Menthol smoking, smoke-free policies and cessation services

Aims: This study examined whether menthol cigarette smoking is related to exposure to smoke-free home and work-place policies, availability of cessation services at work and knowledge of cessation resources among current smokers.

Design: Secondary analysis was conducted using logistic regression of cross-sectional data.

Setting: The 2003 and 2006/07 Tobacco Use Supplement (TUS) to the Current Population Survey, administered by the National Cancer Institute, the Centers for Disease Control and Prevention (CDC) and the Census Bureau, formed the basis for this investigation.

Participants: A total of 66,145 current smokers who participated in the TUS CPS administrations in 2003 and 2006/07.

Measurements: Demographic characteristics (gender, race/ethnicity, age, education, income), smoking frequency, menthol cigarette use, status of smoking bans in the work-place and at home, availability of cessation services at work and knowledge of quitting resources were assessed.

Findings: Among all current smokers with an indoor job, with no smoke-free restrictions at either work or home as the reference, those who smoked menthol cigarettes were about one-third as likely to have a smoke-free policy at both work and home [odds ratio (OR) = 0.32; 95% confidence interval (CI): 0.27-0.38]. In the comparison of those with an indoor smoke-free policy at work only versus those with no restrictions, menthol status was a risk factor for not having a work-place restriction (OR = 0.79; 95% CI: 0.67-0.93); similarly, within this sample, menthol use was a risk factor for not having a home restriction (OR = 0.38; 95% CI: 0.31-0.46). Among all current smokers, the use of menthol cigarettes was a risk factor for not having a smoking restriction at home (OR = 0.93; 95% CI: 0.88-0.98). Menthol smoking was not related to availability of cessation services offered at work or knowledge of cessation services.

Conclusions: This study suggests that menthol smoking is associated with lack of policy protection from second-hand smoke exposure. Policymakers and tobacco control professionals should monitor tobacco control efforts to ensure that policies and interventions reach all menthol smokers.