The US Surgeon General has concluded that combustible tobacco products, such as cigarettes and cigars, are responsible for the overwhelming burden of death and disease from tobacco products.¹ Cigar smoking is associated with several of the same health risks as cigarette smoking, such as heart disease, lung cancer, and all-cause mortality.^1,2 The broad category of cigars includes large cigars, little cigars, and cigarillos. Large cigars include premium hand-rolled cigars and machine-made large cigars. Little cigars are the same size and shape as cigarettes and often include a filter. Cigarillos are typically unfiltered, comparable in size to little cigars.

Although cigarette consumption in the United States continues to decline, demand for cigars has increased in recent decades.^1,3 From 2002 to 2012, per capita sales of cigars increased from 30.5 cigars to 57.4.³ Moreover, self-reported survey data indicate that in 2019, 3.6% (8.7 million) of US adults currently smoked cigars, making it the second most commonly used combustible tobacco product among adults behind cigarettes.⁴ During the same year, 5.3% (1.4 million) of US middle and high school students currently used cigars, making it the second most commonly used tobacco product among US middle and high school students after e-cigarettes.⁵

Self-reported survey data also indicate that the use of certain cigar types is particularly prominent among young people, including little cigars.⁶ The use of little cigars among young people is partly driven by the availability of these products in flavors that are otherwise prohibited in conventional cigarettes.^6,7 Other factors potentially increasing their appeal to consumers, particularly youth, include availability in single-unit quantities and lower prices compared to cigarettes.⁸ Some cigarette products have been modified by manufacturers by wrapping them in brown paper and increasing their weight, which classifies the products as cigars for tax purposes, thereby reducing their price relative to cigarettes.⁹ In addition, some or all of the loose tobacco in cigars can be emptied out and replaced with marijuana while retaining the tobacco leaf wrap, which is often called a “blunt.”¹⁰

Retail sales data can be a timely complement to self-reported surveys, which are frequently conducted once annually and might not fully capture emergent trends. To date, some studies have assessed trends in cigar sales^11-13; however, little is known about more recent trends in cigar sales volume and price, particularly by product and flavor type. This study used Nielsen data to assess US trends in cigar sales during 2016–2020, overall and by product and flavor type. Given the different types of cigars available in the United States, as well as the emergence of policies to prohibit the sale of flavored tobacco products such as little cigars,¹⁴ retail sales data could provide timely subannual data to inform public health policy and practice.

During January 2016–June 2020, monthly cigarillo unit sales increased from about 131 million to 190 million by an average of 0.7% per month (p < .001) during the entire study period (Figure 1, Appendix Table 1). For large cigars, unit sales decreased during the study period (AMPC = −0.8%, p < .001). For little cigars, unit sales decreased (AMPC = −0.2%, p < .001) during the entire study period; however, sales increased during January 2016–mid-August 2016 (AMPC = 1.6%, p = .01), but decreased since then (AMPC = −0.5%, p < .001).

During January 2016–June 2020, the average cigarillo price for a pack of 2 have remained unchanged ($1.31; AMPC = 0.0%, p = .8) for the entire study period (Figure 2, Appendix Table 1). For large cigars, the average price for one increased from $1.44 to $2.06 during the study period (AMPC = 0.6%, p < .001). For little cigars, the average price for a pack of 20 was unchanged ($2.94) during the entire study period (AMPC = 0.0%, p = .6); however, it decreased during mid-June 2016–June 2019 (AMPC = −0.3%, p < .001).

