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BackgroundApproximately one-fourth of all cigarettes sold in the United States have the descriptor “menthol” on the cigarette pack. It is important to determine what socio-demographic factors are associated with smoking menthol cigarettes if indeed these types of cigarettes are related to smoking initiation, higher exposure to smoke constituents, nicotine dependence, or reduced smoking cessation.MethodsThe National Cancer Institute (NCI) conducted a review of the scientific literature on this topic which we completed by adding more recently published articles via PubMed. We also conducted further data analyses using the National Survey on Drug Use and Health, the National Youth Tobacco Survey, the Monitoring the Future Survey, and the National Health and Nutrition Examination Survey to provide up-to-date information on this topic.ResultsMenthol cigarettes are disproportionately smoked by adolescents, blacks/African Americans, adult females, those living in the Northeast of the United States and those with family incomes lower than $50,000. Based on self-reports of menthol cigarette use, menthol cigarette use among smokers have increased from 2004 to 2008. However, no increase was observed during these years for predominantly menthol brands like Newport™, Kool,™ and Salem™, however, this lack of significant trend may be due, at least in part, due to smaller numbers of smokers of specific brands or sub-brands, which provide estimates which are less precise.ConclusionMenthol cigarettes are disproportionately smoked by groups of U.S. cigarette smokers. It is likely that other disparities in menthol cigarette use exist that we have not covered or have not been studied yet.

The extent of concurrent use of cigarettes and one or more other tobacco products (polytobacco use) is important to explore because users may be at an increased risk for adverse health effects and nicotine dependency. We determined national population estimates of current cigarette and current polytobacco use for at least 50,000 students from the 2002 and 2004 National Youth Tobacco Surveys. We identified which tobacco products were most often used in conjunction with cigarettes and used multivariate analyses to identify factors associated with polytobacco use. The overall prevalence was 16.0% for current cigarette smoking among all respondents and 15.0% for current cigarette smoking among respondents with complete information on concurrent cigarette and other tobacco product use: 8.1% used cigarettes only, and 6.9% were polytobacco users. Among current male cigarette smokers, 62.0% used other tobacco products; among current female cigarette smokers, 30.9% did. Among current cigarette smokers using one other tobacco product, cigars or smokeless tobacco were the most frequently used products. In multivariate analysis, polytobacco use was associated with being male; being in middle school; residing in the Midwest, South, or West; being able to obtain cigarettes from a retailer; being subject to peer influence; having favorable beliefs about tobacco; being willing to use tobacco promotional items; being exposed to tobacco advertisements; and having higher levels of lost autonomy (an indicator of nicotine dependency). Youth interventions need to broaden their focus to address the use of all tobacco products, paying particular attention to adolescent males and youth living outside of the Northeast.