Systematic review of cigars, cigarillos, and little cigars among adolescents: Setting research agenda to inform tobacco control policy

Abstract

We conducted a systematic review of the literature on cigar research on youth to identify potential future research agenda to generate evidence to inform cigar regulations to prevent cigar use among youth. We searched articles on Medline, EMBASE, and PsycINFO in April 2017 to identify articles relevant to cigars and adolescents. Two independent coders examined 48 articles to determine eligibility: 1) published between 2000-April 2017; 2) published in English; 3) conducted in the United States; 4) published in a peer-review journal; 5) examined cigars, cigarillos, or little cigars; 6) included youth (12-18 years old); and 7) included empirical data. Three independent coders reviewed the included articles (n=48) to identify whether the studies addressed FDA’s Research Priorities. The studies addressed FDA’s Research Priorities of “behavior” (n=48), “communications” (n=4), “marketing influences” (n=1), and “impact analysis” (n=1). Studies on “behavior” underscored the need for improvements in measurement, such as using brand names and distinguishing cigar products. The review revealed the need for restrictions on cigar flavors, development of media campaigns and interventions, increasing the cost (via taxation), and evaluating the impact of cigar policies. The studies mostly focused on surveillance of behaviors and use patterns, which revealed cigar specific issues to address in policies to decrease cigar use among youth. The lack of studies addressing other FDA’s research priorities highlighted the critical need for future studies that inform prevention of youth cigar use.