{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T11:03:23Z","timestamp":1790075003916,"version":"4.0.1"},"reference-count":31,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2022,11,18]],"date-time":"2022-11-18T00:00:00Z","timestamp":1668729600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute of the National Institutes of Health and the U.S. Food and Drug Administration Center for Tobacco Products","doi-asserted-by":"publisher","award":["R01CA228906"],"award-info":[{"award-number":["R01CA228906"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Introduction: Little filtered cigars and cigarillos (LCCs) are consumed infrequently, co-administered with marijuana, and concurrently used with other tobacco products. Reliance on the past 30-day use estimate, a marker of tobacco user status, may underestimate the dynamic nature of intermittent LCC and other tobacco product use. We developed a framework to capture the intermittent nature of exclusive LCC use and dual\/poly use with cigarettes and large cigars using broader timing of last product use categories and product use modality (e.g., with marijuana). Methods: Data come from the baseline C\u2019RILLOS study, a U.S. nationally representative sample of young adults aged 18\u201334 (n = 1063) collected in October 2019. We developed a consumption taxonomy framework that accounted for respondents\u2019 modality of LCC use (i.e., use with tobacco, LCC-T, or use with marijuana as blunts, LCC-B), the exclusive use of LCCs and other tobacco products (i.e., cigarettes, and large cigars) or their co-use and the timing of last product use (i.e., ever and past 30 days, past 3 months, past 6 months, greater than 6 months). Results: Seventy-five percent of our sample reported ever use of any combustible tobacco product, including LCCs. The most common ever use pattern was poly use of LCC-T + LCC-B + cigarettes (16%). Our consumption taxonomy framework demonstrated the fluid nature of combustible tobacco product use among LCC users. For instance, among past 30-day cigarette users, 48% reported using LCC-T, 39% reported using LCC-B, and 32% reported using large cigars in the past 3 months or more. Discussion: The tobacco use field currently classifies \u2018tobacco users\u2019 based on the product they smoked in the past 30 days. Any tobacco product use beyond the past 30-day period is considered \u2018discontinued use\u2019 and not the focus of intervention or tobacco regulatory science decisions. We documented the substantial proportion of young adult LCC, cigarette, and large cigar users who either exclusively or dual\/poly used these combustible products in recent (e.g., past 3 months) periods. To prevent underestimation of use, surveillance measures should assess the use modality, timing of last product use, and exclusive\/multiple product use to more accurately identify the smoking status of young adult LCC users.<\/jats:p>","DOI":"10.3390\/ijerph192215248","type":"journal-article","created":{"date-parts":[[2022,11,18]],"date-time":"2022-11-18T06:02:29Z","timestamp":1668751349000},"page":"15248","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Tobacco Whack-A-Mole: A Consumption Taxonomy of Cigar &amp; Other Combustible Tobacco Products among a Nationally Representative Sample of Young Adults"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6305-5082","authenticated-orcid":false,"given":"Kymberle Landrum","family":"Sterling","sequence":"first","affiliation":[{"name":"Department of Health Promotion & Behavioral Sciences, School of Public Health, University of Texas Health Sciences Center, Dallas, TX 75207, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5337-1137","authenticated-orcid":false,"given":"Katherine","family":"Masyn","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Public Health, Georgia State University, Atlanta, GA 30302, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6301-9185","authenticated-orcid":false,"given":"Stephanie Pike","family":"Moore","sequence":"additional","affiliation":[{"name":"Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH 44106, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1125-3578","authenticated-orcid":false,"given":"Craig S.","family":"Fryer","sequence":"additional","affiliation":[{"name":"Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD 20742, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5021-8505","authenticated-orcid":false,"given":"Erika","family":"Trapl","sequence":"additional","affiliation":[{"name":"Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH 44106, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8838-4250","authenticated-orcid":false,"given":"Ce","family":"Shang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Wexner Medical Center, Ohio State University, Columbus, OH 43210, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas","family":"Gunzler","sequence":"additional","affiliation":[{"name":"Department of Medicine, The MetroHealth System, Case Western Reserve University, Cleveland, OH 44106, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.addbeh.2015.05.005","article-title":"Changes in use of cigarettes and non-cigarette alternative products among college students","volume":"49","author":"Loukas","year":"2015","journal-title":"Addict. 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