Roll-your-own Cigarettes Research Articles

Roll-your-own tobacco use among people smoking menthol cigarettes in Great Britain, 2020-2023: a population-based survey.

The sale of factory-made cigarettes with menthol as characterising flavour has been prohibited in Great Britain since May-2020. However, menthol accessories like flavoured filters for roll-your-own (RYO) tobacco can be sold legally, possibly undermining the policy. This study aimed to explore the association of RYO and menthol cigarette smoking. Data were collected between October-2020 and October-2023 from a monthly population-based cross-sectional survey, with 82,120 adults (18+) living in Great Britain providing complete data. Logistic regression models assessed the association between predominant RYO tobacco use and menthol cigarette smoking, and whether it differed by sociodemographic characteristics, unadjusted and adjusted for age, gender, ethnicity, nation, and socioeconomic position. Time-trends in RYO tobacco use among people smoking menthol cigarettes were modelled over the study period. There has been no clear decrease in menthol cigarette smoking prevalence among people who smoke (~14%) following the ban. Predominant RYO use increased among people smoking menthol cigarettes from 49.6% (95%CI: 42.2-57.0) in October-2020 to 61.9% (95%CI: 57.5-66.0) in June-2022, after which it remained stable. Predominant RYO use was more common among people smoking menthol than non-flavoured cigarettes overall (adjusted odds ratio (ORadj)=1.30, 95%CI: 1.14-1.49) and across demographic subgroups. This association was most pronounced in middle-aged compared with older people (35 vs. 65 years ORadj=1.18, 95%CI: 1.01-1.35), and in ethnic minorities compared with White people (ORadj=1.56, 95%CI: 1.03-2.36). There was a substantial increase in RYO use among people smoking menthol cigarettes in the first two years after the ban, from approximately 50% to 60%. The availability of menthol accessories may have undermined the ban on factory-made mentholated cigarettes in Great Britain. Roughly one in seven people who smoke cigarettes still report smoking menthol cigarettes and among these, about two thirds predominantly use roll-your-own tobacco. Since there has been no noteworthy change in the prevalence of menthol cigarette smoking since October-2020, new measures will likely be necessary to achieve a further reduction. For example, menthol accessories could be banned or their advertising and availability heavily restricted.

A decomposition analysis of sociodemographic factors and non-cigarette tobacco use as contributors to the change in smoking rates in South Africa between 2017/18 and 2021.

Trends data up to 2018 suggest that tobacco smoking was increasing in South Africa (SA), but only limited information is available on the impact of the COVID-19 pandemic on the current pattern of use of tobacco and nicotine products (TNPs). To assess trends in sociodemographic patterns in the use of TNPs and the extent to which sociodemographic factors and non-cigarette tobacco use may explain possible changes in rates of TNP use between 2017/18 and 2021. Data from three waves (2017, 2018 and 2021) of the South African Social Attitudes Survey (total N=8 140) were analysed. The sociodemographic correlates of current daily and non-daily use of factory-manufactured cigarettes (FMCs), roll-your-own (RYO) cigarettes, waterpipe/hubbly, electronic cigarettes (ECigs), snuff (a smokeless tobacco) and any combination of FMCs, RYO cigarettes and waterpipe/hubbly ('current smoking') in 2017/18 (pre-pandemic) were compared with those for 2021 (during the pandemic). Chi-square analyses and generalised linear models were used to compare the prevalence of TNP use between the two periods. A Blinda-Oaxaca decomposition analysis was also used to explore the roles of various sociodemographic factors, including any differences in the use of TNPs, that may explain any observed differences in smoking rates between 2017/18 and 2021. Current smoking increased significantly from 22.4% (95% confidence interval (CI) 20.4 - 24.5) in 2017/18 to 27.6% (95% CI 24.3 - 31.1) in 2021 (p=0.009). Smoking of FMCs did not change significantly overall between these two periods (20.1% v. 22.1%; p=0.240), except for a significant increase among those who self-identified as black African and a decrease among those who self-identified as coloured and those currently employed. However, the use of waterpipe/hubbly, ECigs, RYO cigarettes and snuff increased significantly. Women, individuals aged <35 years and black Africans had the largest increase in waterpipe/hubbly and ECig use. A decomposition analysis showed that increased waterpipe/hubbly and RYO use explained 52% and 15%, respectively, of the increase in smoking rates, while lower employment during 2021 compared with 2017/18 explained 15% of the increase in smoking rates during 2021. The use of all TNPs continued to increase in SA, particularly among women and unemployed people. These findings have policy and practice implications for addressing socioeconomic disparities in tobacco-related diseases.

