Elsevier

Addictive Behaviors

Volume 32, Issue 9, September 2007, Pages 1964-1969
Addictive Behaviors

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Menthol cigarettes and indicators of tobacco dependence among adolescents

https://doi.org/10.1016/j.addbeh.2006.12.023Get rights and content

Abstract

Objectives

This study examines measures of nicotine dependence among adolescent menthol and non-menthol cigarette smokers in a nationally representative sample.

Methods

We examined rates of menthol smoking and measures of nicotine dependence among 1345 current established smokers in grades 9–12 who participated in the 2004 National Youth Tobacco Survey. Logistic regression was used to generate an adjusted odds ratio (OR) for menthol smoking for four measures of nicotine dependence, controlling for demographic characteristics and smoking patterns.

Results

Approximately 46% of all current established cigarette smokers were menthol smokers. Menthol smokers had 2.6 and 1.6 greater odds than non-menthol smokers for reporting that they could go for less than 1 h before feeling like they need a cigarette and that they experience cravings after not smoking for awhile, respectively.

Conclusions

Menthol cigarette smoking was associated with two dependence measures and may be more addictive than regular cigarettes in young smokers. Future research should continue to explore relationships between dependency and menthol use as well as the high prevalence of menthol use among adolescents.

Introduction

Recently researchers have questioned whether menthol cigarettes, which represent approximately 27% of cigarettes sold in the US (U.S. FTC, 2005), may be more addictive than regular cigarettes. Thus far studies have focused predominately on adults with mixed findings (Ahijevych and Parsley, 1999, Hyland et al., 2002, Okuyemi et al., 2003). Few studies have attended to the issue of adolescent menthol use and dependence (Collins and Moolchan, 2006, Hersey et al., 2006). Collins and Moolchan (2006) found that in a sample of adolescent smokers seeking cessation treatment, menthol smokers were significantly more likely to smoke their first cigarette within 5 min of waking than non-menthol smokers. Hersey et al. (2006) found that among middle and high school current smokers, menthol smokers scored higher on a nicotine dependence scale than non-menthol smokers.

Given the paucity of data on the possible relationship between menthol use and dependence, in particular among adolescents, we further examined whether menthol cigarette smoking is associated with markers of increased nicotine dependence. We compared adolescent menthol and non-menthol smokers' responses to dependence-related questions on the 2004 National Youth Tobacco Survey. In contrast to previous work (Hersey et al., 2006), we focused our analysis on a subpopulation of high school students who were already current established smokers, as these smokers represent young people who have progressed from experimentation to a more regular pattern of smoking and are therefore more likely to already exhibit signs of dependence.

Section snippets

Methods

We analyzed the 2004 National Youth Tobacco Survey (NYTS), an anonymous, self-administered school-based questionnaire of students in grades 6–12, conducted by the Centers for Disease Control and Prevention. The 2004 NYTS employed a multi-stage sampling design to produce a nationally representative sample: 13,738 students in grades 9–12 participated. Of these students, 2597 were current smokers and 1345 were current established smokers. Details of the survey methodology are reported elsewhere (

Results

Overall, 21.7% of 9–12th grade students were current cigarette smokers and 13.8% were current established cigarette smokers (see Table 1). Prevalence of smoking significantly increased by grade among both current and current established smokers and differed by race/ethnicity, with prevalence highest among whites. Approximately 24% of current established smokers indicated smoking a menthol exclusive brand (Newport or Kool) and 44% reported that the cigarettes they usually smoked were menthol

Discussion

This study found that high school menthol smokers were more likely to report symptoms of dependence compared to non-menthol cigarette smokers, even when controlling for race, age, and cigarette consumption. One question (i.e., how long before needing a cigarette) had a strong association with menthol use. This question resembles a commonly used dependence measure in adults, which asks respondents to indicate how soon they have their first cigarette in the morning after waking up (Fagerstrom,

Acknowledgements

We would like to thank Gary Giovino for initial conversations about measures used in this study. In addition, thanks to Jonathan Foulds and to Mary Hrywna for reading drafts and for their feedback and to Patrick Clifford for his support of this work.

References (10)

There are more references available in the full text version of this article.

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