Susan B. Morris & Andrea R. Vansickel Altria Client Services LLC, Richmond, VA 23219 Usage Patterns Among Adult Users: Results of a 73rd TSRC - Tobacco Science Research Conference Large, Nationally Representative Survey September 15-18, 2019, Leesburg, VA, USA WWW.ALTRIA.COM/ALCS-SCIENCE

ABSTRACT SURVEY METHODOLOGY PARTICIPANT DEMOGRAPHICCigarillos – CIGARILLOSEver Use – EVER USE

We present results of a large, cross-sectional survey showing detailed information about usage be- ▶ Ipsos conducted the CLS on behalf of Altria. The study was designed to INFORMATION Tobacco Products Usage (Landscape) havior among self-reported cigarillo users who are legal age to purchase tobacco. Furthering previous provide overall prevalence figures on cigar usage among legal age Cigarillo EverEver Used Used (Landscape) (Landscape) TobaccoTobacco Products Products Usage Usage (Landscape) (Landscape) N = 3,362 (weighted) work, such as PATH, we designed the Cigar Landscape Study (CLS) to improve survey capture of cig- Characteristic Total Sample N = 12,516 N = 12,516 (weighted) N = 3,362 (weighted) adults in the United States, and to provide detailed information about 1% arillo usage among a nationally representative, probability-based web panel. We enrolled an online vs. 59% of Cigarillo Ever 1% cigar usage behavior among self-reported cigar users. Users reported ever sample of adult tobacco users (ATUs; n =12,516) to assess first tobacco product ever used, consump- 27% Gender 51.9% Female use. tion on days used and time to first cigarillo among adult cigarillo users (ACU; n= 3,362). In line with ▶ The survey was conducted using samples from KnowledgePanel® other studies and government data sources, patterns of use for cigarillo consumers vary significantly December 6-12, 2018. from those of cigarette consumers. Overall, the majority (72%) of ACU “Ever Users” smoked less than 18-25: 8.4% 46-55: 15.7% 99% 20 lifetime cigarillos. These data suggest a high degree of trial without repeated use within the ▶ The target population consisted of the following: Adults age 18+ Age 26-35: 20.1% 56-65: 19.3% 99% cigarillo category. Additionally, among ACU who have smoked cigarillos every day or some days in the residing in the United States who were of legal age for tobacco 36-45: 17.3% 66+: 19.2% 73% past 30 days, 11% smoked just one or two puffs on days smoked while another 23% smoked less than purchases in the jurisdiction in which they live. half a cigarillo. These numbers diverge from average daily cigarette consumption estimated by CDC (14.1 per day). ACUs that use cigarillos exclusively every day or some days have an average Employed 63.1% Completion Qualification time to first cigarillo of 467 minutes (relative to 96 minutes among current adult cigarette smokers in N Sampled N Complete N Qualified Si ngl e Tobacc o Produc t PATH Wave 3), suggesting very low dependence on cigarillos. Additionally, of the ATUs that ever used Rate Rate Income less than SingleSiMultiple ngl e TobaccTo Tobaccobacco o Produc Product Products t 34% Ever Used Never Used cigarillos, only 5% reported that cigarillos were the first product they ever used. Patterns of cigarillo 24,328 12,533 52% 12,516 99% $50,000 Multiple TobaccoTobacco Products Products Base: Mass-manufactured medium/large cigar “Ever Users”. MASSEVER: If ever used mass-manufactured cigar. use vary considerably to those reported for cigarettes, with cigarillo consumption generally being far DOV_EVERUSER: If ever used two or more tobacco products/If only one tobacco product ever used/If never used Base:any Mass tobacco-manufactured product. medium/large cigar “Ever Users”. fewer and more intermittent than cigarette use. MASSEVER:PercentagesIf ever may used not massadd up-manufactured to 100% due to cigar. rounding. DOV_EVERUSERCigar landscape: If everstudy used weights two were or more used. tobacco products/If only one tobacco product ever used/If never used Base: all respondents of legal age. any tobacco product. This file was prepared to support regulatory engagement by providing FDA with information relevant to FSPTCA provisions that require FDA to evaluate the initiation and/or cessation of tobacco product use. DRAFT FOR DISCUSSION – HIGHLY CONFIDENTIAL MASSEVERUSER: if ever used mass-manufactured medium/largePercentages .may not add up to 100% due to rounding. 