Impact of Standardised Packaging of Tobacco Products Regulations on cigarette consumption and youth smoking in England: interrupted time-series analysis

BackgroundIn the UK in May 2016, standardised packaging of tobacco products was implemented, including minimum pack sizes of 20 sticks or 30 g loose tobacco. The change was intended to...

Unintended Consequences of Antismoking Pricing Policies: Insights from Smokers’ Household Expenditure on Smoking Behavior and Public Health

Despite e-cigarettes’ increasing popularity, traditional cigarette smoking, particularly with roll-your-own (RYO) tobacco, persists as the predominant form of global tobacco consumption. We examine the effect of an antismoking pricing policy on smokers’ behavior by assessing changes in their households’ consumption of tobacco products. To do so, we use a pricing policy implemented in Israel that introduced significant tax increases on RYO tobacco and factory-made cigarettes as our research setting. We analyze data compiled by a national agency on 8000 households representing the smoking population, evaluating changes in smoking behavior through their expenditures on tobacco products. Our model assesses the policy’s impact on tobacco and cigarettes consumed, as well as the probability of households consuming these products. We find that the policy reduced neither overall tobacco consumption nor cigarettes smoked, contrary to expectations. Instead, it was associated with an increased likelihood of households choosing RYO cigarettes and the number of RYO cigarettes consumed. The study emphasizes that anti-smoking pricing policies may inadvertently promote RYO tobacco use, potentially harming public health. To mitigate this, we recommend designing price policies that eliminate perceived gaps between RYO tobacco and factory-made cigarettes. This approach can discourage substitution and foster the deconsumption of both products.

Illicit cigarette market in Georgia: potential impacts on smoking prevalence and tax revenues

ObjectivesThis study aims to examine the impact of taxation measures implemented between 2017 and 2019 on the illicit cigarette market in Georgia and to assess the potential effects of its full elimination on smoking rates and tax revenues. Study designThis was a cross-sectional and observational study. MethodsThe study uses the gap analysis method to estimate the size of the illicit market by comparing self-reported cigarette consumption with tax-paid cigarette sales. Potential changes in cigarette consumption are calculated using estimates of price demand elasticity and the price difference between licit and illicit cigarettes. The applicable excise tax is then applied to the estimated change in licit cigarette consumption to determine the potential change in tax revenues. ResultsIn 2020, illicit cigarettes accounted for 6.4% of the market, which decreased to 0.6% in 2021. Eliminating the illicit cigarette market could potentially reduce the number of smokers by 0.5% in 2020 and 0.1% in 2021. It could also lead to a 2.8% increase in excise tax revenues in 2020 and a 0.2% increase in 2021. The study highlights a notable shift in consumer behavior since 2019 toward smoking roll-your-own (RYO) cigarettes. ConclusionsTax increases did not have a significant impact on the size of the illicit market in Georgia. The shift in consumer preference toward RYO cigarettes may explain why the illicit cigarette market did not expand after the tax hikes. However, this shift diminishes the effectiveness of taxation policies in reducing smoking rates and leads to a decline in excise tax collection.

