Youth engagement in public awareness and policy addressing low-cost cigars in Boston

Background: Tobacco is the leading cause of preventable death in the United States. For African Americans, smoking-related disease mortality is higher than for Whites. Boston data demonstrates that while cigarette smoking rates are decreasing, other tobacco products including flavored cigars are increasingly popular, particularly among Black and Latino youth. Methods: The Boston Public Health Commission worked with The84, Massachusetts' statewide youth tobacco prevention movement to develop a public awareness campaign addressing low cost cigars and educate Boston's Board of Health on these products. Focus groups were conducted to identify messages that resonated among the target audience of Black and Latino teens and young adults. Using mediums such as a website, public service announcements and billboards, the resulting “Don't Burn It!” campaign educated residents about tobacco industry marketing and low cost cigars. Research was conducted by Boston Public Health Commission to identify regulatory responses to this issue. Results: The “Don't Burn It!” website received 11,585 unique visitors and 13,483 visits. Facebook received 69,813,882 impressions. Over 40 youth and community members testified at Board of Health hearings and 400 letters of support for proposed regulations were submitted. In December of 2012, the Boston Board of Health passed a regulation requiring cigars retailing for less than $2.50 to be packaged and sold in packages of no less than four cigars. Conclusions: Low cost and flavored cigars are increasingly popular among youth. Youth have the skills to raise public awareness among peers and decision-makers to set the stage for regulatory policy change.