Filling the Gaps: A Multi-Method Investigation of Premium Cigar Use and Marketing to Inform the Regulation of Cigar Products

PROJECT SUMMARY/ABSTRACT Premium cigars, which were responsible for the cigar boom in the late 1990s, are now experiencing a resurgence. Through litigation, political forces have succeeded in protecting premium cigars from regulatory oversight via a series of court decisions. Ultimately, a court ruled to vacate FDA of its authority to regulate premium cigars in August 2023. The lack of evidence on the public health impact of premium cigars (e.g., effects on initiation and use among young people) played a major role in these court decisions. Given the paucity of evidence, the FDA commissioned the National Academies of Sciences, Engineering, and Medicine (NASEM) to evaluate the available evidence on premium cigars and to identify future research needs. As noted in the NASEM report, most data on cigar use has either been non-specific (i.e., does not distinguish between cigar types) or has focused on inexpensive, mass-produced cigars. The limited data on users of premium cigars suggest that they are distinct from users of other cigars and that their patterns of use also differ. The negative health effects and extent of addiction of premium cigars vary based on use patterns, therefore examining how premium cigars are used is essential for understanding their impact on public health. Research is also needed on factors that impact patterns of use, such as exposure to cigar marketing. Tobacco marketing is a risk factor for tobacco use in the general population—young people in particular—and marketing research is well-established for cigarettes and other cigars. Yet, research is limited for premium cigars. Premium cigars are not heavily promoted via traditional channels like other tobacco products (e.g., mainstream magazines), but are the focus of lifestyle magazines (e.g., Cigar Aficionado) and online marketing (i.e., websites and social media). Yet the content and impact of premium cigar messaging on perceptions and behavioral intentions in both users and vulnerable non-users (e.g., young adults), remains largely unexamined. The central objective of this multi-method study is to begin to address priority research gaps identified in the premium cigar NASEM report, and to serve as important precursor to a R01 proposal that comprehensively examines perceptions, patterns, severity of dependence, and influences (e.g., marketing) of premium cigar use over time. However, the findings from this R21 can also be used immediately to inform federal, state, and local decision making regarding premium cigars. Specifically, we aim to: 1) Understand consumer experiences and perceptions of premium cigars via focus groups; 2) document and characterize premium cigar marketing via a longitudinal content analysis; and 3) assess the effect of features from premium cigar advertisements on product perceptions and intentions via an online survey experiment.