Donna Vallone interview

Donna Vallone, PhD, MPH

Senior Vice President, Research and Evaluation
Legacy for Longer, Healthier Lives
(Read her biosketch: http://www.legacyforhealth.org/2096.aspx)

Why is the American Legacy Foundation interested in little cigars and cigarillos? Are there new data that warrant attention from your organization and the tobacco control community?

Recent evidence from the U.S. Department of Agriculture indicates rising consumption of little cigars. In fact, consumption more than doubled between 1998 and 2006. Little cigars, also known as cigarillos or small cigars are exempt from taxation and restrictions on single sales. Given the lower price, people are using them as alternatives to cigarettes. Furthermore, there are no warnings of adverse health effects on the individual cigar wrapper; thus, when sold singly, consumers are not exposed to Surgeon General Warnings. Finally, our national surveillance surveys may underestimate the use of these products as some evidence suggests that little cigar smokers do not consider themselves “smokers.”

We are currently analyzing the National Survey on Drug Use and Health (NSDUH) public use data to examine the utilization patterns of these products as a first step. From preliminary analyses, it appears that use of little cigars and cigarillos is less prevalent among youth (ages 12-17) as compared to young adults (ages 18-25).

Why do you think there has been a spike in cigarillo use among youth—because of the price, or other factors?

A number of factors may be leading to the increased consumption. We believe that price is an important factor, particularly since prior to the SCHIP legislation, there had been no taxes levied on little cigars or cigarillo products. Other factors may include the various flavors embedded in these products—a product modification often used to appeal to new smokers and make it easier to inhale.

We also know that the tobacco industry is continuing to develop and market products to various communities including youth and communities of color. Historically, tobacco companies have identified a particular market segment and developed a marketing strategy and products to appeal to that market. This continues today, backed by millions of dollars invested in new brands and products. In fact, Phillip Morris (Altria) recently purchased Black and Mild (the second-largest brand of little cigars), and there is the possibility of RJR acquiring Swisher Sweets (the number one brand). Clearly, there is an interest by two of the largest tobacco manufacturers to invest in and market this product.

Are there any cigarillo-specific policy initiatives or prevention campaigns that Legacy is involved with?

Our focus now is to validly document the demographics of the little cigar and cigarillo smoker as a first step toward addressing this problem.

What can community organizations do to help prevent cigarillo use among disadvantaged youth?

Community organizations can help raise awareness of these products and their deadly health consequences. Unfortunately, many youth and young adults have reported perceiving these products as less harmful than cigarettes, and we need to help correct that misperception.

Does the American Legacy Foundation have any new tobacco-related health disparities projects on tap for 2009? If so, is there a specific population or group that will be examined more closely?

In regard to little cigars or cigarillos, Legacy issued an RFA for grant funding in January, 2009, which included documenting the use of these products. We are also considering a somewhat greater focus on urban youth and young adults to address use of these products.

Other tobacco-related health disparities projects for the coming year include public dissemination of recent findings about effects of the truth campaign by race/ethnicity and publication of a study examining awareness of and receptivity to the truth campaign by SES. We are beginning to evaluate the EX campaign, which was designed specifically to reach low SES smokers. I believe—in keeping with what we now know about the often differential programmatic effects by race/ethnicity and SES—that every evaluation must include a focus on disadvantaged populations, so that is the focus I bring to my work at Legacy. Also, Legacy is committed to serving priority populations, which are those who are at greater risk for smoking or tobacco-related morbidity and mortality, so that view is very much reflected throughout all of the efforts of the Foundation.