title: Individual, Parental, and Environmental Correlates of Cigar, Cigarillo, and Little Cigar Use Among Middle School Adolescents.
abstract: BACKGROUND
  Youth use of cigars, cigarillos, and little cigars (CCLC) is increasing. While correlates of cigarette smoking have been well documented, use of CCLC is not as well understood among young adolescents. This study assessed whether smoking beliefs, parenting practices, and environmental exposures were associated with CCLC use among 7th to 8th grade youth in an urban, mid-Western city.
  
  
  METHODS
  The Cleveland Youth Risk Behavior Survey was conducted with 7th to 8th grade students in spring 2012. CCLC use was assessed by asking if students had smoked CCLC in the past 30 days. Covariates include self-reported gender, race, grade, acceptability of smoking, parental monitoring, hours of self-care, visits to corner stores, and current cigarette smoking. Bivariate and multivariate analyses were conducted to determine associations with current CCLC use.
  
  
  RESULTS
  Overall, 14.3% of youth reported current CCLC use. Students reporting higher acceptability of smoking, lower parental monitoring, longer periods of self-care, more visits to corner stores and current cigarette smoking were more likely to report current CCLC use in both bivariate and multivariable logistic regression models.
  
  
  CONCLUSIONS
  CCLC use is associated with multiple levels of influence, indicating that prevention of youth CCLC use must utilize a multilevel approach. Increased utilization of corner stores was associated with higher odds of CCLC use, and could indicate that youth stopping at corner stores may be exposed to increased tobacco retail advertising and tobacco products. The findings of this study have implications for FDA regulation to prevent CCLC initiation among youth.
  
  
  CONCLUSIONS
  While correlates of cigarette smoking have been well documented, use of CCLC is not as well understood among young adolescents. This is the first study that has examined the association between individual, family, and environmental characteristics and CCLC use. The results of this study illustrate that youth attitudes, perceived parenting practices, and environmental exposure are associated with adolescent CCLC use. This is important as the tobacco control community begins to identify strategies to prevent and reduce CCLC use. The findings of this study have clear implications for FDA regulation to prevent CCLC initiation among youth.
authors.affiliation: Prevention Research Center for Healthy Neighborhoods, Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH; Erika.Trapl@case.edu.
authors.forename: Erika S
authors.initials: ES
authors.lastname: Trapl
authors.affiliation: Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI.
authors.forename: Laura D
authors.initials: LD
authors.lastname: Yoder
authors.affiliation: Prevention Research Center for Healthy Neighborhoods, Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH;
authors.forename: Jean L
authors.initials: JL
authors.lastname: Frank
authors.affiliation: Prevention Research Center for Healthy Neighborhoods, Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH;
authors.forename: Elaine A
authors.initials: EA
authors.lastname: Borawski
authors.affiliation: ; Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH.
authors.forename: Abdus
authors.initials: A
authors.lastname: Sattar
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D000329:Advertising; D003132:Commerce / Q000706:statistics & numerical data*; D004781:Environmental Exposure / Q000517:prevention & control*; D005260:Female; D005421:Flavoring Agents; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008297:Male; D009820:Ohio / Q000453:epidemiology; D010379:Peer Group; D015995:Prevalence; D012309:Risk-Taking; D012907:Smoking; D013334:Students / Q000706:statistics & numerical data; D062789:Tobacco Products; D014029:Tobacco Use Disorder / Q000453:epidemiology* / Q000517:prevention & control; D014481:United States / Q000453:epidemiology; D014486:United States Food and Drug Administration
chemical_list: D005421:Flavoring Agents