30 RESULTS Percentages may not add up to 100% due to rounding. Cigar landscape study weights were used. Cigar landscape study weights were used. INTRODUCTION This file was prepared to support regulatory engagement by providing FDA with information relevant to FSPTCA provisions that require FDA to evaluate the initiation and/or cessation of tobacco product use. DRAFT FOR DISCUSSION – HIGHLY CONFIDENTIAL 30 This file was prepared to support regulatory engagement by providing FDA with information relevant to FSPTCA provisions that require FDA to evaluate the initiation and/or cessation of tobacco product use. DRAFT FOR DISCUSSION – HIGHLY CONFIDENTIAL 29 ▶ The CLS surveyed legal age adults to collect information for measuring ever use of cigars and CHARACTERISTICS OF CIGARILLO EVER USERS Lifetime Cigarette Use in Sticks LIFETIMECigarillos USE – Lifetime Use in Sticks cigar usage behaviors within a demographically representative sample. Those who indicated Tobacco Product First Used N = 3,320 (Weighted) having ever used a cigar within the survey were asked additional questions regarding cigar Tobacco Product First Used Tobacco ProductTobacco FirstProduct Used First Used Fairly Fairly Regularly Regularly Cigarette Usage in Lifetime (Landscape) Cigarillos Usage (Landscape) Ethnicity by 100 Sticks or More (Landscape) N = 457 (Weighted) subcategories, brands, lifetime consumption thresholds, and usage behavior with regard to N = 3,320 (Weighted) N = 457 (Weighted) N = 3,133 N = 3,362 (weighted) N = 3,362 (weighted) Hookah, 11% 11% of respondents who have ever their tobacco portfolio. Loose snus, Moist snuff, dip, spit, 100 or more 100% Electronic 1% 2% or chewing tobacco, used cigarillos have smoked at least product, 1% Pipe filled with 65% of respondents who have ever used 90% 6% White (A) 90% 10% Pipe filled with tobacco, 1% (B) ▶ cigarettes have smoked at least 100 11% 100 cigarillos in their entire life. The CLS improves survey capture of cigarillo and other cigar usage relative to previous national 1% tobacco, Snus pouchs/Loose Refused, cigarettes in their entire life. 51 to 99 80% Hookah, 1% 2% 12% surveys by capturing brand-level information with improved product descriptions. snus/Dissolvable/Another 2% 65% Premium cigar, 2% Another product, 70% Black (B) 81% 19% product, 1% 0.37% 21 to 50 Moist snuff, dip, spit, or 60% 32% ▶ The following analyses look at cigarillo usage as reported in the CLS. We observe respondents Refused, 1% Premium cigar, chewing tobacco, 4% Electronic 3% 50% who have ever used cigarillos and analyze usage behavior within Ever Users (Cigarillos: nicotine product, 11 to 20 Hispanic (C) 88% 12% Mass-Manufactured Medium/Large Cigars). 3% 40% Mass-manufactured Little cigar 3% 6% 28% Multi- medium/large cigar, 5% 8% 1 to 10 30% 6% Racial (D) 89% 11% 20% 10% Cigarette 66% less than 1 10% Cigarette, 78% Mass-manufactured Other (E) SUMMARY AND CONCLUSIONS Little cigar, 5% 10% 95% 5% medium/large cigar, 0% 12% LIFETIME THRESHOLD: Base: Cigarette “Ever Users” (TS100). TS100: Have you ever smoked a cigarette, even one or two puffs? 1 to 10 11 to 20 21 to 50 51 to 99 < 100 Sticks in Lif etim e ≥ 100 Sticks in Lifetime Characteristics of Cigarillo Ever Users Cigar landscape study weight was used. Less than 1 100 or more ▶ For Ever Users of cigarillos, we notice that 28% of respondents report having used less TFOL710: How many cigarettes have you smoked in your entire life? This file was prepared to support regulatory engagement by providing FDA with information relevant to FSPTCA provisions that require FDA to evaluate the initiation and/or cessation of tobacco product use. DRAFT FOR DISCUSSIONMASSEVERUSER: – HIGHLY CONFIDENTIALIf ever used mass-manufactured32 medium/large cigar. MASSEVERUSER: If ever used mass-manufactured medium/large cigar. than 1 stick in their lifetime as opposed to 10% of Ever Users of cigarettes CIGAR120: How many mass-manufactured cigars have you smoked in your