Rutgers School of Public Health faculty find that menthol cigarette initiation is influenced by multiple factors including sensory properties, marketing, perceived popularity and availability. Menthol flavored cigarettes are the cigarette of choice for young adult and black smokers and have been called smoking “starter products”. They may also be more difficult to quit. While the prevalence of menthol cigarette use has been studied, little research exists on young adults’ perceptions of and experiences with these flavored products.
[Photo: Dr. Olivia Wackowski]
Dr. Olivia Wackowski, lead author and assistant professor, Dr. Cristine Delnevo, interim dean, and Dr. Jane Lewis, associate professor, all in the department of health education and behavioral science at the Rutgers School of Public Health, along with colleagues at the University of Texas and Monmouth University, aimed to capture a current picture of menthol cigarette initiation and product beliefs among young people. The authors, he authors, who are also research members in the Cancer Prevention and Control Program at Rutgers Cancer Institute of New Jersey, conducted six focus groups with young adult (ages 18-24) menthol smokers in New Jersey between December 2014 and March 2015, including three groups exclusively with black menthol smokers. Participants were asked open-ended questions about how and why they started smoking menthol cigarettes, if they ever substitute them, and perceptions of product risks and potential regulation efforts.
The researchers found that participant’s menthol cigarette use and preference are influenced by the products’ perceived popularity, brand recognition, taste, smoothness, satisfaction, and access. Study participants first tried smoking between the ages of 5-21, by receiving cigarettes from older friends, stealing them from relatives, or by frequenting community stores known to sell tobacco to minors, often in the form of “loosies” or loose cigarettes not part of a pack. Almost half of the study participants indicated that all or most of their first cigarettes were menthol flavored. Participants’ menthol cigarette initiation was heavily influenced by use among their friends and perceptions that menthol cigarettes were the type of cigarettes that were popular, normal, and accepted in their communities, factors undoubtedly related to advertising. Some also explicitly noted that they started with menthol cigarettes because they liked or recognized the packaging and advertising used for menthol cigarettes. Participants also said that the “cool,” “minty,” and “refreshing” taste were reasons why they preferred menthol cigarettes, qualities that masked the harshness of tobacco and made them easier to use. Some also perceived menthol cigarettes to be more “satisfying,” allowing them to smoke fewer cigarettes per day. Although most participants currently perceived menthol cigarettes to be as or more harmful than non-menthol cigarettes, some believed menthol cigarettes were less harmful when initiating smoking because they were less harsh. Many said that they would rarely substitute menthol cigarettes for non-menthol cigarettes (e.g., unless they were “desperate”) and acknowledged that a ban on menthol cigarettes might actually help them quit.
The results of the study supports previous research which finds that taste, perceived coolness, smoothness, and marketing are all important factors in young people selecting menthol-flavored cigarettes. Availability of menthol cigarettes as “loosies” and lax enforcement of retailers also continue to remain gateways to menthol cigarette initiation. Study results support the need for continued efforts by the FDA and the U.S. tobacco control community to pursue a ban on menthol flavored cigarettes. According to the authors, “the U.S. tobacco control community has unfinished business with menthol cigarettes and the Food and Drug Administration should continue to pursue closing this flavored cigarette loophole,” under which all flavored cigarettes are currently banned except menthol-flavored cigarettes.
“In Their Own Words: Young Adults’ Menthol Cigarette Initiation, Perceptions, Experiences and Regulation Perspectives,” was published in February in Nicotine & Tobacco Research. https://academic.oup.com/ntr/article/3002783/In