Assessment of heavy metal levels in roll-your-own cigarette and water pipe tobacco blends

The increased consumption of roll-your-own (RYO) cigarettes and water pipe (hookah), both globally and in Bulgaria, necessitated the current investigation aimed at the assessment of heavy metal levels in the tobacco blends used in those products. The concentrations of Mn, Zn, Cu, Cd, Pb, and Ni were determined by AAS in five brands of RYO tobacco (R1-R5) and seven brands of water pipe tobacco (W1- W7), all distributed on Bulgarian market. The average heavy metal contents (mg/kg) in the two types of tobacco blends, RYO and water pipe, respectively, were as follows: Mn - 214.20 and 37.89; Zn - 31.90 and 134.87; Cu - 12.06 and 10.07; Cd - 0.80 and 1.33; Pb - 1.60 and 3.57; Ni - 1.36 and 0.80. RYO cigarette tobaccos contained higher concentration of Mn, Cu and Ni, while water pipe tobaccos - Zn, Cd and Pb. Strong correlations were found between Cu and Zn (r=0.81), Cu and Cd (r=0.90) in RYO tobacco blends, and between Cu and Zn (r=0.86) - in water pipe blends, respectively. The results from the study give reason to recommend that this information be provided to the consumers, who consider the regarded tobacco products as a safer alternative to conventional cigarettes.

Prevalence and correlates of roll-your-own cigarette smoking among South African adults during 2010-2011 and 2017-2018.

The increasing use of roll-your own (RYO) cigarettes has been documented globally, but there are no recent data from South Africa, particularly among youths and low-income groups. We assessed changes in prevalence and correlates of RYO smoking among South African adults during 2010-2011 and 2017-2018, and explored expenditure differences between daily smokers of RYO and manufactured cigarettes. Nationally representative data of South Africans aged ≥16 years used in this study were from the South African Social Attitudes Survey (SASAS) for 2010-2011 (n=6116), and 2017-2018 (n=5799). Current RYO cigarette use included daily and non-daily use. Annual expenditures were estimated based on typical usage patterns for daily users. Descriptive and multivariable analyses were performed using Stata Version 15 with the level of statistical significance set at p<0.05. The prevalence of ever RYO cigarette use increased from 6.5% (95% CI: 5.6-7.5) during 2010-2011, to 8.5% (95% CI: 7.0-10.0) during 2017-2018 (p=0.026). Current RYO cigarette use prevalence however remained largely unchanged when we compared 2010-2011 to 2017-2018 (5.2% vs 6.3%, p=0.544). During 2017-2018, current RYO cigarette use prevalence was highest among men (11.6%), those who self-identified as Coloreds (11.1%), people aged 25-34 years (7.8%), those with no schooling (7.5%), and those unemployed (9.8%). Annual expenditures associated with typical patterns of daily RYO cigarette smoking were substantially less than for smoking of manufactured cigarettes. The prevalence of ever RYO cigarette use increased between 2010-2011 and 2017-2018. Current RYO cigarette use during 2017-2018 was more prevalent among Coloreds, Black Africans, youths, those with lower education, and the unemployed. This study's findings highlight the need to harmonize taxation of cigarettes and RYO cigarettes, and to intensify implementation of evidence-based tobacco control and prevention interventions in South Africa.

Motivations to Change Smoking Behaviors Between 2007 and 2019 in Australia: A Repeated Cross-sectional Study.

