title: Youth Acquisition and Situational Use of Cigars, Cigarillos, and Little Cigars:: A Cross-sectional Study.
abstract: BACKGROUND
  Although adolescent use of cigars, cigarillos, and little cigars (CCLCs) has been increasing, little research has been conducted to understand how adolescents acquire CCLCs and the situations in which they smoke CCLCs. Thus, this study aims to understand how adolescent smokers acquire CCLCs and the situations in which they smoke them.
  
  
  METHODS
  Data were drawn from the 2011 Cuyahoga County Youth Risk Behavior Survey. Current CCLC smoking was assessed; analysis was limited to current smokers (n=1,337). Current users were asked to identify situations in which they use cigars and ways in which they get cigars. Bivariate analyses assessed differences by sex, race, and concurrent substance use. Data were analyzed in 2014.
  
  
  RESULTS
  Youth acquired CCLCs most commonly by buying (64.2%). CCLC smokers also reported high rates of social use (81.1%). There were no significant differences is situational use across sexes, but female adolescents were significantly more likely than male adolescents to share CCLCs and significantly less likely to buy or take CCLCs. Conversely, significant differences were seen for situational use by race/ethnicity, with whites significantly more likely to use in social situations and less likely to use in solitary situations versus blacks and Hispanics. Finally, significant differences were observed in both acquisition and use for youth who concurrently used CCLCs and cigarettes compared with CCLCs only; fewer differences were noted among those who concurrently used CCLCs and marijuana compared with CCLCs only.
  
  
  CONCLUSIONS
  These findings highlight how adolescents acquire and use CCLCs and can inform tobacco control strategies to prevent and reduce CCLC use.
authors.affiliation: Prevention Research Center for Healthy Neighborhoods, Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio. Electronic address: erika.trapl@case.edu.
authors.forename: Erika S
authors.initials: ES
authors.lastname: Trapl
authors.affiliation: Prevention Research Center for Healthy Neighborhoods, Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio.
authors.forename: Danielle
authors.initials: D
authors.lastname: O'Rourke-Suchoff
authors.affiliation: Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan.
authors.forename: Laura D
authors.initials: LD
authors.lastname: Yoder
authors.affiliation: Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina.
authors.forename: Leslie E
authors.initials: LE
authors.lastname: Cofie
authors.affiliation: Prevention Research Center for Healthy Neighborhoods, Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio.
authors.forename: Jean L
authors.initials: JL
authors.lastname: Frank
authors.affiliation: Maryland Center for Health Equity, Department of Behavioral and Community Health, University of Maryland, College Park, Maryland.
authors.forename: Craig S
authors.initials: CS
authors.lastname: Fryer
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D009820:Ohio / Q000453:epidemiology; D012907:Smoking / Q000453:epidemiology*