title: Measuring cigar use in adolescents: inclusion of a brand-specific item.
abstract: BACKGROUND
  This study examined whether the standard measure of cigar use in adolescents could be improved by the addition of a brand-specific example.
  
  
  METHODS
  In 2002, prevalence of tobacco use was assessed in six midwestern U.S. high schools using the Youth Risk Behavior Survey. The survey was readministered to the same schools in 2004, with the brand name "Black and Milds" added to the item measuring cigar use. Changes in local prevalence rates were compared with national rates.
  
  
  RESULTS
  Local rates of cigar and cigarette use in 2002 were consistent with national rates reported in 2003. In 2004, when the cigar item was modified to include a brand-specific example, the percentage of students reporting cigar use nearly doubled-from 12.9% to 20.7%. This difference was particularly notable among Black teens. During the same period, local rates of cigarette use remained constant, as did national rates of reported cigar and cigarette use.
  
  
  CONCLUSIONS
  Results suggest that the current national survey item may not adequately measure cigar use. Accordingly, prevalence of cigar use among adolescents may be greatly underestimated, especially among Black youth.
authors.affiliation: Department of Family Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106-4945, USA. joshua.terchek@case.edu
authors.forename: Joshua J
authors.initials: JJ
authors.lastname: Terchek
authors.forename: Elizabeth M G
authors.initials: EM
authors.lastname: Larkin
authors.forename: Margaret L
authors.initials: ML
authors.lastname: Male
authors.forename: Scott H
authors.initials: SH
authors.lastname: Frank
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D001294:Attitude to Health; D003132:Commerce / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D015146:Midwestern United States; D012574:Schools; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology; D016540:Smoking Cessation / Q000706:statistics & numerical data; D013334:Students / Q000523:psychology / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014342:Truth Disclosure