Consumption of Cigarettes and Combustible Tobacco

United States, 2000-2011

Michael A. Tynan; Tim McAfee, MD; Gabbi Promoff, MA; Terry Pechacek, PhD


Morbidity and Mortality Weekly Report. 2012;61(30):565-569. 

In This Article

Editorial Note

Despite continued decreases in cigarette smoking in the United States, consumption of pipe tobacco and large cigars has increased substantially since the federal tobacco excise tax was increased in 2009, creating tax disparities that made 1) pipe tobacco less expensive than roll-your-own tobacco and manufactured cigarettes, and 2) large cigars less heavily taxed than small cigars and manufactured cigarettes.[7,8] Because loose tobacco products are classified based on how they are labeled, the loose tobacco tax disparity of $21.95 per pound led manufacturers to relabel roll-your-own tobacco as pipe tobacco and then market this relabeled pipe tobacco for roll-your-own use.[7–9] In addition, manufacturers were able to increase the per-unit weight of certain small cigars to take advantage of a tax benefit when classified as large cigars, which are taxed based on the product price rather than per cigar.[7] As a result of relatively minor increases in per-unit weight, the new "large cigar" can appear almost identical to a "small cigar," which resembles a typical cigarette and can cost as little as 7 cents per cigar (Figure 1).[7]

This analysis shows that cigarette consumption continues to decline in the United States, a trend that has persisted since the 1960s. However, recent changes in consumption patterns, particularly increases in large cigar and pipe tobacco use, have resulted in a slowing of the decline in consumption of all combustible tobacco, and indicate that certain cigarette smokers have switched to using lower-taxed noncigarette combustible products. Moreover, a 2012 Surgeon General's report found that youths and young adults had even higher rates of cigar use and simultaneous use of multiple tobacco products.[10]

Recent analysis of excise tax data for pipe tobacco, roll-your-own cigarette tobacco, small cigars, and large cigars reveals that the tobacco industry is adapting the marketing and production of cigars and roll-your-own tobacco products to minimize federal excise tax and thus reduce these tobacco products' prices compared with cigarettes.[7–9] Reducing the effective federal and state excise tax rates on tobacco lessens the impact of cost on reducing smoking and preventing smoking initiation. The Government Accountability Office (GAO) recommends modifying federal tobacco taxes to eliminate large tax differentials between roll-your-own and pipe tobacco and small and large cigars.[7] In addition, because Food and Drug Administration (FDA) regulations currently do not apply to cigars and pipe tobacco, these products can be produced with flavoring, can be labeled with misleading descriptors such as "light" or "low tar," and can be marketed and sold with fewer restrictions than apply to cigarettes.

The findings in this report are subject to at least one limitation. CDC's measure for cigarette and combustible tobacco consumption only accounts for products taxed for legal sale in the United States and does not account for illicit cigarette sales, such as those smuggled into or out of the country, or for untaxed cigarettes that are produced or sold on American Indian sovereign lands. Currently, no method exists for measuring or estimating illicit or untaxed tobacco trade in the United States.

Smoke from pipes and cigars contains the same toxic chemicals as cigarette smoke.[1] The evidence that the increase in cigar and pipe tobacco use is the result of offering cigarette smokers a low-priced alternative product is a particular public health concern, because the morbidity and mortality effects of other forms of combustible tobacco are similar to those of cigarettes. Increasing prices has been one of the most effective ways to reduce tobacco use and prevent youth smoking initiation.[10] In addition, combustible tobacco products that are similar in design but not legally considered to be cigarettes are not subject to FDA regulations related to manufacturing, flavoring, labeling, and marketing. The availability of low-priced and less regulated alternative products appears to have led certain cigarette smokers to switch to other combustible tobacco products. This group also might include persons who otherwise might have quit smoking as a result of the 2009 federal tobacco excise tax increase and FDA cigarette regulations. Diminishing the public health impact of excise tax increases and regulation can hamper efforts to prevent youth smoking initiation, reduce consumption, and prompt quitting.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.