title: The Most Natural Tobacco Used: A Qualitative Investigation of Young Adult Smokers' Risk Perceptions of Flavored Little Cigars and Cigarillos.
abstract: BACKGROUND
  Flavored little cigar and cigarillo (LCC) smoking prevalence rate is increasing among young adults; little is known about their comprehension of its risks. To inform tobacco control regulatory policy and prevention methods, we explored young adult smokers' risk perceptions of flavored LCC products and its use.
  
  
  METHODS
  Purposive samples (n = 90) of African American, Hispanic, and white young adults who self-identified as dual (smoked ≥ 1 LCC and cigarette in past 30 days) and cigarette-only (≥1 cigarette in past 30 days) smokers participated in 12 audiotaped focus groups and a semi-structured interview conducted in the Southeastern United States. Participants discussed their experiences smoking flavored LCCs and perceived health risks of smoking flavored LCCs. A brief survey was administered to characterize participants.
  
  
  RESULTS
  The participants had a mean age of 25.1 years (SD = 4.5), were majority male (53.1%), and were 60.0% African American, 29.5% white, and 17.5% Hispanic. Along with health risks and addiction, three major themes emerged as underlying contributors of risk perceptions: affect, participants' smoking practices (amount smoked and inhalation), and beliefs about the components of LCCs (including flavoring and filters). Participants' reported intention to smoke flavored LCCs with its tobacco or as blunts (filled with marijuana) also influenced perceptions. Flavored LCCs were viewed along a continuum of risks compared to cigarettes and blunt smoking.
  
  
  CONCLUSIONS
  Our study revealed dimensions that were important for the formation of risk perceptions about flavored LCCs. A multidimensional conceptual model and a measure of risk perceptions that is inclusive of these dimensions should be developed and examined for LCC use patterns.
authors.affiliation: School of Public Health, Georgia State University, Atlanta, GA; ksterling@gsu.edu.
authors.forename: Kymberle L
authors.initials: KL
authors.lastname: Sterling
authors.affiliation: School of Public Health, University of Maryland, College Park, MD;
authors.forename: Craig S
authors.initials: CS
authors.lastname: Fryer
authors.affiliation: Cancer Prevention and Control Program, University of Hawaii at Manoa, Honolulu, HI.
authors.forename: Pebbles
authors.initials: P
authors.lastname: Fagan
mesh_terms: D000328:Adult; D016739:Behavior, Addictive / Q000523:psychology*; D005260:Female; D005421:Flavoring Agents; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D015995:Prevalence; D036301:Qualitative Research; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology* / Q000523:psychology; D012938:Social Perception; D013649:Taste; D019460:Tobacco Industry / Q000379:methods*; D062789:Tobacco Products / Q000009:adverse effects / Q000706:statistics & numerical data; D014029:Tobacco Use Disorder / Q000150:complications / Q000453:epidemiology* / Q000523:psychology; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D005421:Flavoring Agents