The early to mid-1990s saw a large surge in U.S. cigar consumption, including premium cigars. Based on recent import data, premium cigar use may be increasing, though they currently make up a small percent of the total U.S. cigar market. Premium cigars have also been the subject of legal and regulatory efforts for the past decade. In 1998, the National Cancer Institute undertook a comprehensive review of available knowledge about cigars - the only one to date. The resulting research recommendations have largely not been addressed, and many of the identified information gaps persist. Furthermore, there is no single, consistent definition of premium cigars, making research challenging. In response, the Food and Drug Administration (FDA) and the National Institutes of Health commissioned the National Academies of Sciences, Engineering, and Medicine to convene a committee of experts to address this issue. The resulting report, Premium Cigars: Patterns of Use, Marketing, and Health Effects, includes 13 findings, 24 conclusions, and nine priority research recommendations and assesses the state of evidence on premium cigar characteristics, current patterns of use, marketing and perceptions of the product, and short- long-term health effects. Table of ContentsFront MatterSummary1 Context and MethodsChapter 1 Annex: Premium Cigar Definitions2 Characteristics of Cigars3 Patterns of Use and Prevalence of Cigars4 Cigar Marketing and PerceptionsChapter 4 Annex: Evidence Tables5 Health Effects of Premium CigarsChapter 5 Annex: Health Effects Evidence Tables6 Priority Research NeedsAppendix A: Research QuestionsAppendix B: Overview of Literature SearchAppendix C: Cross-Sectional Patterns of Cigar Use by Type in the National Survey on Drug Use and HealthAppendix D: Cross-Sectional Patterns and Longitudinal Transitions of Cigar Use by Type in the PATH StudyAppendix E: Cigar Brands from PATH and NSDUH AnalysesAppendix F: Cigar Physical CharacteristicsAppendix G: Exploratory Spatial Analyses of the Locations of 20192021 Premium Cigar Association Retailers, United StatesAppendix H: Public Meeting AgendasAppendix I: Committee Member and Staff Biographies
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