults. She also has expertise in translational research to improve tobacco control policy and program decision-making, including tobacco regulatory science. Her work focuses on design, collection, and analysis of population survey data and conducting experiments and intervention trials in large, online samples. Dr. Villanti’s current NIH-funded research projects include testing a nicotine corrective messaging intervention, evaluating the substitutability of plausible menthol cigarette alternatives, and evaluating state-level policy and communication efforts to prevent substance use in youth and young adults. Dr. Villanti earned her M.P.H. from the Mailman School of Public Health at Columbia University and her Ph.D. from the Johns Hopkins Bloomberg School of Public Health.

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Health Effects and Patterns of Use of Premium Cigars

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Suggested citation

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Health Effects and Patterns of Use of Premium Cigars

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Featured publication

Premium Cigars: Patterns of Use, Marketing, and Health Effects

Description

Collaborators

Committee

Sponsors

Staff

Parent projects

Board on Population Health and Public Health Practice

Major units and sub-units

Contact

Contact us

Provide feedback

Request materials

More like this

Review of the draft United by Nature assessment

Modernizing Mathematics Education for Grades 9-14

Health Care Financing to Improve Availability of Affordable Contraception: Identifying Promising Practices

Transit Cooperative Research Program

Review of the draft United by Nature assessment

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Review of Methods in the Report on Carcinogens Handbook

Exploring Relevant Policy Domains — Housing Policy and Population Health: A Workshop