Menthol Cigarette Use among Adults who Smoke Cigarettes, 2008 to 2020: Rapid Growth and Widening Ine

Goodwin RD, Ganz O, Weinberger AH, Smith PH, Wyka K, Delnevo CD.
Menthol Cigarette Use among Adults who Smoke Cigarettes, 2008 to 2020: Rapid Growth and Widening Inequities in the United States.
[published online ahead of print, 2022 Oct 13]. Nicotine Tob Res. 2022;ntac214. doi:10.1093/ntr/ntac214

Introduction. In April 2021, the United States (US) Food and Drug Administration announced its intention to issue a product standard banning menthol as a characterizing flavor in cigarettes. Given the potential relevance of national estimates of menthol use to pending legislation, this study estimated the prevalence of menthol use among US adults who smoke cigarettes in 2020 and investigated changes in menthol use from 2008-2019 by sociodemographics, mental health, and substance use.
Methods. Nationally representative annual, cross-sectional data from individuals ages 18 and older residing in the US from the 2008-2019 and 2020 National Survey on Drug Use and Health (NSDUH) were analyzed using logistic and linear regression models to estimate trends in menthol use among adults who smoke cigarettes by sociodemographic, mental health and substance use variables (total analytic sample 2008-2019 n=128,327).
Results. In 2020, 43.4% of adults who smoked cigarettes in the past-month used menthol. Menthol use was most common among Black adults (80%) and over 50% of those Hispanic, female, young (ages 18-34), lesbian/gay, with serious psychological distress, and with cigar use used menthol. Menthol use increased among adults who used cigarettes from 2008 to 2019, overall, and grew more rapidly among adults ages 26-34, Hispanic, light cigarette use (1-5 per day) and those who smoked cigars.
Conclusions. Menthol use has increased among US adults who smoke cigarettes over the past decade. Enacting menthol bans could have a widespread public health impact, especially among younger and minoritized groups.
Implications. Menthol cigarette use increased among individuals who smoke cigarettes across from 2008 to 2019 in the US. In 2020, over 40% of smokers used menthol, and menthol use was considerably higher among adult smokers from racial/ethnic minoritized groups, who were younger and who reported mental health problems. The US Food and Drug Administration seeks to ban menthol as a characterizing flavor in cigarettes; our results suggest that such ban is likely to have a wide-ranging impact on public health.