entire life? CIGAR120: How many mass-manufactured cigars have you smoked in your entire life? % of Cigarillo Ever Users TobaccoTobacco Portfolio Portfolio Usage Usage Distribution Distribution (100+ Sticks)(100 + Sticks) PPETHM: Race/Ethnicity, Census categories. This file was prepared to support regulatory engagement by providing FDA with information relevant to FSPTCA% of provisions Cigarillo that require Ever FDA to Usersevaluate the initiation and/or cessation of tobacco product use. DRAFT FOR DISCUSSION – HIGHLY CONFIDENTIAL Cigar landscape study weights were used. This file was prepared to support regulatory engagement by providing FDA with information relevant to FSPTCA1 provisions that require FDA to evaluate the initiation and/or cessation of tobacco product use. DRAFT FOR DISCUSSION – HIGHLY CONFIDENTIAL Cigar landscape study weights were used. ▶ In addition, 11% of cigarillo Ever Users reached the lifetime criterion of 100 sticks as N = 3,362 (weighted) 2 NN = = 371 371 (weighted) (weighted) A pairwise proportion test with the Bonferroni adjustment was conducted to test the percentage of “more than 100 N = 3,362 (weighted) CONSUMPTIONsticks”between ethnic groups at the 95% confidence level. Tobacco Portfolio (Ever Users) 35% This file was prepared to support regulatory engagement by providing FDA with information relevant to FSPTCA provisions that require FDA to evaluate the initiation and/or cessation of tobacco product use. DRAFT FOR DISCUSSION – HIGHLY CONFIDENTIAL opposed to 65% of Ever Users of cigarettes. 34% 21 % of Cigarillo Amount and Frequency of Consumption Among Cigarillo ▶ These findings demonstrate more trial use of cigarillos relative to cigarettes. Tobacco Types Ever User Every Day/Some Day Users Cigarettes + premium cigar + little or filtered cigar + cigarillo 23% 27% 6.9 N = 326 (weighted) TOBACCO PORTFOLIO: 23% Cigarettes + electronic nicotine product + premium cigar + little or filtered cigar + cigarillo 14% 22% Cigarettes + premium cigar + cigarillo 11% ▶ Of the 27% of respondents who have ever used cigarillos, almost all (99%) report being 19% 18% Cigarettes + electronic nicotine product + premium cigar + little or filtered cigar + cigarillo + snus 8% 56% of cigarillo every Ever Users of multiple tobacco products. + smokeless tobacco day/some56% of cigarillo day every consumers day/some Cigarettes + premium cigar + little or filtered cigar + cigarillo + snus + smokeless tobacco 6% reportedday consumers using reported less than using 1 ▶ When looking at groups of cigarillo Ever Users who have also ever used any other tobacco 11% less than 1 cigar per occasion Cigarettes + premium cigar + little or filtered cigar + cigarillo + smokeless tobacco 5% 2.9 cigar per occasion products: Cigarettes + little or filtered cigar + cigarillo 4% 5% - With the exception of cigarettes, the majority (60%-85%) report never having used 5% Cigarettes + electronic nicotine product + premium cigar + little or filtered cigar + cigarillo +smokeless tobacco 3% 1.5 Cigarettes + electronic nicotine product + premium cigar + cigarillo 3% 1% other tobacco products fairly regularly Cigarettes + electronic nicotine product + little or filtered cigar + cigarillo 3% CigarillosCigarillos Only Only 1 Other Category 22 Other Other Categories 33 Other Other Categories 44 orOther more Categories 55 or or more more Categories Premium cigar + cigarillo 2% 1 Other1 Other Category Category 2 Other2 Other Categories Categories 3 Other3 Other Categories Categories 4 Other4 Other Categories Categories 5 or5 ormore more Other Categories Categories AvgAvg # # DaysDays SmokedSmoked AvgAvg # of# of Times Times Smoked Smoked Cigar Cigar on Avg # ofAvg Cigars # of Smoked Cigars Smokedon Days - (A) Category Categories Categories Other Categories Other Categories The majority (65%-92%) report not currently using tobacco products at all ( A) (B) ( C) (D) (E) (F) Cigarettes + premium cigar + cigarillo + smokeless tobacco 2% (A) ( A) (B) (B) (C)( C) (D)(D) (E)(E) onDays Days Smoked Smoked onSmoked Days Smoked (B) (C) (D) (E) (F) POLYUSE: ▶ 36% of respondents who have ever used Among cigarillo Ever Users who have ever