In 2010, Australian tobacco excise (administered federally) increased by 25%, and by 12.5% annually from 2013 to 2020, with additional increases on roll-your-own (RYO) tobacco between 2017 and 2020. We estimated past year changes in smoking behavior among Australian adults who smoked (daily and non-daily) in the past year, and the association between consumer characteristics and stated motivations to change/attempt to change smoking behavior between 2007 and 2019. Logistic regression analysis of combined data from national representative triennial cross-sectional surveys in Australia (N = 22 977). The main motivation cited for changing smoking behavior switched from health-related from 2007 to 2010 to cost-related from 2013 to 2019. Among those who quit between one and 12 months ago, living in a lower socioeconomic area (odds ratio (OR) = 1.61, 95% CI = 1.18% to -2.18%), was associated with reporting the cost of smoking motivated them to quit. Among those who reduced their smoking, smoking daily and >20 cigarettes/day vs. non-daily smoking (OR = 2.11, 95% CI = 1.60% to 2.78%), having high/very high psychological distress (OR = 1.33, 95% CI = 1.12% to 1.59%), and alcohol consumption (ORdaily drinking = 1.38, 95% CI = 1.05% to 1.81%) was associated with cost as a motivation. Exclusive (OR = 0.65, 95% CI = 0.53% to 0.80%) and non-exclusive (OR = 0.77, 95% CI = 0.65% to 0.91%) RYO use was associated with being less likely to report the cost of tobacco as motivation for cutting down. The cost of smoking became the most cited motivator to change smoking behavior (eg, quitting and cutting down), particularly for those who lived in low socioeconomic areas, smoked more cigarettes per day, drank alcohol, and had high/very high psychological distress. A change in the main federal tobacco control intervention implemented in Australia from mass-media campaigns to tobacco tax increases has likely led to cost, rather than health, being the main motivation cited for changing smoking behavior in Australia since 2013. Further monitoring is needed to ensure the harmonization in tax rates for RYO and factory-made cigarettes has effectively reduced the price difference between these products because the lower cost of RYO may have reduced the effectiveness of tax increases as a motivator to change smoking behavior.

Demand for Factory-Made Cigarettes and Roll-Your-Own Tobacco and Differences Between Age and Socioeconomic Groups: Findings From the International Tobacco Control Netherlands Survey.

IntroductionMacroeconomic studies have shown that young individuals who smoke, and have a low socioeconomic status respond more strongly to price increases. Most of this evidence stems from research on factory-made (FM) cigarettes. With the rising popularity of roll-your-own (RYO) tobacco, there is a need for studies on cigarette demand that distinguish between both.Aims and MethodsThis study examined whether individual demand differed for FM and RYO tobacco, and across age, and socioeconomic (income and education) groups. Purchase tasks for FM and RYO cigarettes were included in the 2020 International Tobacco Control (ITC) Netherlands Survey. Adults who smoke daily (n = 1620) stated how many cigarettes they would smoke in 24 hours across eight prices. Four demand indices were derived: intensity (consumption at zero costs), alpha (rate of change in elasticity), Pmax (turning point elasticity), and breakpoint (lowest price where consumption equals zero). The indices were tested for subgroup differences.ResultsIndividuals who smoke RYO tobacco indicated higher intensity, and greater alpha than individuals who smoke FM cigarettes. Participants aged 25–39 had lower Pmax, and 18–24 year olds displayed higher breakpoints. Participants with low income displayed higher intensity, and lower Pmax than other income groups. No associations were found with education.ConclusionsIndividuals who smoke RYO tobacco indicated higher price sensitivity than those smoking FM cigarettes, supporting the need to harmonize tobacco taxation. Taxation may be especially beneficial to reducing consumption among individuals with a low income or smoke RYO tobacco. Substantially higher prices are needed in the Netherlands to achieve the desired results.ImplicationsIndividuals who smoke daily were willing to pay substantially higher prices than the current market prices, indicating the room and need for much higher taxation levels. Demand for RYO tobacco was more sensitive to price changes than demand for FM cigarettes. Taxation should be raised at equivalent rates for FM and RYO cigarettes. Taxation appears to be especially effective in reducing consumption among people who smoke RYO tobacco and low-income individuals. It remains important to combine increased taxation with other tobacco control measures.

