Upload
sitara
View
41
Download
0
Embed Size (px)
DESCRIPTION
TM. Overview of Current Use of Menthol Cigarettes and Trends in Recent Years. Ralph S. Caraballo, PhD, MPH Valerie J. Rock, MPH Epidemiology Branch Chief Office on Smoking and Health CDC. 2nd Conference on Menthol Cigarettes October 19, 2009. Smoking Prevalence by Race/Ethnicity - PowerPoint PPT Presentation
Citation preview
Ralph S. Caraballo, PhD, MPHValerie J. Rock, MPHEpidemiology Branch ChiefOffice on Smoking and HealthCDC
TM
2nd Conference on Menthol Cigarettes
October 19, 2009
Overview of Current Use of Menthol Cigarettes and Trends in Recent Years
Presentation Outline
Smoking Prevalence by Race/Ethnicity
Who is smoking menthol cigarettes?
Recent trends: smokers of menthol cigarettes
Summary
Future directions
Smoking Prevalence by Race/Ethnicity
Prevalence of Cigarette Smoking among Racial/Ethnic Groups, United States, 2002-2005
WhiteAfrican American
American Indian/Alaska Native
Asian
Hispanic
Smoking PrevalenceAmong Race
27.327.623.
9
14.5 37.1Native Hawaiian and Other Pacific Islander 31.4
Source: Caraballo RS, Yee SL, Gfroerer J, Mirza SA. Adult Tobacco Use among Racial and Ethnic Groups Living in the United States, 2002-2005. Preventing Chronic Disease, 2008; 5(3). http://www.cdc.gov/pcd/issues/2008/jul/07_0116htm
Race or Ethnicity SexMen Women Total
NON-HISPANICWhite 29.7 25.9 27.7African American 33.6 22.8 27.6 American Indian or Alaska Native 39.3 35.2 37.1Native Hawaiian and Other PI 35.9 26.6 31.4Asian 21.6 8.1 14.5 Chinese 13.9 4.6 8.8 Filipino 25.5 10.2 16.7 Japanese 17.2 8.0 12.1 Asian Indian 19.1 3.5 11.9 Korean 37.4 20.1 26.6 Vietnamese 32.5 8.0 21.5
HISPANIC 30.1 17.5 23.9 Mexican 31.0 15.7 23.8 Puerto Rican 35.6 28.0 31.5 Central or South American 25.3 14.7 20.2 Cuban 29.3 21.5 25.2
Percentage of Respondents Aged 18 or Older Who Smoked Cigarettes During the 30 Days Before Being Surveyed, by Race/Ethnicity and Sex, NSDUH, 2002-2005
Source: Caraballo RS, Yee SL, Gfroerer J, Mirza SA. Adult Tobacco Use among Racial and Ethnic Groups Living in the United States, 2002-2005. Preventing Chronic Disease, 2008; 5(3). http://www.cdc.gov/pcd/issues/2008/jul/07_0116htm
Who is Smoking Menthol Cigarettes?
Domestic Market Share of Menthol Cigarettes: United States, 1963 – 2006
0
10
20
30
40
50
1965 1970 1975 1980 1985 1990 1995 2000 2005
Year
Perc
ent
Source: Federal Trade Commission, 2009
20%
27%29%
16%
26.030.5
25.4
0
10
20
30
40
50
Perc
ent
Market Share of Menthol Cigarette Brands and Percentage of Smokers Who Use Menthol Cigarettes—United States, 2001-2007
Sources: 2009 FTC Report 2001-2006, NSDUH 2002-2007, and NHANES 2001-2006.
Market Share
2001-2006
NSDUH Menthol Use Prevalence
2002-2007
NHANES Menthol Use Prevalence
2001-2006
n=87,810 n=2,135Out of 371 billion cigarettes sold
per year
Percentage of Smokers Who Use Menthol Cigarettes by Race/Ethnicity—United States, NSDUH 2002-2007 and NHANES 2001-2006
Sources: Self-Reports from the Population Aged 12 Years or Older from the National Surveys on Drug Use & Health, 2002-2007; and UPC (Bar Code) Collected from the Population Aged 20 Years or Older from the Data National Health and Nutrition Examination Surveys, 2001-2006
* NSDUH captures Hispanic/Latinos; NHANES captures specifically Mexican Americans.