used multiple tobacco products, 78% indicated cigarillos and snuff, dip, spit or chewing TIME TO FIRST USE Altria Client Services l Regulatory Affairs l 4/16/2018 l Confidential 2 that their first product was cigarettes Altria Client Services l Regulatory Affairs l 4/16/2018 l Confidential 1 tobacco used them (snuff, dip, spit or chewing tobacco) in the past hour. - 11% indicated it was cigars Recency of Tobacco Consumption of Cigarillo Ever Users (Landscape) Tobacco Product Usually Used First in the Day Time toTime First to TobaccoFirst Tobacco Product Product Among AmongAltriaCigarillo Cigarillo Client Services Every Every Day/ l Regulatory SomeDay/Some DayAffairs Users l Day4/16/2018 Users l Confidential 6 Tobacco Product Usually Used First in the Day ▶ Of those who have ever used cigarillos and more than one other tobacco product fairly N = 292 (Weighted) 1% N = 326 (Weighted) 3% 5% 4% 2% N = 326 (Weighted) N = 326 (Weighted) regularly, only 12% indicated that their first (fairly regular) use of a tobacco product 6% 10% 5% 6% Another product, 1% 8% 15% Refused, 1% 23% Cigarillo Users Who Pipe filled with tobacco, 8% 8% Time to First* Time to First* Premium cigar, 4% was cigarillos 32% 11% 12% Use Every Day/ Polyuse Status 34% 11% 36% (Minutes) (Minutes) 1% Loose snus, 1% 14% Some Days Moist snuff, dip, spit, or Snus pouches, 0.2% ▶ Among respondents who have ever used cigarillos and currently use them either every 19% 6% 5% 10% 54% 7% 23% chewing tobacco, 4% Hookah, 1% 7% 6% Time to First day or some days: 9% Exclusive 13% Cigarillo 467 15% 18% Cigarillo Electronic nicotine 16% 12% N = 34 minutes product, 9% 19% 24% 13% Users - 14% indicated that their first product of the day was a cigarillo (Weighted) 13% 11% N = 326 259 Cigarette, 39% Among respondents who use both - 31% indicated that their first product of the day was any type of cigar 13% 11% (Weighted) minutes Cigarillo + Time to First 15% 4% Little cigar, 13% cigar and another tobacco product 209 - 8% 63% 16% 13% Other Tobacco Product every day/some day, 39% usually The average time to their first tobacco product after waking is over 4 hours 18% 59% Tobacco N = 292 minutes use cigarette first in the day. 11% 51% 56% 46% 12% Product(s) (Weighted) - For exclusive cigarillo users, it’s almost double The average time taken to first smoke after 5% 38% Use only one type of 29% waking is 4.3 hours (259 minutes) for 26% tobacco product on the 8% 18% respondents who have ever used cigarillos and Overall, findings of the CLS demonstrate that patterns of cigarillo use vary considerably 17% same day, 14% 7% now use cigarillos every day or some days. Mass-manufactured 2% 1% 1% 1% medium/large cigar, 14% to those reported for cigarettes, with cigarillo consumption generally being far fewer and Ci gare ttes Dissolvable Tobacco E-Products Ho okah Little Cigars Lo ose Snu s Mass-Manufactured Pipe Tobacco Premium Cigars Snuff, Dip, Spit or Snus Pouches N = 71 2 (wei ghted ) N = 19 (w eig hted) N = 34 9 (wei ghted ) N = 13 3 (wei ghted ) N = 31 0 (wei ghted ) N = 50 (w eig hted) Med ium/La rge Ci gars N = 98 (w eig hted) N = 35 5 (wei ghted ) Ch ewi ng Toba cco N = 60 (w eig hted) more intermittent than cigarette use. N = 32 6 (wei ghted ) N = 12 4 (wei ghted ) In the past hour Sometime today Yest erd ay Day before yesterday More than three days ago, but within the last month More than one month ago Refused This file was prepared to support regulatory engagement by providing FDA with information relevant to FSPTCA provisions that require FDA to evaluate the initiation and/or cessation of tobacco product use. DRAFT FOR DISCUSSION – HIGHLY CONFIDENTIAL 39

This file was prepared to support regulatory engagement by providing FDA with information relevant to FSPTCA provisions that require FDA to evaluate the initiation and/or cessation of tobacco product use. DRAFT FOR DISCUSSION – HIGHLY CONFIDENTIAL 40

This file was prepared to support regulatory engagement by providing FDA with information relevant to FSPTCA provisions that require FDA to evaluate the initiation and/or cessation of tobacco product use. DRAFT FOR DISCUSSION – HIGHLY CONFIDENTIAL 1