Gender and racial differences in smoking of long/ultra-long and king size cigarettes among U.S. adult smokers, NHANES 1999-2012

Drug Alcohol Depend. 2014 Mar 1:136:28-35. doi: 10.1016/j.drugalcdep.2013.12.004. Epub 2013 Dec 24.


Background: Cigarette rod length as a design feature may play a specific role in harm perception and tobacco use. Internal tobacco industry documents have shown targeting of females with long/ultra-long cigarettes. This study assessed trends and differences in smoking of long/ultra-long cigarettes among U.S. smokers aged ≥20 years during 1999 through 2012.

Methods: Data were obtained from the 1999/2000 through 2011/2012 National Health and Nutrition Examination Survey. The proportion of current smokers who reported using long/ultra-long cigarettes during each survey year was calculated and compared using χ(2) statistics. Linear and quadratic trends during 1999 through 2012 were assessed using binary logistic regression (p<0.05). Multi-variable analyses were performed to assess current disparities in smoking of long/ultra-long cigarettes.

Results: Despite overall declines in current smoking of long/ultra-long cigarettes during the 1999 through 2012 period (p<0.001 for both linear and quadratic trends), the proportion of smokers of long/ultra-long brands increased in recent years, with over a third (38.7%) of current smokers reporting smoking of long/ultra-long cigarettes during 2011/2012. Current smokers of long/ultra-long cigarettes were more likely to be female compared to males (aOR=3.09; 95%CI: 2.09-4.58), of black race compared to whites (aOR=2.07; 95%CI: 1.30-3.28), or aged 45-64, or ≥65 years (aOR=2.39 and 5.27, respectively), compared to 18-24 year olds.

Conclusions: Specific gender, age and race/ethnic characteristics of smokers of long/ultra-long cigarettes were noted, hence potentially contributing to the widening of health disparities. Cigarette rod length should be considered an important aspect of cigarette engineering/design in regulatory efforts to reduce the burden of tobacco-related disease.

Keywords: Abuse liability; Cigarettes; Design; Long; Product appeal; Slim.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Data Interpretation, Statistical
  • Ethnicity
  • Female
  • Health Surveys
  • Humans
  • Linear Models
  • Logistic Models
  • Male
  • Middle Aged
  • Nutrition Surveys
  • Prevalence
  • Product Packaging
  • Sex Factors
  • Smoking / epidemiology*
  • Smoking / psychology
  • Socioeconomic Factors
  • Tobacco Products*
  • United States / epidemiology
  • Young Adult