title: Switching between menthol and nonmenthol cigarettes: findings from the U.S. Cohort of the International Tobacco Control Four Country Survey.
abstract: BACKGROUND
  This article examines trends in switching between menthol and nonmenthol cigarettes, smoker characteristics associated with switching, and associations among switching, indicators of nicotine dependence, and quitting activity.
  
  
  METHODS
  Participants were 5,932 U.S. adult smokers who were interviewed annually as part of the International Tobacco Control Four Country Survey between 2002 and 2011. Generalized estimating equations (GEEs) were used to examine the prevalence of menthol cigarette use and switching between menthol and nonmenthol cigarettes (among 3,118 smokers who participated in at least 2 consecutive surveys). We also evaluated characteristics associated with menthol cigarette use and associations among switching, indicators of nicotine dependence, and quitting activity using GEEs.
  
  
  RESULTS
  Across the entire study period, 27% of smokers smoked menthol cigarettes; prevalence was highest among Blacks (79%), young adults (36%), and females (30%). Prevalence of switching between menthol and nonmenthol cigarettes was low (3% switched to menthol and 8% switched to nonmenthol), and switchers tended to revert back to their previous type. Switching types was not associated with indicators of nicotine dependence or quit attempts. However, those who switched cigarette brands within cigarette types were more likely to attempt to quit smoking.
  
  
  CONCLUSIONS
  While overall switching rates were low, the percentage who switched from menthol to nonmenthol was significantly higher than the percentage who switched from nonmenthol to menthol. An asymmetry was seen in patterns of switching such that reverting back to menthol was more common than reverting back to nonmenthol, particularly among Black smokers.
authors.affiliation: Division of Cancer Prevention and Population Sciences, Roswell Park Cancer Institute, Buffalo, NY; karin.kasza@roswellpark.org.
authors.forename: Karin A
authors.initials: KA
authors.lastname: Kasza
authors.affiliation: Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY;
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Hyland
authors.affiliation: Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY;
authors.forename: Maansi
authors.initials: M
authors.lastname: Bansal-Travers
authors.affiliation: Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY;
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Vogl
authors.affiliation: Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD;
authors.forename: Jiping
authors.initials: J
authors.lastname: Chen
authors.affiliation: Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD;
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Evans
authors.affiliation: Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada; Ontario Institute for Cancer Research, Toronto, Ontario, Canada;
authors.forename: Geoffrey T
authors.initials: GT
authors.lastname: Fong
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC.
authors.forename: Kenneth Michael
authors.initials: KM
authors.lastname: Cummings
authors.affiliation: Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY;
authors.forename: Richard J
authors.initials: RJ
authors.lastname: O'Connor
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008610:Menthol; D008875:Middle Aged; D012907:Smoking / Q000453:epidemiology / Q000639:trends*; D016540:Smoking Cessation / Q000706:statistics & numerical data; D062789:Tobacco Products / Q000145:classification*; D014029:Tobacco Use Disorder / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D008610:Menthol