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Black & Mild cigars present unique issues to health

Smoked by nearly a quarter of 18- to 24-year-old blacks in the city, Black & Mild cigars are small, inexpensive, sometimes flavored and sold singly. They are taxed at a lower rate and carry fewer health warnings than cigarettes.

"These are not your grandfather's cigars," said Frances Stillman, co-director of the Institute for Global Tobacco Control at the Johns Hopkins Bloomberg School of Public Health.

The school conducted a tobacco use study.

"I think there's total confusion about what these products really are," she said. "... They're making them hip and cool, and the price is right and they can get them."

Black & Milds come in flavors such as apple, cream and wine. According to Baltimore health officials and Hopkins researchers, the cigars pose the same health risks as, or potentially more, than cigarettes.

Health officials said that Black & Milds are probably inhaled like a cigarette, rather than smoked with minimal inhalation like a cigar. They can be smoked, put out, and smoked again. And they can be repacked with marijuana or other substances.

The Health Department report, citing Hopkins data, said that nearly 24 percent of black Baltimore residents ages 18 to 24 said they smoked a Black & Mild at least once in the past 30 days.

Dr. Joshua M. Sharfstein, Baltimore's health commissioner, said, "The statistic that a quarter of young people are smoking them was eye-opening. If you look around, you realize they're all over the place."

According to the Centers for Disease Control and Prevention, Black & Mild is the most popular brand of cigars for smokers 12 and older.

Baltimore health officials, in an effort to call attention to the potential public health issues, hosted a panel Monday at the Youth Opportunity (YO!) Community Center in West Baltimore, featuring public health researchers, young adults and legal experts.

Manufactured by John Middleton Inc. of Pennsylvania, Black & Mild cigars are filled with pipe tobacco and come in a full and half size. Individually, they are sold for 50 cents to $1; a pack of five sells for about $3.

The Health Department report said that the little cigars are wrapped in tobacco leaf rather than paper, allowing them to be treated differently under the law from cigarettes.

Black & Milds are regulated like cigars rather than cigarettes. Therefore, they are required to prominently display only one of five surgeon general's warnings on packs and in displays.

There are no warnings on individually sold cigars.

The amount of tobacco in a Black & Mild is more than a cigarette but less than a regular cigar, according to the Health Department. The report lists cigar risks that include cancer, heart attacks and respiratory diseases.

The average cigar smoker loses five years of life by age 40, according to the report.

Sharfstein said the Health Department is studying the issue. "We see enough red flags that we want to understand more," he said.