23.2
77.3
29.7
19.3
82.2
12.0
0
10
20
30
40
50
60
70
80
90
100
White African American Hispanic/MexicanAmerican
Perc
ent
NSDUH NHANES
*
n=461
n=1,350 n=324
n=62,502
n=8,563
n=10,302
*
Percentage of Smokers Who Use Menthol Cigarettes by Race/Ethnicity—United States, 2002-2007
§National Surveys on Drug Use and Health, 2002-2007
77.3
35.329.8
23.2
45.7
32.025.0
0
1020
304050
60708090
100
Perc
ent
African American
Native Hawaiian and Other
Pacific Islander
Multi-racial Asian Hispanic American Indian and
Alaska Native
White
0.1
0.3
0.4
2.0
5.3
<0.1
10.1
Population in millions
White
Multi-racial
American Indian/AN
Native Hawaiian PI
Asian
Hispanic
African American
Population in millions
Source: National Surveys on Drug Use & Health, 2002-2007
Number of Smokers Who Use Menthol Cigarettes by Race/Ethnicity—United States, 2002-2007
Hispanic11%
African American
Source: National Survey on Drug Use & Health, 2006
White
Hispanic
Asian (2.4%)
55.1%
11.1%
28.7%
Multi-race (1.6%)
Native Hawaiian PI (0.5%)
AIAN (0.6%)
Percent Distribution of Menthol Cigarette Smokers by Race/Ethnicity—United States, 2002-2007
74.9
19.225.8
20.2
37.9
27.7 30.5
80.1
27.436.9
30.0
55.4
42.2 40.9
0
10
20
30
40
50
60
70
80
90
100
Perc
ent
MaleFemale
Percentage of Current Smokers Aged ≥ 12 Years Who Use Menthol Cigarettes, by Race/Ethnicity and Sex—United States, 2002-2007
§National Surveys on Drug Use & Health, 2002-2007*Statistically significant
African American White Hispanic American
Indian/ Alaska Native
Native Hawaiian
and Pacific Islander
Asian
*
*
*
Multi-racial
*
0102030405060708090
100
Perc
ent
12-17 years18-25 years26-64 years65+ years
Percentage of Current Smokers Aged ≥ 12 Years Who Use Menthol Cigarettes by Race/Ethnicity and Age Group— United States, 2002-2007
§National Surveys on Drug Use & Health, 2002-2007
African American White Hispanic American
Indian/ Alaska Native
Native Hawaiian and Other
Pacific Islander
Asian Multi-racial
50%
Percentage of Smokers Who Use Menthol Cigarettes by Education among Persons Aged ≥18 Years—United States, 2002-2007
§National Surveys on Drug Use and Health, 2002-2007
31.3 30.731.422.8
0
1020
304050
60708090
100
Perc
ent
<HS High School Some College College Grad
Percentage of Smokers Who Use Menthol Cigarettes by Family Income among Persons Aged ≥25 Years—United States, 2002-2007
§National Surveys on Drug Use and Health, 2002-2007
34.728.530.2 27.6
0
1020
304050
60708090
100
Perc
ent
<20K 20-49K 50-74K 75+K
Trends: Menthol Cigarette Use
Trends in Menthol and Non-Menthol Cigarette Use among Current Smokers Aged ≥ 12 Years, United States, 2002-2007
Source: National Surveys on Drug Use & Health, 2002-2007
0102030405060708090
100
2002 2003 2004 2005 2006 2007Years
Perc
ent Menthol
Non-Menthol
Significant
Significant
Trends in Menthol Cigarette Use among Current Smokers Aged ≥ 12 Years, by Family Income, United States, 2002-2007
Source: National Surveys on Drug Use & Health, 2002-2007
0
10
20
30
40
50
2002 2003 2004 2005 2006 2007Years
Perc
ent
<20K20-49K50-74K75+K
Significant
Significant
Significant
Trends in Menthol Cigarette Use among Current Smokers Aged ≥ 18 Years, by Education, United States, 2002-2007
Source: National Surveys on Drug Use & Health, 2002-2007
Significant
Trends in Menthol Cigarette Use among Current Smokers Aged ≥ 12 Years, by Race/Ethnicity, United States, 2002-2007
Source: National Surveys on Drug Use & Health, 2002-2007
0102030405060708090
100
2002 2003 2004 2005 2006 2007Years
Perc
ent
African AmericanWhiteHispanicAIANAsianMulti-race
Significant
