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Association between menthol-flavoured cigarette smoking and flavoured little cigar and cigarillo use among African-American, Hispanic, and white young and middle-aged adult smokers
  1. K Sterling1,
  2. C Fryer2,
  3. I Pagano3,
  4. D Jones1,
  5. P Fagan4
  1. 1School of Public Health, Georgia State University, Atlanta, Georgia, USA
  2. 2University of Maryland, College Park, Maryland, USA
  3. 3University of Hawaii at Manoa, Honolulu, Hawaii, USA
  4. 4Univeristy of Arkansas for Medical Sciences, Fay W. Boozman College of Public Health, USA
  1. Correspondence to Dr K Sterling, Georgia State University, One Park Place, Suite 715, Atlanta, GA 30303, USA; ksterling{at}


Objectives Flavour additives in cigarettes and little cigars and cigarillos (LCCs), which influence smokers’ risk perceptions, may reinforce dual flavoured tobacco use. We examined the association among mentholated cigarette use, risk perceptions for flavour additives in LCCs and flavoured LCC smoking behaviour.

Methods Data from a national probability sample of 964 young and middle-aged adult current cigarette smokers were analysed. Multinomial logistic regression models examined the relationship among mentholated cigarette smoking, risk perceptions and current flavoured LCC use for the analytic sample and gender and race/ethnicity.

Results Daily menthol cigarette smokers, compared to occasional, non-menthol smokers, had increased odds of flavoured LCC smoking (OR=1.75, 95% CI 1.02 to 2.98). This relationship was found for males, blacks/African-Americans and Hispanics/Latinos (p<0.05). Positive perceptions of menthol-flavoured additives in LCCs was associated with increased odds of flavoured LCC use among the analytic sample, males and blacks/African-Americans (p<0.05). Positive perceptions for clove-flavoured, spice-flavoured and alcohol-flavoured additives were also associated with flavoured LCC use among the analytic sample (p<0.05).

Conclusions Use of menthol-flavoured cigarettes and positive perceptions about menthol-flavoured and other flavour additives in LCCs may contribute to dual use with flavoured LCCs among adult cigarette smokers, specifically those from vulnerable populations.

  • Disparities
  • Non-cigarette tobacco products
  • Priority/special populations
  • Surveillance and monitoring
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  • Contributors KS conceived the study, obtained study funding, and was responsible for data collection and analysis and manuscript preparation and writing. CF contributed the study's methodological development, manuscript preparation and provided detailed feedback on all manuscript drafts. IP contributed to the study's data analysis and interpretation and provided detailed feedback on all manuscript drafts. DJ provided detailed feedback on all manuscript drafts. PF contributed the study's methodological development, data analysis and interpretation, manuscript preparation, and provided detailed feedback on all manuscript drafts.

  • Funding This study was supported by the National Institutes of Health/National Cancer Institute (NIH/NCI) and the FDA Center for Tobacco Products (CTP), grant number 1R21CA180934-01 (PI Sterling). Dr. Fryer was supported, in part, by his NCI-funded Career Development Award (K01CA148789).

  • Competing interests None declared.

  • Ethics approval Georgia State University Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Only members of the research team working on this project have access to the data in this study. Findings obtained from the research will be shared with the scientific community through peer-reviewed manuscripts, presentations at scientific conferences and through NIH or FDA's Center for Tobacco Products progress reports.

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