Menthol Cigarette Smoking Trends Among United States Adults, 2003-2019

Background: Smoking is declining, except among current menthol cigarette smokers. This study examines menthol cigarette smoking in the United States.

Methods: Cross-sectional data from 35,279 self-respondent current adult smokers who selected menthol cigarettes as their usual type, across the 2003, 2006-2007, 2010-2011, 2014-2015, and 2018-2019 waves of the nationally-representative Tobacco Use Supplement to the Current Population Survey, were analyzed in SAS/SUDAAN. Menthol cigarette smoking among current smokers was assessed by sex, age, race/ethnicity, employment, geography, and educational attainment. Linear contrasts were used to assess trends.

Results: Overall cigarette smoking (12.6% in 2018-2019 from 17.3% in 2003) and menthol cigarette smoking (4.0% in 2018-2019 from 4.7% in 2003) in the population decreased in 2018-2019 from 2003 (both P < 0.001). Using predicted marginals, adjusted by demographics, menthol smoking among current smokers increased to 33.8% in 2018-2019 from 27.9% in 2003 (P < 0.001). Among current smoking adults, increases in menthol smoking were observed among non-Hispanic Black persons (76.8% in 2018-2019 from 73.0% in 2003), young adults (37.7% in 2018-2019 from 31.7% in 2003), and women (39.6% in 2018-2019 from 32.1% in 2003).

Conclusions: Smoking and menthol smoking in the population has decreased, yet menthol smoking among current smokers increased from 2003 to 2018-2019. Young adult, female, and non-Hispanic Black current smokers were more likely to use menthol cigarettes than their counterparts; these differences have persisted.

Impact: Increased menthol smoking among current smokers, notably young adults, women, and non-Hispanic Black individuals, highlights the need for targeted tobacco control interventions for these health disparity populations.