Candy-flavored cigars like these in a shop in Albany, N.Y.,  are the focus of efforts to restrict sales of sweet-flavored tobacco.

Candy-flavored cigars like these in a shop in Albany, N.Y., are the focus of efforts to restrict sales of sweet-flavored tobacco.

Hans Pennink/Associated Press

The good news: Cigarette sales are down by about a third over the past decade. Not so for little cigars and cigarillos. Their sales more than doubled over the same time period, in large part owing to the growing popularity of these little cigars among teenagers and 20-somethings.

The appeal among young people has lots to do with the large variety of candylike flavors in the little cigars, according to Jennifer Cantrell, director of research and evaluation at the anti-tobacco Legacy Foundation.

"We're seeing chocolate, cherry, wild cherry, strawberry, grape, candy apple," Cantrell says. "Pretty much every flavor you can think of that you might see in a gum or candy product we're seeing in little cigars and cigarillos."

To examine how heavily companies market to young people, Cantrell sent field researchers out to about 750 small grocery and convenience stores in Washington, D.C.

Stores in areas dominated by young people had far more ads for little cigars, compared with markets in other neighborhoods. Many ads were outside the store, so people didn't even have to go in to be wooed. And they were clearly targeted to a youthful eye. Cantrell says, "They're almost indistinguishable from candy packaging; they tend to be bright and colorful. One ad looks like a big box of colorful crayons."

And the price is right, too. Unlike cigarettes, which cost about $6.50 a pack and can't be sold individually, little cigars are wrapped in packages of one, two or three and average about 99 cents per cigar. Some cost as little as 25 cents.

Altria, which makes one of the most popular brand of cigarillos, says it markets to adult tobacco smokers, not to children. A spokesman said in an emailed response to NPR: "The company designs its marketing programs to enhance brand awareness, recognition and loyalty among adult tobacco smokers to grow market share. At retail, we present our brands to legal-aged tobacco smokers at the point of purchase."

Little cigars are easier to obtain than cigarettes, but they're no less harmful, according to Mayo Clinic researcher and public health advocate Mignonne Guy. "The average cigarette has approximately 8 milligrams of nicotine in it; the average cigar can range anywhere from 100 to 200 milligrams of nicotine," she says.

Unlike cigarettes, cigarillos can be bought individually or in small packages.

Unlike cigarettes, cigarillos can be bought individually or in small packages.

Legacy Foundation

Another problem is that today's teens and young adults don't just puff on their cigars, like in the old days. They inhale. "They're treating it like a cigarette and using it like a cigarette," Guy says. "They'll say I'll use one when I'm stressed out or after a test, or after a long day of work."

Flavored cigars and cigarillos are also sometimes used as wrappers to smoke marijuana.

Cigar use among high school students rose from 7 percent in 2009 to 12 percent in 2011, according to a study released earlier this month by the Centers for Disease Control and Prevention. High school boys are now as likely to smoke cigars as cigarettes. About 3 percent of middle-schoolers said they'd smoked cigars, compared with 4 percent who smoked cigarettes.

That alarms public health officials, because the earlier in life people start using tobacco products, the harder it is to quit. "We've done a great job in communicating to the general public about the dangers of cigarettes," Guy says. "But we have not done a great job of communicating the harm, risk and danger of little cigars and cigarillos."

About four years ago, the Food and Drug Administration expanded its oversight of cigarettes, restricting advertising and banning most flavors, including popular fruit flavors like grape or cherry, cocoa, and spice flavors like clove.

The federal agency is now considering whether to take a similarly strict stance when it comes to regulating little cigars and cigarillos.

Copyright 2015 NPR. To see more, visit http://www.npr.org/.

Transcript

RENEE MONTAGNE, HOST:

And among today's teens and young adults, there is a worrisome, unhealthy trend. Sales of little cigars are on the rise. NPR's Patti Neighmond reports.

PATTI NEIGHMOND, BYLINE: Cigarette sales are down by about a third over the past decade. Not so for little cigars and cigarillos. Their sales more than doubled, particularly among teenagers and 20-somethings. One reason? They're flavored - sort of like candy. Jennifer Cantrell directs research at the anti-tobacco Legacy Foundation.

JENNIFER CANTRELL: We're seeing chocolate, cherry, wild cherry, strawberry, grape - pretty much every flavor you can think of that you might see in a gum or a candy product, we're' seeing in little cigars and cigarillos.

NEIGHMOND: To examine how heavily companies market to young people, Cantrell sent field researchers out to about 750 small grocery and convenience stores in Washington, D.C. She found stores in areas dominated by young people had far more ads for little cigars. They were outside the store, and they were clearly targeted to a youthful eye.

CANTRELL: They're almost indistinguishable from candy packaging. Some ads that we've seen on the outside of stores, it almost looks like a big box of colorful crayons.

NEIGHMOND: And the price is right, too. Unlike cigarettes, which cost about $6.50 a pack and can't be sold individually, little cigars are wrapped in packages of one, two or three and average about 99 cents per cigar. The Altria Co., which makes one of the most popular cigarillos, says they market to adult tobacco smokers, not to children. Even so, Mayo Clinic researcher and public health advocate Mignonne Guy says little cigars are easier for kids to access than cigarettes, but no less harmful.

MIGNONNE GUY: The average cigarette has approx 8 milligrams of nicotine in it. The average cigar can range anywhere from 100 to 200 milligrams of nicotine.

NEIGHMOND: That's a lot more nicotine than in a cigarette. And the problem is today's teens and young adults don't just puff, like in the old days. They inhale.

GUY: They're treating it like a cigarette, and they're using them like cigarettes. They will say, "I'll use them when I'm really stressed out," after a test, or after a long day's worth of work.

NEIGHMOND: Guy says kids as young as middle-schoolers are trying little cigars. And evidence shows the earlier in life people start using tobacco products, the harder it is to quit.

GUY: We've done a great job in communicating to the general public about the dangers of cigarettes, but we have not done a great job of communicating the harm - and the risk and the danger - of little cigars and cigarillos.

NEIGHMOND: About four years ago, the FDA expanded oversight of cigarettes, restricting advertising and banning most flavors. The agency is now considering whether to take a similar strict stance when it comes to regulating little cigars and cigarillos.

Patti Neighmond, NPR News. Transcript provided by NPR, Copyright NPR.

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