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Design: A random digit dial telephone survey conducted in 1993 and a subsequent monthly random digit dial survey conducted March 1995 to June 2000.
Participants: 4733 adults who completed the 1993 survey and 14 868 adults who completed the monthly survey between 1995 and 2000.
Main outcome measures: Trends in current and experimental cigar use and perceptions of health risks.
Results: Current cigar usage increased significantly among men aged 18–34 years between 1993 (5.8%) and 1997-98 (18.2%), but began to decrease in 1999-2000 (13.5%). Young men were much more likely than older men or women of any age to have experimented with cigars in the year before interview, but this trend appears to have decreased slightly since 1998. Young male cigar smokers were increasingly those who never smoked cigarettes. Former cigarette smokers were not smoking cigars in greater numbers. Cigar smokers were roughly three times as likely as those who do not smoke cigars to believe cigars are a safer alternative to cigarettes, and that perception did not appear to change much over time.
Conclusion: Cigar usage increased dramatically among young men in Massachusetts in conjunction with national increases in sales and marketing of cigars, but now appears to be decreasing.