Future intentions and beliefs about roll-your-own cigarettes in adolescents

ObjectiveTo determine the predisposition to use roll-your-own (RYO) cigarettes and the beliefs about RYO cigarettes of all the students of 3°–4° of ESO during the years 2016–17 and 2018–19. A cross-sectional study. SettingBisaura High School from Sant Quirze de Besora. Primary Health Care in the Catalan Health Institute, Catalunya, Spain. Participants111 3rd and 4th of ESO (14–16 years). Main measurementsDependent variables used were future intentions of smoking and beliefs regarding RYO cigarettes. Independent variables were sex, course and ever smoked. The prevalence of the different dependent variables was described and compared according to the different independent variables with Pearson's Khi-square test. Results26.6% of the adolescents intended to smoke in the future of which 17.4% intended to smoke RYO cigarettes and 13.8% manufactured cigarettes (MC). Around 30% of adolescents express at least one wrong belief regarding RYO cigarettes. For example, the 26.7% believed that smoking RYO cigarettes generated less addiction than MC and the 32.1% that was less harmful. Those who had smoked at some time in their life had a greater intention to smoke in the future (54.5%), to smoke MC (27.3%) and RYO cigarettes (40.9%) than those who had never smoked (7.7%, 4.6% and 1.5% respectively) (p<0.005). Some misconceptions differed depending on whether adolescents had ever smoked in life, sex and course. The boys believed that smoking RYO cigarettes was more natural than smoking MC (p<0.005). ConclusionsEducational activities to improve the information that young people have regarding RYO cigarettes are needed.

New Zealand roll-your-own smokers' reaction to novel roll-your-own tobacco packaging warning labels.

Although roll-your-own (RYO) loose tobacco is increasingly popular among smokers, no jurisdictions have used RYO-specific pictorial warning labels (PWL) on tobacco packaging. We explored how New Zealand RYO smokers, a population with over 10 years of exposure to PWLs, reacted to RYO-specific warnings featuring novel themes. We conducted an online survey of 785 RYO smokers in March 2019. Eligible participants were smokers aged 18-70 years who smoked predominantly RYO cigarettes. Participants randomly viewed two of eight RYO-specific PWLs featuring themes of health information (mouth and throat cancer), suffering (male and female), toxins, material hardship, cost, family transmission of smoking and harm to pets and answered items assessing negative emotions and perceived effectiveness. Compared to a reference health information PWL (most similar in content and tone to New Zealand's existing PWLs), only a male suffering PWL elicited both significantly stronger negative emotion and higher perceived effectiveness. No themes performed significantly worse than the health information PWL, suggesting any of the themes could be at least as effective as existing health warnings among New Zealand RYO smokers. The individual-level factors consistently associated with negative emotion and perceived effectiveness were age, desire to quit smoking, believing quitting could reduce risk of serious disease, a quit attempt within the previous 6months and ever-planning to quit. Our findings suggest that, in the New Zealand context, a PWL emphasising male suffering could be a useful starting point for assessing RYO-specific PWLs compared to general smoking warnings.

Impact of three annual tobacco tax rises on tobacco sales in remote Australian Aboriginal community stores

BackgroundThere is strong evidence from many settings that tobacco tax rises which increase prices reduce tobacco consumption, but only limited evidence from Indigenous settings.MethodsWe analysed 3 years (2016–2018) of weekly...

Analysis of tobacco industry pricing strategies in 23 European Union countries using commercial pricing data

BackgroundThe tobacco industry (TI) can act to undermine the impact of tobacco tax increases by adopting various pricing strategies. Little is known about strategies used across the European Union (EU),...

Smokers’ strategies across social grades to minimise the cost of smoking in a period with annual tax increases: evidence from a national survey in England

ObjectivesTo assess associations between smokers’ strategies to minimise how much their smoking costs and cost of smoking among smokers across three social grades during a period of annual tax increases...

