Because type of cigarettes smoked, including brand preference, varies by age group [9
], data on socio-demographic factors associated with smoking menthol cigarettes will be presented separately for youth and adults. A review of the scientific literature on socio-demographic factors related to smoking menthol cigarettes was provided by the Department of Health and Human Services’ National Cancer Institute (NCI) [11
]. For youth, there were nine articles listed in the bibliography, of which one was conducted in Japan [12
]. Of the eight studies conducted in the U.S., five [13
] collected data using national samples, two were conducted in specific communities [18
], and one study [20
] was qualitative (focus groups) in study design. Four of these 8 U.S. articles presented data from cross-sectional studies [13
], two from a longitudinal study [15
], and two from a convenience sample [19
]. Because more recent information has been published or available since the NCI bibliography was provided, additional studies or reports [8
] are included in the youth section in this article. When appropriate, we report results from these studies in this review article.
For adults, there were 15 articles listed and one letter to the editor on the bibliography provided by NCI. Eleven of these 15 articles presented data from cross-sectional studies, four presented data from case-control studies or data were collected using convenience samples. The most recent study listed [22
] reported data collected in 2002 from a specific U.S. population group (heroin users) in a specific location. Because of lack of recent data in the NCI bibliography, other studies and reports [8
] were included in the adult section to provide more recent information on this topic. Also when appropriate, we report results from these studies in this review article.
To provide up-to-date information on this topic, data analyses were performed using specific data sets such as the National Survey on Drug Use & Health
], hence referred as NSDUH; the National Youth Tobacco Survey
], hence referred as NYTS; the Monitoring the Future Survey
], hence referred as MTFS; and the National Health and Nutrition Examination Survey
], hence referred as NHANES. It is important to note that the consistent collection of national data on menthol cigarette use started fairly recently, in the late 1990’s (MTFS) or in the early 2000’s (NSDUH, NYTS, and NHANES). Two-sided t tests were used to assess differences between population group percentages. For all tests, p<0.05 was considered statistically significant.
The National Survey on Drug Use and Health (NSDUH) is a nationwide household survey that collects data on drug use and drug abuse, including tobacco use, from a representative sample of the U.S. civilian, noninstitutionalized population aged 12 years or older. Specifically, the NSDUH collects data on overall tobacco use, cigarette smoking, and other behavioral information related to cigarette smoking and brand preference. NSDUH data are collected through a computerized questionnaire administered in the privacy of participants’ homes by a professional field interviewer who visits each selected household. Most responses are answered in private by the participant, although the interviewer reads and enters the responses to some questions in the presence of the participant. Questions about tobacco use were administered through audio, computer-assisted, self-interview methods to maximize privacy and improve reporting of sensitive behaviors. For our analysis using these data, we used information for adolescents aged 12-17 years old who smoked in the past month (N=9,595) and adult smokers (aged 18 years or older) who smoked in the past month (N=62,010) from the 5 surveys conducted in 2004, 2005, 2006, 2007, and 2008 in order to determine prevalence of menthol cigarette use in the overall population of smokers as well as for specific subgroups of smokers and to assess trends in smoking menthol cigarette use among smokers.
The NYTS is a nationally representative sample of students enrolled in grades 6 through 12. The sampling universe consists of public and private school students in the 50 states and the District of Columbia. The sampling frame stratified the 50 states and the District of Columbia by region and urbanicity. Primary sampling units (PSUs), are selected with probability proportional to the student enrollment in the PSU but giving disproportionate weight to Black, Asian, and Hispanic students.
Schools are grouped by size as either large or small, depending on whether they have at least 125 students combined in eligible grades. All students present in a selected classroom on the day of the interview are selected for the study. Schools or students who refused to participate in the study are not replaced in the sample.
Our analysis included 1,978 middle school students and 6,163 high school students from year 2004, 2006, and 2009 combined who had valid information on the school year, past 30 day smoking, brand use, and menthol questions. Those who were excluded included: those who did not specify a grade in school or didn’t answer the question (n=397); those who were not a current smoker or didn’t answer the question (n=67,809); those who said they didn’t smoke cigarettes during the past 30 days, that they did not have a usual brand when asked about brand use, or did not answer the question (n=66,719); and those who said they do not smoke cigarettes when asked about menthol cigarettes or did not answer the question (n=59,965).
We analyzed data from 2,580 adolescent smokers selected throughout 35 states (not all states are represented because the survey design did not control for this) and from 267 large and small private and public schools.
The Monitoring the Future Survey (MTFS) main data collection involves a series of large, annual surveys of nationally representative samples of public and private secondary school students in grades 8th, 10th, and 12th throughout the coterminous United States. Staff members administer the questionnaires to students, usually in their classrooms during a regular class period. Participation is voluntary. Parents are notified well in advance of the survey administration and are provided the opportunity to decline their child’s participation. Questionnaires are self-completed. For the combined years of 1998 to 2008, there were 20,863 8th grade current smokers, 30,722 10th grade current smokers, and 40,914 12th grade current smokers in our data analysis. We assessed trends in smoking menthol cigarettes among adolescent smokers.
The National Health and Nutrition Examination Survey (NHANES) consists of a number of questionnaires administered in the household followed by standardized physical examinations and additional tobacco use questions administered in specially equipped mobile examination centers (MECs). The NHANES target population is the civilian, noninstitutionalized U.S. population. This nationally representative sample permits calculation of national estimates. NHANES over-samples low-income persons, adolescents 12–19 years, persons 60+ years of age, blacks, and Mexican Americans. We used NHANES data collected between January 2001 and December 2006. The overall response rate to NHANES for 2003–2008 was 78%. The analytic sample for this study included smokers aged 20 years and older who had smoked, who were recoded by NHANES as non-Hispanic white, non-Hispanic black/African American, or Mexican American. Of the 14,272 white, black, or Mexican American adults aged 20 years and older who completed the NHANES home interview. The final analytic sample included 2,319 individuals, of which 1,581 showed the 8 or 12 digit Universal Product Code (UPC) information on the side of the cigarette pack.