Short communication: Racial/ethnic disparities in cigar and cigarette exclusive, dual, and polyuse among adults.

Background: Despite documented racial/ethnic differences in cigar use, disparities in the context of dual and polyuse with cigarettes are unclear. Methods: Using the Population Assessment of Tobacco and Health Study (2016-18), we examined prevalence and intensity of use patterns among adults (18+) who were Non-Hispanic (NH) Black, NH White, Hispanic, or another race/ethnicity: exclusive cigarillo, filtered cigar, traditional cigar, or cigarette use; dual use of each cigar product with cigarettes; dual or polyuse of cigars without cigarettes; and cigar and cigarette polyuse. We used multinomial logistic regression to compare odds of each pattern of use to non-use of cigars or cigarettes and quantile regression to assess differences in median products used per day. Results: In our sample (n = 33,424), NH Black adults were more likely to exclusively smoke cigarillos (1.8%), cigarillos and cigarettes (1.6%), and multiple cigar products with or without cigarettes than other racial/ethnic groups. In adjusted models, NH Black compared to NH White adults had higher odds of exclusive cigarillo use (aOR 5.24, 95% CI 3.74-7.34), exclusive filtered cigar use (aOR 2.40, 95% CI 1.33-4.35), cigarillo and cigarette dual use (aOR 2.19, 95% CI 1.60-3.00), and dual/polyuse of cigar products (aOR 2.03, 95% CI 1.22-3.38) compared to non-current use. However, NH White adults tended to smoke the most cigarettes and filtered cigars per day. Conclusions: While the prevalence of cigar use was generally highest among NH Black adults, intensity of use was often highest among NH White users. These patterns may further explain racial/ethnic disparities in tobacco-related health outcomes.