Trends in and Correlates of Use of Roll-Your-Own Cigarettes: A Population Study in England 2008–2017

Understanding the use of cheaper roll-your-own (RYO) cigarettes may have implications for tobacco tax policy. We examined trends in RYO cigarette use in England between 2008 and 2017, and characterized users' sociodemographic and smoking profiles. We used data from 211 469 respondents to a survey representative of the adult (≥16 years) population. In current smokers across the entire study period (n = 43 389), we assessed multivariable associations between cigarette type (RYO or factory-made [FM]) and sociodemographic and smoking characteristics. Among current smokers in 2008 and 2017 (n = 7685), we tested interactions between year and cigarette type to assess the stability of each characteristic. Between 2008 and 2017, FM cigarette use declined from 15.3% to 9.2% whereas RYO use increased from 6.7% to 8.1%. Greater odds of RYO use were observed among younger, male smokers from lower social grades, who were more addicted and used electronic cigarettes (ORrange = 1.28-1.86, p < .001). Lower odds of RYO use were observed among nondaily smokers, those with high motivation to stop, and higher spending on smoking (ORrange = 0.46-0.89, p ≤ .001). The RYO smoker profile was relatively stable between 2008 and 2017. However, compared with FM use, RYO use increased in younger (p < .001) and female (p = .019) smokers, and there was a relatively smaller decline in the proportion cutting down or trying to quit (p = .004). In England, RYO use increased when overall smoking prevalence and FM use decreased. The profile of RYO smokers remained relatively stable, with users typically younger, male, more addicted, deprived, spending less on smoking, and less inclined to quit than FM smokers. This population-based study provides novel insight into recent trends in RYO use in England, providing an up-to-date understanding of the profile of RYO smokers. Without the consistent application of tax across the range of combustible products, smokers who are more dependent are able to capitalize on the lower cost of RYO in order to continue smoking, undermining the potential benefit of taxation on cessation.

Who uses rollies? Trends in product offerings, price and use of roll-your-own tobacco in Australia

ObjectiveWe examined the roll-your-own (RYO) tobacco product market in Australia from 2001 to 2016. Trends in use of RYO tobacco among Australian adults were examined for 2004–2016.MethodsChanges in brand availability,...

Patterns of alternative tobacco product experimentation among ever smoker adolescents.

Alternative tobacco product (ATP) use is popular among adolescents in Western countries, however, little is known about factors influencing ATP experimentation in Europe. The aim of this study was to explore factors associated with ATP experimentation, and to identify patterns of ATP experimentation among Hungarian adolescents who had ever tried manufactured cigarette smoking. Logistic regression analyses were applied to estimate the relationship between individual cigarette smoking experiences, social smoking influences, demographics, and ATP experimentation (roll-your-own (RYO) cigarettes, cigars/cigarillos, waterpipe, traditional pipe and flavoured cigarettes) in a cross-sectional sample of 8th and 11th grade students (N = 1,067, 56.0% of girls) who had ever tried manufactured cigarette smoking in six metropolitan cities of Hungary. Latent class analysis (LCA) was performed to identify patterns of different ATP use. Almost 90% of the sample had ever tried ATPs and significantly more commonly older (91.8%) versus younger (79.8%) students. Waterpipe was the most popular product to try followed by flavoured cigarettes, cigars/cigarillos, RYO cigarettes, and pipe. Boys were more likely to report ATP experimentation compared to girls. Younger age of cigarette smoking experimentation, greater frequency of past month cigarette smoking and history of ever daily smoking for 30 days showed strong association with ATP experimentation. Students with one or more smoking friends were more vulnerable to experiment with ATPs. Weekly allowance, school academic achievement and household smoking exposure showed no effect on the experimentation. LCA identified four subgroups of ATP experimenters comprising intense polytobacco experimenters (38.4%), mainly waterpipe experimenters (34.2%), moderate polytobacco experimenters (14.9%), and less interested experimenters (12.5%). Tobacco prevention programmes targeting adolescents should emphasize the risks of using ATPs in addition to manufactured cigarettes. Accessibility of ATPs should be better regulated and restrictions should be strongly enforced in order to prevent potential harmful consequences of adolescent polytobacco use.

Cigarette brand loyalty among smokers in six European countries: Findings from the EUREST-PLUS ITC Europe Surveys.

