This marks a reversal in a 20-year decline in cigar smoking from 1973 to 1993. Smoking surveys show that the current level of cigar smoking among adolescents exceeds the use of smokeless tobacco. These rates are double the use of smokeless tobacco. The same survey showed that 6 percent to 7 percent of girls in grades nine to 11 reported they had used cigars in the past month. In general, twice as many teenage boys compared to girls are likely to smoke cigars.
Adult males are about eight times more likely to smoke than females.
The health consequences of regular cigar use, along with the increased use in teenagers, raises several concerns among public health officials. Addiction studies with cigarettes and spit tobacco clearly show that addiction to nicotine occurs almost exclusively during adolescence and young adulthood when young people begin using these tobacco products. The high rates of adolescent use of cigars may result in higher rates of nicotine dependence in this age group. Recent data suggest that cigar smoking today begins at a much younger age than in the past when it was begun primarily as an adult. Donald R. Shopland from NCI's Smoking and Tobacco Control Program and the coordinator of the monograph, commented that the health risks posed by cigars have been overlooked because for decades cigar use has been so insignificant compared with cigarette smoking.