The early to mid-1990s saw a large surge in U.S. cigar consumption, including premium cigars. Based on recent import data, premium cigar use may be increasing, though they currently make up a small percent of the total U.S. cigar market. Premium cigars have also been the subject of legal and regulatory efforts for the past decade. In 1998, the National Cancer Institute undertook a comprehensive review of available knowledge about cigars - the only one to date. The resulting research recommendations have largely not been addressed, and many of the identified information gaps persist. Furthermore, there is no single, consistent definition of premium cigars, making research challenging.

In response, the Food and Drug Administration (FDA) and the National Institutes of Health commissioned the National Academies of Sciences, Engineering, and Medicine to convene a committee of experts to address this issue. The resulting report, Premium Cigars: Patterns of Use, Marketing, and Health Effects, includes 13 findings, 24 conclusions, and nine priority research recommendations and assesses the state of evidence on premium cigar characteristics, current patterns of use, marketing and perceptions of the product, and short- long-term health effects.

Table of Contents

Front Matter
Summary
1 Context and Methods
Chapter 1 Annex: Premium Cigar Definitions
2 Characteristics of Cigars
3 Patterns of Use and Prevalence of Cigars
4 Cigar Marketing and Perceptions
Chapter 4 Annex: Evidence Tables
5 Health Effects of Premium Cigars
Chapter 5 Annex: Health Effects Evidence Tables
6 Priority Research Needs
Appendix A: Research Questions
Appendix B: Overview of Literature Search
Appendix C: Cross-Sectional Patterns of Cigar Use by Type in the National Survey on Drug Use and Health
Appendix D: Cross-Sectional Patterns and Longitudinal Transitions of Cigar Use by Type in the PATH Study
Appendix E: Cigar Brands from PATH and NSDUH Analyses
Appendix F: Cigar Physical Characteristics
Appendix G: Exploratory Spatial Analyses of the Locations of 20192021 Premium Cigar Association Retailers, United States
Appendix H: Public Meeting Agendas
Appendix I: Committee Member and Staff Biographies

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