The cigar as a drug delivery device: youth use of blunts.

AIMS Blunts are hollowed-out cigars used to smoke marijuana (and perhaps other substances) in the United States. We investigated rates of blunt use; whether cigar use reported in surveys may actually be blunt use; the relationship of blunt to cigar use; characteristics of blunt users; brands of cigars used to make blunts; and drugs added to blunts. DESIGN A school-based survey of youth, the Cigar Use Reasons Evaluation (CURE). SETTING Eleven schools across Massachusetts. PARTICIPANTS A total of 5016 students in grades 7-12. MEASUREMENTS CURE items assessing blunt, cigar and cigarette use, brands used to make blunts, drugs added to blunts and demographics were used. FINDINGS Life-time blunt use was reported by 20.0% of the sample, with use greater among high school (25.6%) than middle school (11.4%) students, and among males (23.7%) than females (16.6%). Self-reported cigar use rates were not influenced strongly by blunt use being misreported as cigar use. In a multivariate model, blunt use was associated with male gender, higher grade in school, lower GPA, truancy, lower school attachment, not living in a two-parent family, being of 'other' race/ethnicity and current use of both cigarettes and cigars. 'Phillies' was the most popular brand of cigar for making blunts, used by 59% of users. 'Garcia y Vega' (18.0%) was the second most popular. Twenty-eight per cent of blunt users had added drugs other than marijuana to blunts. CONCLUSIONS The use of blunts as a drug delivery device is a serious problem. Efforts to address it will require the cooperation of the tobacco control and substance abuse prevention systems.