Significant Significantt
Trends in Menthol Cigarette Use among African American Current Smokers Aged ≥12 Years, by Sex, United States, 2002-2007
Source: National Surveys on Drug Use & Health, 2002-2007
0102030405060708090
100
2002 2003 2004 2005 2006 2007Years
Perc
ent
MaleFemale
Significant increase for males and females
Trends in Menthol Cigarette Use among African American Current Smokers Aged ≥ 12 Years, by Age, United States, 2002-2007
Source: National Surveys on Drug Use & Health, 2002-2007
0102030405060708090
100
2002 2003 2004 2005 2006 2007Years
Perc
ent
12-1718-2526-64
All 3 had significant increases
Trends in Menthol Cigarette Use among African American Current Smokers Aged ≥ 12 Years, by Reported Age of Smoking Initiation, United States, 2002-2007
Source: National Surveys on Drug Use & Health, 2002-2007
0102030405060708090
100
2002 2003 2004 2005 2006 2007Years
Perc
ent
Init <14 y/oInit 15-17 y/oInit 18+
All 3 had significant increases
Trends in Menthol Cigarette Use among African American Current Smokers Aged ≥ 12 Years Number of Cigarettes Smoked Per Day, United States, 2002-2007
Source: National Surveys on Drug Use & Health, 2002-2007
0102030405060708090
100
2002 2003 2004 2005 2006 2007Years
Perc
ent <5 CPD
6-15 CPD16-25 CPD
Significant
Significant
Quantity and Frequency of Past Month Cigarette Use among Students Aged 12-18 Years, National Youth Tobacco Survey, United States, 2004
Source: Caraballo RS, Novak SP, Asman K. Linking quantity and frequency profiles of cigarette smoking to the presence of nicotine dependence symptoms among adolescent smokers: findings from the 2004 NYTS. Nicotine Tob Res 2009;11(1):49-57.
Trends in Menthol Cigarette Use among White Current Smokers Aged ≥ 12 Years, by Age, United States, 2002-2007
Source: National Surveys on Drug Use & Health, 2002-2007
0102030405060708090
100
2002 2003 2004 2005 2006 2007Years
Perc
ent
12-1718-2526-6465+
stat. sig.
Trends in Menthol Cigarette Use among Hispanic Current Smokers Aged ≥ 12 Years, by Sex, United States, 2002-2007
Source: National Surveys on Drug Use & Health, 2002-2007
0102030405060708090
100
2002 2003 2004 2005 2006 2007Years
Perc
ent
MaleFemale
Significant
Signiificant
Menthol Brand Use by Race/Ethnicity
Top 10 Cigarette Brands Smoked by African American Current Smokers Aged ≥ 12 Years, United States, 2006
Source: National Survey on Drug Use and Health, 2006
55.4
11.3 8.5 5 4.6 2.3 2.2 1.9 1.4 1.20
102030405060708090
100
Perc
ent
New
port
Kool
Marlboro
Salem
Doral
Basic
B&
H
Winston
GPC
Virginia Slim
s
Summary
Significant overall increase of menthol cigarette use among smokers
Women seem to be more likely to smoke menthol cigarettes than men
Proportionally, African Americans more likely to smoke menthol cigarettes than other groups
Numerically, Whites are the majority of smokers of menthol cigarettes
Significant increase of cigarette menthol use among the following African American smokers:
Men and Women
Ages 12 – 64 years
All “age of initiation” groups
Who smoke <5 cigarettes per day when they smoke
Who smoke 16 – 25 cigarettes per day when they smoke
Significant overall increase of menthol use among smokers of all family incomes except $50,000 – $74,999 per year
Significant increase of cigarette menthol use among White smokers aged 12 – 25 years
Significant increase of cigarette menthol use among Hispanics
The leading menthol brand among African American smokers is Newport, the leading brand smoked by other Racial/Ethnic groups is Marlboro
Future Directions
