Menthol and mint cigarettes and cigars: Initiation and progression in youth, young adults and adults in Waves 1 - 4 of the PATH Study, 2013 - 2017.

INTRODUCTION This study examined in youth (12-17 years), young adults (18-24 years), and adults (25+ years) the: 1) prevalence of first menthol cigarette and menthol/mint cigar use among new tobacco users; 2) association between first menthol/mint use, subsequent tobacco use, and nicotine dependence approximately one year later compared to first non-menthol/mint use. METHODS Longitudinal analysis of data from Waves 1-4 of the Population Assessment of Tobacco and Health (PATH) Study (2013-2017; 10,086 youth and 21,281 adults). Main outcome measures were past 12-month and past 30-day cigarette and cigar use, and nicotine dependence. RESULTS Youth and young adult new cigarette users are more likely to smoke a menthol cigarette or indicate that they don't know the flavor compared to adults aged 25+. A greater proportion of adults aged 25+ first used menthol/mint-flavored cigars (13.4%) compared to youth (8.5%) and young adults (7.4%). Among young adults, first use of a menthol cigarette is associated with past 12-month use of cigarettes at the subsequent wave and first use of any menthol/mint-flavored cigars is associated with past 30-day use of these products at the subsequent wave in both youth and young adults. In youth and adults, there were no significant relationships between first use of a menthol/mint cigarette or cigar and nicotine dependence scores at a subsequent wave in multivariable analyses. CONCLUSIONS First use of menthol/mint cigarettes and cigars is associated with subsequent cigarette and cigar use in young people aged 12-24.