Summary of Public Comments

1724 Massachusetts Avenue, NW
Washington, DC 20036
202-454-5555
www.LegacyForHealth.org

Benjamin K. Chu, M.D., M.P.H., M.A.C.P., Chair
President, Southern California Region
Kaiser Foundation Health Plan and Hospitals
Pasadena, CA
Susan Curry, Ph.D., Vice-Chair
Dean, College of Public Health
Distinguished Professor, Health Management and Policy
University of Iowa
Iowa City, IA
Lawrence G. Wasden, Treasurer
Attorney General of Idaho
Boise, ID
Donald K. Boswell
President and CEO
Western New York Public Broadcasting Association’
Buffalo, NY
Jonathan E. Fielding
Director Health Officer,
Los Angeles County Department of Public Health
Professor of Health Services and Pediatrics
Schools of Public Health and Medicine
University of California, Los Angeles
Los Angeles, CA
Tom Miller
Attorney General of Iowa
Des Moines, IA
Charles K. Scott
Wyoming State Senator
Casper, WY
Leticia Van de Putte
Texas State Senator
San Antonio, TX
Cass Wheeler
Chief Executive Officer Emeritus
American Heart Association
Dallas, TX
Lee Storrow (Youth Board Liaison)
University of North Carolina at Chapel Hill
Chapel Hill, NC
Cheryl G. Healton, Dr. P.H. Ex-Officio
President and CEO
Legacy

December 22, 2009
Anne Hartman
National Cancer Institute
6130 Executive Blvd – MSC 7344
Executive Plaza North, Suite 4005
Bethesda, MD 20892-7344
RE: REINSTATEMENT WITH CHANGE OMB #0925-0368:
Next Series of Tobacco Use Supplements to the Current
Population Survey (TUS-CPS)
Legacy appreciates the opportunity to comment on the Next
Series of Tobacco Use Supplements to the Current Population
Survey (TUS-CPS), and would like to attest to the practical
utility of the information to be collected by this survey. This
survey is an important source of information regarding tobacco
use in the United States that is available to researchers and
policymakers. The information is critical to give a picture of
tobacco use in the country, determine the effectiveness of
tobacco control programs, help develop new programs and target
areas and inform research into tobacco use issues. Legacy was
especially pleased to see the revision and addition of questions
surrounding little cigar and cigarillo use, as well as questions
around mentholated tobacco products.
Legacy is a national, independent public health foundation
created in 1998 out of the landmark Master Settlement
Agreement (“MSA”) between the tobacco industry, 46 state
governments and five U.S. territories. Our mission is to build a
world where young people reject tobacco and anyone can quit.
Legacy does not lobby or take positions on specific legislation.
Our programs include:
truth® - A national youth smoking prevention media campaign
responsible for preventing approximately 450,000 youth from
initiating smoking from 2000 through 2004.
EX® - An innovative smoking cessation public education
campaign designed to help smokers “re-learn” life without
cigarettes.
Research Initiatives – Examining the various causes and effects
of tobacco use in the United States.

Outreach to Priority Populations – Priority Populations Initiatives and grants provide critical
interventions using methods that are culturally competent and tailored for the specific needs of
communities disproportionately affected by the toll of tobacco.
Little Cigars and Cigarillos
Little cigars and cigarillos are tobacco products that have been considered “fringe” tobacco products
for many years. Recently, however, these products have experienced significant sales and
importation increases. Between 1997 and 2007, sales of little cigars have increased by 240% while
cigarillo sales increased by almost 150%. (During the same time period, large cigar sales decreased
by 6%.) 1 U.S. imports of little cigars increased from 34 million pieces in 1997 to 311 million pieces
in 2007, an increase of more than 800%. During the same time period, large cigar imports jumped
from 587 million to 889 million, an increase of only 51%.2
Currently, there is no national prevalence data for consumption of little cigar or cigarillo products
specifically. Because these are subtypes of the general “cigar” category, without these data, it is
difficult to tease out the distinctions in who is using little cigars and cigarillos and how often they
are being used. Some of that may be due to the lexicon surrounding these products. Colloquially,
these products have varying names, so it is often difficult to ascertain whether someone uses them or
not.
The revisions in the proposed TUS-CPS make an effort to address this issue. To illustrate, currently
there are three major cigar products—cigars, cigarillos and little cigars. However, the current
federal classifications narrowly define them into two categories, little (or small) cigars and large
cigars3, based on weight:
*

Little cigars weigh less than 3 pounds per thousand.