To closely monitor menthol cigarette use among: African Americans Hispanics Native Hawaiians and Pacific Islanders Youth and Young Adults Triers and Experimenters
Although out of the scope of this presentation, to closely monitor: Targeted advertising and promotions to all segments of
the U.S. populations, especially African Americans Hispanics Native Hawaiians and Pacific Islanders Asians Youth and Young Adults Triers and Experimenters Low income LGBT
Acknowledgment
Kat Asman
Valerie Rock
Julie Cessna
Lynn Hughley
Ralph Caraballo, PhD, MPHValerie Rock, MPH Epidemiology Branch ChiefOffice on Smoking and Health
TM
Overview of Current Use of Menthol Cigarettes and Trends in Recent Years
E-mail: [email protected]
The findings and conclusions in this presentation are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
Extra Slides Not Presented
Other0%
African American
Source:http://www.census.gov/ July 1, 2006 estimates (accessed September 29, 2009)
White
Hispanic
Asian (4.2%)
Percent Population Distribution by Race/Ethnicity— United States, July 1, 2006
66.5%
14.5%
12.2%
Multi-race (1.4%)
Other (0.4%)
AIAN (0.8%)
Measurement of Menthol Use (Cigarettes) in National Surveys
First Conference on Menthol Cigarettes’ Selected Epidemiological (Surveillance) Needs (Giovino et al.)
“The best way to measure menthol use in large national surveys must be explored”
Of all smokers who self-reported they smoked a specific menthol or non-menthol only brand, 0.25% of them seem to have miss-reported the information (NSDUH)
No inaccurate reporting (0.00%) was found in NHANES among smokers for which UPC cigarette data were not available (NHANES)
Sources: National Cancer Institute. The First Conference on Menthol Cigarettes: Setting the Research Agenda; Executive Summary: March 21-22, 2002. Atlanta, GA; National Surveys on Drug Use & Health, 2002-2007.
First Conference on Menthol Cigarettes’ Selected Epidemiological (Surveillance) Needs (Giovino et al.)
However,
Of all smokers who self-reported they smoked Newport, Salem, Alpine, Belair, Coronas or Jade, 7.2% of them said they smoked a non-menthol version of those brands (NSDUH)
About 1.13% of Newport smokers reported smoking a non-menthol brand (NSDUH)
Sources: National Cancer Institute. The First Conference on Menthol Cigarettes: Setting the Research Agenda; Executive Summary: March 21-22, 2002. Atlanta, GA; National Surveys on Drug Use & Health, 2002-2007.
First Conference on Menthol Cigarettes’ Selected Epidemiological (Surveillance) Needs (Giovino et al.)
“The best way to measure menthol use in large national surveys must be explored”
Funded by CDC’s Office on Smoking and Health, since 2001 NHANES collects UPC bar code data on the side of the cigarette pack
Sources: National Cancer Institute. The First Conference on Menthol Cigarettes: Setting the Research Agenda; Executive Summary: March 21-22, 2002. Atlanta, GA; National Surveys on Drug Use & Health, 2002-2007.
“The need to monitor the use of “cross-brands” such as Marlboro Menthol and non-menthol Newport”
Of all Marlboro smokers (n=879), 7.6% (n=65) provided a brand (UPC code) that was Marlboro Menthol
Of all Newport smokers (n=276), 0.4% (n=1) provided a brand (UPC code) that was Newport Non-Menthol
Sources: National Cancer Institute. The First Conference on Menthol Cigarettes: Setting the Research Agenda; Executive Summary: March 21-22, 2002. Atlanta, GA; National Health and Nutrition Examination Surveys, 2001-2006.
First Conference on Menthol Cigarettes’ Selected Epidemiological (Surveillance) Needs (Giovino et al.)
