Background Multiple tobacco product (MTP) use is common among young adults. Most MTP users are combustible cigarette smokers that use one or more other tobacco products. This study aims to explore menthol as a risk factor for MTP use among a cohort of young adult cigarette smokers.
Methods Participants were 18–29 years cigarette smokers at 24 Texas colleges in a 6-wave study. Participants (n=4700 observations) were classified as: single product users (ie, exclusive cigarette smoking); dual product users and poly product users. A multilevel, ordered logistic regression model was used to examine the association between menthol cigarette smoking and MTP use. Two longitudinal, multilevel, multinomial logistic regressions were used to examine the relationship between menthol cigarette smoking and number of tobacco products used.
Results Overall, 40.7% of the sample were single product users, 33.7% were dual product users and 25.6% were poly product users. Menthol was associated with 1.28 greater odds of MTP use. Further, menthol was associated with 1.19 greater risk of dual and 1.40 greater risk of poly product use, relative to single product use. Lastly, menthol cigarette smoking was associated with 1.18 greater risk of poly product use, relative to dual product use.
Conclusions There was a gradient relationship between menthol cigarette smoking and number of tobacco products used among young adult cigarette smokers. Findings provide for greater regulatory and programmatic efforts to reduce the use of menthol cigarettes.
- public policy
- priority/special populations
- non-cigarette tobacco products
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Contributors DM and MH wrote the initial draft of the manuscript. DM and BC conducted the data analysis. BC and AL contributed to the analysis, interpretation of the data. SHK and CP contributed to the review, revision and approval of the final article. AL, MH and CP designed data collection tools, monitored data collection for the project.
Funding Research reported in this presentation was supported by grant number (1 P50 CA180906) from the National Cancer Institute and the FDA Center for Tobacco Products (CTP). University of Texas Health Science Center at Houston School of Public Health Cancer Education and Career Development Program—National Cancer Institute/NIH Grant—National Cancer Institute/NIH Grant T32/CA057712.
Disclaimer The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or the Food and Drug Administration. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health.
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval The University of Texas at Austin IRB (Protocol Number: 2013-06-0034) provided approval to conduct this research.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available on reasonable request.