Dual Use of Cigarettes, Little Cigars, Cigarillos, and Large Cigars: Smoking Topography and Toxicant Exposure

Objective Smoking topography variables and toxicant exposure (plasma nicotine and exhaled CO) were examined in 3 groups of study participants that smoked both cigarettes and either filtered little cigars (Winchester), cigarillos (Black & Mild), or large cigars (Phillies Blunt). Methods Laboratory ad lib smoking of the cigar products was collected with a smoking puff analyzer; plasma levels of nicotine and exhaled CO were collected before and after smoking. Results Although there were no statistically significant differences in demographic and cigarette smoking topography among the groups, there were significant differences in how the different cigar products were smoked. Plasma nicotine boost was similar after all products but exhaled CO was greater after the cigarillo and large cigar than the little cigar. Some of the differences were due to the differences in article size but other differences were apparent even after adjustment for the amount of tobacco burned or the mouth intake (puff volume). Conclusions The topography findings of differences among products challenge the practice of grouping cigars as a single entity in surveys, regulatory decisions, and discussions of toxicant exposure. The results add to the discussion of distinctions among products in the scientific assessment of public health risk and regulatory decisions.