Association of adolescent cigar use with other high-risk behaviors

Objectives. To describe the association of cigar use with use of cigarettes , smokeless tobacco, and alcohol among adolescents; and to examine the asso ciation of self-esteem, physical activity, and use of tobacco promotional i tems with cigar use. Methods. A cross-sectional study of 7104 girls and 5499 boys 10 to 15 years of age in 1997. Data were collected from self-report questionnaires. Results. The prevalence of cigar use increased with age among both girls an d boys. Among 11-year-olds, only 1% of girls and 3% of boys had used a ciga r, whereas among 15-year-olds, 11% of girls and 25% of boys had used a ciga r. Cigar users were much more likely than nonusers to have experimented wit h cigarettes (girls, odds ratio [OR]: 23.6; 95% confidence interval [CI]: 1 7.2-32.3; boys, OR: 21.3; 95% CI: 17.1-26.6), smokeless tobacco (girls, OR: 7.5; 95% CI: 4.5-12.4; boys, OR: 13.0; 95% CI: 9.8-17.4), and alcohol (gir ls, OR: 6.6; 95% CI: 4.8-9.1; boys, OR: 6.8; 95% CI: 5.3-8.8). There was a strong association between cigar use and binge drinking, especially among b oys (girls, OR: 11.6; 95% CI: 7.9-16.9; boys, OR: 34.8; 95% CI: 19.4-62.3). Cigar users reported more hours of weekly physical activity than did nonus ers. Additionally, cigar users were more likely to report high social self- esteem and to possess a tobacco promotional item. Conclusions. Adolescents who use cigars are more likely to use other tobacc o products and alcohol, to report high social self-esteem, and to possess t obacco promotional items. Health care professionals and teachers should inc lude cigar use in discussions with adolescents addressing substance use.