INTRODUCTIONThis study aims to describe the degree of smokers’ loyalty to a specific brand of tobacco products and the variables related to choosing a specific brand among smokers in six European countries.METHODSA cross-sectional analysis was conducted for a representative sample of adult smokers from Germany, Greece, Hungary, Poland, Romania, and Spain (approximately 1000 smokers per country). The prevalence of smokers’ having a usual brand of cigarettes smoked (factory-made or roll-yourown cigarettes), the brand of choice, the factors for choosing a specific brand and the degree of loyalty to that brand (not at all, a little, somewhat and a lot) were assessed by country, sociodemographics and smoking-related variables.RESULTSIn total, 86.6% of the smokers reported having a usual brand. In three out of the six countries, one brand holds the loyalty of between 17.8% and 24.5% of the smokers that reported having a usual brand for factory-made cigarettes. Most participants reported being loyal ‘a lot’ to their brand of choice (44.4%). The reasons most reported for choosing a cigarette brand were the taste (83.2%) and the price (51.7%).CONCLUSIONSBrand loyalty is high among factory-made and roll-your-own cigarette smokers in six European countries. Future research on longitudinal trends of brand loyalty to evaluate the effect of tobacco control policies in these European countries is warranted.

Roll-your-own cigarette use in Italy: sales and consumer profile-data from PASSI surveillance, 2015-2016.

The use of roll-your-own (RYO) cigarette has substantially increased in most high-income countries recently. This work aims to update Italian trends on loose tobacco sales and to describe the consumer profile of predominant RYO users. Data from the Italian Agency of Customs and State Monopolies and from PASSI (Italian behavioral risk factor surveillance system) were used. Information on 16,858 interviews to current smokers aged 18-69 was analyzed. Sales of loose tobacco increased more than sevenfold between 2004 and 2017. In 2015-2016, 11.6% of smokers reported smoking predominantly RYO cigarettes, with higher percentages among the youngest where a significant association between use of RYO and education was observed, unlike what happened in older adults. The association between economic difficulties and use of RYO was observed only in older adults. A growing trend in RYO cigarette sales was registered between 2004 and 2017. In young smokers, the greater use of RYO was observed among the most educated regardless of financial strain, while in older ones among those with economic difficulties.

Comparison of TSNAs concentration in saliva according to type of tobacco smoked

ObjectiveTo compare tobacco-specific nitrosamines (TSNAs) measured in saliva according to different types of tobacco smoked in a sample of smokers of the city of Barcelona (Spain). MethodsWe used data from a cross-sectional study of a sample of the adult smoking population of Barcelona, Spain in 2013–2014 (n = 165). We classified smokers in five groups according to the type of tobacco smoked: a) manufactured cigarettes only, b) roll-your-own (RYO) cigarettes only, c) dual smokers (both manufactured and RYO cigarettes), d) manufactured plus other types of tobacco products different from RYO and e) other types of tobacco products different from manufactured and RYO cigarettes. We calculated the geometric mean (GM) and geometric standard deviation (GSD) of TSNAs concentration in saliva (pg/mL), including N’-nitroaonornicotine (NNN), 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) according to the five tobacco groups. We also described all TSNAs concentration in each tobacco group stratified by the number of cigarettes smoked per day. ResultsSmokers from the RYO cigarette group had higher TSNAs concentration than smokers from the manufactured cigarette group: 13 pg/mL vs 4.9 pg/mL of NNN, 1.9 pg/mL vs 1.7 pg/mL in NNK and 1.1 pg/mL vs 0.9 pg/mL of NNAL. There were significant differences in NNN concentrations between smokers of RYO vs manufactured cigarettes. The higher the number of cigarettes smoked, the higher the TSNAs concentrations. After adjusted by number of cigarettes smoked, there were not statistically significant differences in TSNAs between RYO and manufactured cigarettes. ConclusionsOur data shows that RYO cigarette is at least as hazardous as manufactured cigarettes. Regulating RYO tobacco prices could be an effective strategy to control tobacco use.