Trends in Menthol Cigarette Use among White Current Smokers Aged ≥12 Years, by Sex, United States, 2002-2007
Source: National Surveys on Drug Use & Health, 2002-2007
0102030405060708090
100
2002 2003 2004 2005 2006 2007Years
Perc
ent
MaleFemale
No 2002-2007 change
No 2002-2007 change
Trends in Menthol Cigarette Use among Current Smokers Aged ≥ 20 Years, by Race/Ethnicity, NHANES, 2001-2006
Source: National Health and Nutrition Examination Survey, 2001-2006
0102030405060708090
100
2001-2002 2003-2004 2005-2006Years
Perc
ent
African AmericanWhiteMexican American
No Change
Significant increase
No change
Trends in Menthol Cigarette Use among African American Current Smokers Aged ≥ 20 Years, by Sex, NHANES, 2001-2006
Source: National Health and Nutrition Examination Survey, 2001-2006
0102030405060708090
100
2001-2002 2003-2004 2005-2006Years
Perc
ent
Male
Female
Significant 2001-2002 to 2005-2006 increase
no change
Trends in Menthol Cigarette Use among White Current Smokers Aged ≥ 20 Years, by Sex, NHANES, 2001-2006
Source: National Health and Nutrition Examination Survey, 2001-2006
0102030405060708090
100
2001-2002 2003-2004 2005-2006Years
Perc
ent
MaleFemale
Significant 2001-2002 to 2005-2006 increase
no change
Top 10 Cigarette Brands Smoked by White Current Smokers Aged ≥ 12 Years, United States, 2006
Source: National Survey on Drug Use and Health, 2006
49.8
10.5 6.5 5.5 3.4 3.1 3 2.2 2.1 20
102030405060708090
100
Perc
ent
M
arlboro
Cam
el
New
port
Basic
Doral
Winston
Parliament
USA
Gold
Pall Mall
Kool
Top 10 Cigarette Brands Smoked by American Indian/ Alaska Native Current Smokers Aged ≥ 12 Years, United States, 2006
Source: National Survey on Drug Use & Health, 2006
45.4
9.4 8.1 6.5 6.2 5.2 4.4 3.3 2.9 2.20
1020304050
60708090
100
Perc
ent
Marlboro
New
port
Cam
el
Basic
Benson &
H
edges
GPC
Doral
Misty
USA
Gold
Kool
61.8
16.16.4
1.9 1.7 1.5 1.2 1.2 1.1 1.10
102030405060708090
100
Perc
ent
Top 10 Cigarette Brands Smoked by Hispanic Current Smokers Aged ≥ 12 Years, United States, 2006
Source: National Survey on Drug Use & Health, 2006
Marlboro
New
port
Cam
el
Kool
Benson &
H
edges
Doral
Winston
Virginia Slim
Salem
Pall Mall
68.4
7.7 5.9 5.8 3.7 2.8 1.3 1.1 0.7 0.70
10203040
5060708090
100
Perc
ent
Top 10 Cigarette Brands Smoked by Asian Current Smokers Aged ≥ 12 Years, United States, 2006
Source: National Survey on Drug Use & Health, 2006 C
amel
Am
erican Spirit
Parliament
Benson &
H
edges
New
port
Kool
Capri
USA
Gold
Kent
Marlboro
38.2
17.18.3 7.1 6.2 5.4 3.6 3 2.6 1.6
0102030405060708090
100
Perc
ent
Top 10 Cigarette Brands Smoked by Multiracial Current Smokers Aged ≥ 12 Years, United States, 2006
Source: National Survey on Drug Use & Health, 2006
Marlboro
New
port
Basic
Cam
el
GPC
Doral
Misty
USA
Gold
Kool
Monarch
Percentage of African American Current Smokers Who Used Newport Cigarettes, by Sex and Age, United States, 2002-2007
Source: National Survey on Drug Use and Health, 2002-2007
82.5 79.4
46.4
82.9 82.6
45.1
0102030405060708090
100
12-17 18-25 26+
Perc
ent
MaleFemale
Percentage of White Current Smokers Who Used Newport Cigarettes, by Sex and Age, United States, 2002-2007
Source: National Survey on Drug Use and Health, 2002-2007
17.19.7
3.1
20.311
40
102030405060708090
100
12-17 18-25 26+
Perc
ent
MaleFemale
Percentage of Hispanic Current Smokers Who Used Newport Cigarettes, by Sex and Age, United States, 2002-2007
Source: National Survey on Drug Use and Health, 2002-2007
23.717.5
10.1
28.423.5
15.5
0102030405060708090
100
12-17 18-25 26+
Perc
ent
MaleFemale