Examining the role of menthol cigarettes in progression to established T smoking among youth

Authors

James Nonnemaker, RTI InternationalFollow
Shari P. Feirman, Center for Tobacco Products, Food and Drug Administration
Anna MacMonegle, RTI International
Bridget K. Ambrose, Center for Tobacco Products, Food and Drug Administration
Kia J. Jackson, Center for Tobacco Products, Food and Drug Administration
Megan J. Schroeder, Center for Tobacco Products, Food and Drug Administration
Alexandria A. Smith, Center for Tobacco Products, Food and Drug Administration
William Ridgeway, RTI International
Olga Rass, Center for Tobacco Products, Food and Drug Administration

Date of this Version

2019

Document Type

Article

Citation

Addictive Behaviors 98 (2019) 106045

https://doi.org/10.1016/j.addbeh.2019.106045

Comments

2019 Elsevier Ltd. All rights reserved.

Abstract

Background: Menthol, a flavoring compound added to cigarettes, makes cigarettes more appealing to youth and inexperienced smokers and increases cigarettes' abuse liability. However, limited studies are available on menthol's role in smoking progression.

Methods: To assess the association between menthol in cigarettes and progression to established smoking, we used five waves of data from the Evaluation of Public Education Campaign on Teen Tobacco Cohort Study, a nationally representative longitudinal survey of U.S. youth conducted as part of “The Real Cost” evaluation. We used discrete time survival analysis to model the occurrence of two event outcomes—progression to established, current smoking and progression to established, frequent smoking—using a logit model with a menthol use indicator as the key explanatory variable. Based on this framework, we estimated the effect of prior menthol use on the odds of smoking progression.

Results: In the progression to established, current smoking model, prior menthol use was significantly associated with progression [adjusted odds ratio (aOR) = 1.80, p < .05, confidence interval (CI) = (1.03–3.16)]. While results were in a similar direction for the model of progression to established, frequent smoking, the association between prior menthol use and this progression model did not reach significance [aOR=1.56, CI = (0.80–3.03)].

Conclusion: The results suggest a relationship between using menthol cigarettes and progression from experi- mental to established, current smoking among youth. This study adds to a growing literature base that supports that menthol cigarettes, compared to nonmenthol cigarettes, put youth at increased risk for regular cigarette use.