Association of adolescent cigar use with other high-risk behaviors.
OBJECTIVE
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.
Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. lindsay.frazier@channing.harvard.edu
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Frazier
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Fisher
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Camargo
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Tomeo
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Colditz
D000293:Adolescent; D000294:Adolescent Behavior / Q000502:physiology; D000328:Adult; D017677:Age Distribution; D000428:Alcohol Drinking / Q000453:epidemiology; D000886:Anthropometry; D001828:Body Image; D002648:Child; D015444:Exercise; D005260:Female; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D010379:Peer Group; D010947:Plants, Toxic; D015995:Prevalence; D012309:Risk-Taking; D012649:Self Concept; D017678:Sex Distribution; D012907:Smoking / Q000453:epidemiology* / Q000503:physiopathology; D014030:Tobacco, Smokeless; D014481:United States / Q000453:epidemiology