Are age of smoking initiation and purchasing patterns associated with menthol smoking?

Aims The purpose of this study was to examine the relationship between age of cigarette smoking initiation and cigarette purchasing patterns on menthol smoking among current smokers. Design Secondary analyses were conducted using logistic regression with balanced replicated weights. Setting Data from the 2003 and 2006/07 Tobacco Use Supplement (TUS) to the Current Population Survey (CPS), collected by the National Cancer Institute, the Centers for Disease Control and Prevention and the Census Bureau, formed the basis for this investigation. Participants A total of 66 145 current smokers who participated in the TUS CPS administration in 2003 and 2006/07 were examined. Measurements Demographic characteristics (gender, race/ethnicity, age, education and income), smoking frequency, purchase type (pack, carton, or both), age of initiation and menthol cigarette use were assessed. Findings One-quarter of the sample smoked menthol cigarettes; most purchased their cigarettes by the pack when rather than by the carton; average age of cigarette smoking initiation was 18 years; and females, ethnic/racial minorities and younger participants were more likely to smoke menthol cigarettes compared with males, whites or older respondents. Other demographic factors associated with menthol cigarette use among current smokers included a high school education (the prevalence of menthol use among this cohort was greater than either those with less education or those with more). The multivariate logistic model only marginally revealed that age of smoking initiation predicted menthol smoking: findings are suggestive that the longer the delay of initiation the more likely that an individual smoked menthol cigarettes [odds ratio (OR) = 1.01; 95% confidence interval (CI): 1.00-1.01]. In addition, relative to those who purchased cigarettes by the pack, smokers who purchased cigarettes by the carton were less (OR = 0.86; 95% CI: 0.81-0.91) likely to be menthol smokers. Conclusions Menthol smokers in the United States are more likely to be female, younger, from ethnic minority groups, and to have a high school education. The findings that menthol smokers in the U.S. tend to start smoking later than smokers of other types of cigarettes are suggestive only and require further study.