During the study period, total unit sales and unit sale share were greatest for cigarillos (9 688 537 764, 94.2% of unit sales), followed by little cigars (318 202 059, 3.1% of unit sales), and large cigars (274 519 531, 2.7% of unit sales; Appendix Table 2). Tobacco-flavored/unflavored products were the most common for all three product types assessed; annual unit sale share of tobacco-flavored/unflavored prod-ucts was 83%−87% for large cigars, 51%−54% for little cigars, and 49%−52% for cigarillos during January 2016–June 2020. For cigarillos, fruit flavor had the second greatest unit sale share, followed by candy/sweet flavors. Unit sales of tobacco-flavored/unflavored cigarillos increased by an average 0.9% per month overall (p < .001); unit sales of candy/ sweet- (AMPC = 1.0%, p < .001) and other- (AMPC = 2.5%, p < .001) flavored products also increased. For large cigars, candy/sweet and alcohol-flavored products were most popular after tobacco-flavored/unflavored products. Unit sales of tobacco-flavored/unflavored large cigars decreased overall (AMPC = −1.0%, p < .001); unit sales of candy/sweet- (AMPC = 0.8%, p < .001) and coffee- (AMPC = 9.8%, p < .001) flavored products increased, while the unit sales of fruit-flavored products decreased (AMPC = −4.4%, p < .001). For little cigars, menthol had the second highest proportion of overall sales, followed by fruit and candy/sweet flavors. Unit sales of tobacco-flavored/unflavored little cigars decreased overall (AMPC = −0.3%, p < .001); unit sales of alcohol-flavored products also decreased (AMPC = −6.6%, p < .001).

During January 2016–June 2020, unit sales of cigars increased in the United States. This increase was driven by steady growth in cigarillo sales during the assessed period, despite decreases in sales of large cigars and little cigars. Moreover, cigarillos were the most commonly sold cigar product, comprising 94.2% of overall sales, followed by little cigars (3.1%) and large cigars (2.7%). During August 2017–June 2020, the average price of cigarillos decreased. These findings re-inforce the importance of evidence-based strategies, including increasing price, to reduce the affordability and consumption of the full scope of cigar types being used in the United States, particularly among youth.

The current study found that decreases in unit sales of large cigars were accompanied by increases in the price of large cigars; in contrast, the price of cigarillos and little cigars re-mained unchanged during the full study period. When comparing to other higher priced products such as cigarettes, the relatively low cost of cigar products can be an appealing al-ternative to cigarettes, especially among youth.^6,16 Increasing price is the single most effective strategy for reducing cigarette consumption through both reducing initiation and increased cessation.^1,17 Similarly, studies have shown that increases in the price of cigars can effectively reduce cigar usage.^1,18 For example, Jawad et al estimated that a 10% price increase of cigars reduces cigar demand by 8%.¹⁸ Therefore, pricing is an important public health strategy for reducing cigar consumption, including preventing not only youth use but also potential tobacco product substitution.

The majority of cigar products sold during the assessed period were tobacco-flavored/unflavored products (annual market share of 50%−80%) and fruit was the second most commonly sold flavor for cigarillos and menthol was the second most commonly sold flavor for little cigars. Addressing flavored tobacco product sales, particularly candy/sweet flavored cigarillos is important for public health because flavors can mask the harshness of tobacco, making them more appealing to youth and young adults.^6,7 States and communities have adopted population-wide strategies to prevent youth use of flavored tobacco products, including policies that are specific to cigars. In 2009, New York City prohibited the sale of flavored cigars and smokeless tobacco products, though that policy excluded mint, menthol, and wintergreen and allowed flavored sales to continue in certain adult-only tobacco retailers.⁷ Similarly, Maine adopted a law in 2009 that prohibited the sale of flavored cigars, exempting premium cigars.¹⁹ An analysis of New York’s flavor policy found that cigar sales declined by 7.4%, compared with a 12% national increase.²⁰ Similar policies later were adopted by jurisdictions in California, Minnesota, and Rhode Island.⁷ In 2020, five states (California, Massachusetts, New Jersey, New York, and Rhode Island) adopted statewide laws that prohibited the sale of all flavored tobacco prod-ucts, including menthol.¹⁴ In April 2021, the US Food and Drug Administration announced that it plans to issue product standards to ban all characterizing flavors, including menthol, in cigars. The increased sales of cigars documented in this study, coupled with the high proportion of sales that were for flavored products, reinforce the importance of such standards for preventing and reducing cigar use in the United States.

Cigarillos were the most commonly sold cigar product, with sales increasing steadily as prices remained generally un-changed with slight decreases in recent years. Sales of certain flavors increased depending on cigar type. Comprehensive strategies that address the full scope of cigar products and flavors are warranted to prevent and reduce cigar use in the United States, especially among youth and young adults. These include longstanding strategies, such as increasing price,¹ and emerging strategies such as the restriction on flavor sales. Further surveillance of cigar demand, including through more rapidly collected mechanisms such as retail sales, is important to inform the development, implementation, and sustainment of efforts to address cigar use at the national, state, and local levels.