Trends in prevalence and sociodemographic and geographic patterns of current menthol cigarette use among U.S. adults, 2005–2015

Abstract

Despite overall reductions in U.S. smoking prevalence, prior evidence suggests similar reductions may not have occurred for menthol cigarette users. This study examines nationally representative current menthol and non-menthol cigarette use prevalence and trends for adults (18+) overall and by sociodemographic and geographic characteristics using the 2005 (n = 31,132), 2010 (n = 26,967), and 2015 (n = 33,541) National Health Interview Survey. Between 2005 and 2015, non-menthol cigarette use decreased overall (14.7% to 9.6%, p < 0.001) and within all sociodemographic and geographic subgroups analyzed (i.e., by sex, age, race/ethnicity, sexual orientation, education, family income, and geographic region), except non-Hispanic American Indians/Alaskan Natives (NH AI/AN) and non-Hispanic Others. Menthol cigarette use significantly decreased overall (5.3% to 4.4%, p < 0.001), and among females (5.6% to 4.6%); participants aged 18–24 (7.1% to 4.3%) and 35–54 (6.2% to 4.9%); non-Hispanic Whites (4.1% to 3.6%) and non-Hispanic Blacks (14.8% to 11.9%); participants with high school degrees/GEDs (7.0% to 5.9%); participants with a family income of $75,000 or higher (3.4% to 2.3%); and participants residing in the Northeast (6.0% to 4.3%). Menthol cigarette use remained stable or did not significantly decrease among males; adults aged 25–34 and 55 years and older; NH AI/ANs, NH Others, and Hispanics; participants with less than high school education, some college, or a college degree; participants with a family income below $75,000; and participants residing in the North Central/Midwest, South, and West. Given that menthol cigarette use did not significantly change or decrease for multiple subgroups, further restriction on menthol manufacturing may help reduce tobacco use disparities.

Menthol Smoking and Nicotine Dependence among Black/African American Women Smokers Living in Low-Resource, Rural Communities

“…Despite the small sample size, the present study provides novel data, as few studies have reported any data on smoking, and menthol smoking in particular, social deprivation, nicotine dependence, and quitting behaviors among rural Black/African American women who face many social structural barriers to smoking cessation. These data are not generalizable, but our results are similar to what other studies have found among Black/African American women [14,17,[51][52][53]. It is also plausible that our data may reflect what future studies could find among Black/African American women smokers who live in similar rural, low-resource counties in the South.…”

“…Prior studies have found that menthol smoking and flavored LCC use is most prevalent among African Americans, those with less education, and those living in poverty [51][52][53]. Mattingly and colleagues found that from 2005-2015, menthol cigarette smoking remained stable among those aged 25-34, with less than a high school education, with a household income less than $35,000, and those residing in the South, but it decreased among females and non-Hispanic Blacks [17]. Despite these trends, the prevalence of menthol cigarette smoking was highest among smokers with these sociodemographic characteristics [17].…”

“…Mattingly and colleagues found that from 2005-2015, menthol cigarette smoking remained stable among those aged 25-34, with less than a high school education, with a household income less than $35,000, and those residing in the South, but it decreased among females and non-Hispanic Blacks [17]. Despite these trends, the prevalence of menthol cigarette smoking was highest among smokers with these sociodemographic characteristics [17]. Interestingly, nearly all menthol LCC smokers in our study reported current menthol cigarette smoking, and menthol smokers were also more likely to smoke cigarettes daily.…”

“…Moreover, Black/African American women smokers who resided in non-metropolitan (vs. large metropolitan) counties had a higher prevalence of menthol smoking (91.8% vs. 84.4%) [11]. Rates of menthol smoking have also remained stable from 2005-2015 and are highest among Blacks/African Americans (11.9%) and those residing in the U.S. South (5.2%), with a less than high school education (6.6%), and with a family income less than $35,000 (7.0%) [17]. This is especially concerning, given the increased cessation difficulties associated with menthol smoking.…”

The Impact of Menthol Cigarette Flavor in the U.S.: Cigarette and ENDS Transitions by Sociodemographic Group

“…enthol cigarettes have been associated with increased youth experimentation and initiation and with decreased adult quitting success, 1−5 and the prevalence of menthol smoking has remained nearly constant in the U.S. over the past few decades. 6,7 Menthol cigarettes are disproportionately used by youth and young adults, women, non-Hispanic Blacks (NHBs), and other minorities. 4,6,8−12 Menthol is the only flavor currently allowed in cigarettes in the U.S.…”