The intersection of gender and race/ethnicity in smoking behaviors among menthol and non-menthol smokers in the United States

Aims: To determine whether menthol is related to initiation, quantity or quitting, we examined differences in smoking behaviors among menthol and non-menthol smokers, stratified by gender and race/ethnicity, and adjusting for age, income and educational attainment.

Design: Cross-sectional, using data from the 2005 National Health Interview Survey and Cancer Control Supplement.

Setting: United States.

Participants: Black, Hispanic and white women and men aged 25-64 years.

Measurements: For each group, we examined (i) proportion of menthol smokers (comparing current and former smokers); (ii) age of initiation, cigarettes smoked per day and quit attempt in the past year (comparing menthol and non-menthol current smokers); and (iii) time since quitting (comparing menthol and non-menthol former smokers). We calculated predicted values for each demographic group, adjusting for age, income and educational attainment.

Findings: After adjusting for age, income and education, black (compared with Hispanic and white) and female (compared with male) smokers were more likely to choose menthol cigarettes. There was only one statistically significant difference in age of initiation, cigarettes smoked per day, quit attempts or time since quitting between menthol and non-menthol smokers: white women who smoked menthol cigarettes reported longer cessation compared with those who smoked non-menthol cigarettes.

Conclusions: The results do not support the hypothesis that menthol smokers initiate earlier, smoke more or have a harder time quitting compared with non-menthol smokers. A menthol additive and the marketing of it, given the clear demographic preferences demonstrated here, however, may be responsible for enticing the groups least likely to smoke into this addictive behavior.