Premium and Non-Premium Cigar Use Among a Nationally Representative Sample of Reproductive Age Women: Findings from the 2010–2019 National Survey on Drug Use and Health

INTRODUCTION: Little is known about cigar use among women of reproductive age, especially potential differences relating to the use of premium versus non-premium cigars. AIMS AND METHODS: Using 2010–2019 data from the National Survey on Drug Use and Health, rates and trends in premium and non-premium cigar use were determined among women of reproductive age (18–49; n = 5651). Weighted sociodemographic characteristics, substance co-use, patterns of use, and health indicators were compared between women using premium versus non-premium cigars. RESULTS: Among reproductive-aged women who smoked cigars in the past 30 days, 4.9% reported use of premium cigar brands. The most commonly used premium brands were Romeo y Julieta, Cohiba, and Macanudos. Women who used premium versus non-premium cigars were less likely to identify as non-Hispanic black (16.5% vs. 35.5%), more likely to have household income >$50 000 (54.2% vs. 26.6%), and less likely to report past 30-day marijuana (28.7% vs. 55.7%) or blunt use (26.0% vs. 53.9%; ps < .001). Women who used premium cigars also reported later age of onset of cigar use (24.1 vs. 20.3 years; p < .001) and smoked fewer cigars in the last 30 days (9.8 vs. 2.3 days; p < .001). Trend analysis revealed that although rates of past 30-day premium cigar use remained consistent from 2010 (4.7%) to 2019 (4.9%), prevalence decreased from 6.6% in 2017 to 2.8% in 2018 before increasing to 4.9% in 2019. CONCLUSIONS: Understanding premium and non-premium cigar use among reproductive-age women, an understudied vulnerable population, will provide critical data to the Food and Drug Administration to inform policy and regulatory decisions. IMPLICATIONS: The current study revealed prevalence of ~5% premium cigar use among women of reproductive age who smoke cigars, and evidence for consistency in women’s rates of premium cigar use across time. Women who used premium versus non-premium cigars were more likely to identify as non-Hispanic white, older, and of higher socioeconomic status were in better health and less likely to co-use cigarettes and marijuana, but more likely to co-use alcohol. Consideration of reproductive age and pregnant women as uniquely vulnerable populations is warranted in the development of regulations regarding premium and non-premium cigars. Comprehensive regulation of cigars (both premium and non-premium) may offer the potential to positively impact women’s health.