*

Large cigars weigh 3 pounds per thousand or more.

Mid-sized cigars, colloquially known as “cigarillos,” “blunts” or “cheroots” (referred to as cigarillos
in these comments), do not have an official definition, and are included in the “large cigar” category
despite significant differences in their marketing and packaging from that of typical large cigars.
However, the consumer is likely not aware of these legal definitions. Therefore, when a cigarillo
consumer is asked whether they use large cigars (which would include cigarillos, even though they
are smaller than the typical “stogie” type cigar), the consumer may not consider themselves large
cigar smokers, and may answer in the negative. Similarly, cigarillos are not legally a “small” or
1

Maxwell JC. The Maxwell Report: Cigar Industry in 2007. Richmond, VA: John C. Maxwell, Jr. 2008. Original
concept in Kozlowski LT, Dollar KM, Giovino GA. Cigar/cigarillo surveillance: limitations of the U.S.
Department of Agriculture system. American Journal of Preventive Medicine, 2008; 34(5); 424-6.
2
U.S. Department of Treasury, Alcohol and Tobacco Tax Trade Bureau. Tobacco Statistics home page.
Available at: http://www.ttb.gov/tobacco/tobacco_stats.shtml
3
U.S. Department of Treasury, Alcohol and Tobacco Tax Trade Bureau. Tobacco Products home page.
Available at: http://www.ttb.gov/tobacco/tobacco_products.shtml

“little” cigar, but consumers may think of them as “small cigars”. The wording of the questions in
section J of this proposed survey (particularly JB and JC) will do much to garner better, more
accurate data about all of these different products – especially the demographic characteristics of
users.
Further, because of the recent law giving the Food and Drug Administration (FDA) authority to
regulate tobacco, this information is all the more important. For example, the law (referred to as the
“FDA law” in these comments) banned the sale of flavored cigarettes. Because of the definition of
“cigarette” in the new law, many little cigars, but not cigarillos, may be covered by the ban.4 The
data gathered from this survey will help inform FDA and those working in tobacco control about this
ban, and whether it needs to be expanded to other products as well.
The questions in Section J of the revised TUS-CPS will go a long way to secure more information
about who is using these products, perhaps why they are increasing in popularity, and help inform
policies to discourage initiation of these products and to help users quit.
Menthol
Legacy also appreciates the inclusion of questions surrounding mentholated products in the revised
TUS-CPS – in particular question K7. The FDA law requires the Tobacco Products Scientific
Advisory Committee, established by the law, to review information on menthol flavored cigarettes
and submit a report to FDA summarizing its findings, and include recommendations on whether
cigarettes with menthol as a characterizing flavor should be removed from the market, or other
restrictions placed on them. The TUS-CPS not only asks participants whether or not they smoke(ed) mentholated cigarettes, but also attempts to ascertain what might happen should menthol
cigarettes be removed from the market. While this information is hypothetical, it has the potential to
inform policies associated with menthol cigarettes.
Legacy believes the changes in this iteration of the TUS-CPS can expand the knowledge base about
little cigars, cigarillos and menthol cigarettes, and can also impact policies surrounding those
products. We applaud NCI for including these important changes and look forward to using the
information gained from the survey. Please contact Stephenie Foster, Senior Vice President of
Government Affairs at 202-454-5559 or [email protected], if you have questions or need
more information.

4

Food and Drug Administration. General Questions and Answers on the Ban of Cigarettes that Contain
Certain Characterizing Flavors. September 22, 2007. Accessed at:
http://www.fda.gov/TobaccoProducts/GuidanceComplianceRegulatoryInformation/FlavoredTobacco/ucm1832
28.htm