Study finds increased menthol cigarette use among young people

BUFFALO, N.Y. – A new study on mentholated cigarette use in the U.S. finds an increase in menthol cigarette smoking among young adults and concludes that efforts to reduce smoking likely are being thwarted by the sale and marketing of mentholated cigarettes, including emerging varieties of established youth brands.

“Our findings indicate that youth are heavy consumers of mentholated cigarettes, and that overall menthol cigarette smoking has either remained constant or increased in all three age groups we studied, while non-menthol smoking has decreased,” says lead researcher Gary Giovino, PhD, professor and chair of the University at Buffalo Department of Community Health and Health Behaviors.

Giovino, one of the world’s leading tobacco surveillance researchers, estimated menthol and non-menthol cigarette use during 2004-10 using annual data on nearly 390,000 persons 12 years old and older who took part in the National Surveys on Drug Use and Health. The data included more than 84,000 smokers.

The results, which were published online in the international journal,Tobacco Control, showed that:

• Among cigarette smokers, menthol cigarette use was more common among 12-17 year olds (56.7 percent) and 18-25 year olds (45 percent) than among older persons (range 30.5 percent to 34.7 percent)
• Menthol use was associated with being younger, female, and of non-white race or ethnicity.
• Among all adolescents, the percent who smoked non-menthol cigarettes decreased from 2004-10, while menthol smoking rates remained constant.
• Among all young adults, the percent who smoked non-menthol cigarettes also declined, while menthol smoking rates increased.
• The use of Camel menthol and Marlboro menthol increased among adolescent and young adult smokers, particularly non-Hispanic whites, during the study period.
• “The study results should inform the FDA regarding the potential public health impact of a menthol ban,” Giovino says. 

“The FDA is considering banning menthol cigarettes, or other regulatory options,” he says. “This research provides an important view of the trends and patterns of menthol use in the nation as a whole. The FDA will consider these findings and findings from multiple other studies as it goes forward.

Giovino is particularly alarmed that the findings show youth are heavy consumers of mentholated cigarettes and the use of menthols is specifically associated with being younger, female and of non-white ethnicity.

“This finding indicates that mentholated cigarettes are a ‘starter product’ for kids in part because menthol makes it easier to inhale for beginners,” says Giovino. “Simply stated, menthol sweetens the poison, making it easier to smoke. Young people often think menthol cigarettes are safer, in part because they feel less harsh.

“When I was growing up, one of my older friends said he didn't think that menthol cigarette smoking was that dangerous because he was told that they were good for you if you got a cold,” says Giovino. “It turns out that Kool was advertising that way for a long time but was stopped from doing so by the Federal Trade Commission (FTC) around 1955.

“This ‘urban legend’ has persisted.”

Funding for the research was provided by Legacy (http://www.legacyforhealth.org/), a leading public health non-profit whose primary mission is to reduce tobacco use. Co-author Andrea Villanti, PhD, MPH, associate director for Regulatory Science and Policy at Legacy’s Schroeder Institute for Tobacco Research and Policy Studies, noted, “Our findings support that the presence of menthol cigarettes in the marketplace has slowed progress in reducing smoking prevalence in the U.S. This is of great concern given the tremendous health effects of smoking cigarettes.”

In addition to Giovino and Villanti the following researchers collaborated on the study: David Abrams and Raymond Niaura, from the Schroeder Institute for Tobacco Research and Policy Studies, Legacy, and the Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health; Donna Vallone from the Department of Research and Evaluation, Legacy, and the Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health; and Paul Mowery and Varadan Sevilimedu from Biostatistics Inc.