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PEDIATRICS Vol. 106 No. 2 August 2000, p. e26

ELECTRONIC ARTICLE:
Association of Adolescent Cigar Use With Other High-Risk Behaviors

Received Dec 10, 1999; accepted Mar 14, 2000.

A. Lindsay Frazier*, Dagger , Laurie Fisher*, Carlos A. Camargo*, §, Catherine Tomeo*, and Graham Colditz*, parallel

From * Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School; Dagger  Department of Pediatric Oncology, Dana Farber Cancer Institute; § Department of Emergency Medicine, Massachusetts General Hospital; and parallel  Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts.

Objectives.  To describe the association of cigar use with use of cigarettes, smokeless tobacco, and alcohol among adolescents; and to examine the association of self-esteem, physical activity, and use of tobacco promotional items with cigar use.

Methods.  A cross-sectional study of 7104 girls and 5499 boys 10 to 15 years of age in 1997. Data were collected from self-report questionnaires.

Results.  The prevalence of cigar use increased with age among both girls and boys. Among 11-year-olds, only 1% of girls and 3% of boys had used a cigar, whereas among 15-year-olds, 11% of girls and 25% of boys had used a cigar. Cigar users were much more likely than nonusers to have experimented with cigarettes (girls, odds ratio [OR]: 23.6; 95% confidence interval [CI]: 17.2-32.3; boys, OR: 21.3; 95% CI: 17.1-26.6), smokeless tobacco (girls, OR: 7.5; 95% CI: 4.5-12.4; boys, OR: 13.0; 95% CI: 9.8-17.4), and alcohol (girls, OR: 6.6; 95% CI: 4.8-9.1; boys, OR: 6.8; 95% CI: 5.3-8.8). There was a strong association between cigar use and binge drinking, especially among boys (girls, OR: 11.6; 95% CI: 7.9-16.9; boys, OR: 34.8; 95% CI: 19.4-62.3). Cigar users reported more hours of weekly physical activity than did nonusers. Additionally, cigar users were more likely to report high social self-esteem and to possess a tobacco promotional item.

Conclusions.  Adolescents who use cigars are more likely to use other tobacco products and alcohol, to report high social self-esteem, and to possess tobacco promotional items. Health care professionals and teachers should include cigar use in discussions with adolescents addressing substance use.  Key words:  adolescent, cigar, cigarette, smokeless tobacco, tobacco, alcohol, binge drinking, physical activity, self-esteem.


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