The decline of menthol cigarette smoking in Australia, 1980-2008.

INTRODUCTION Concerns have been expressed that menthol cigarettes are highly conducive to uptake and hence function as "starter cigarettes" for adolescents. There is strong evidence for this in the United States. If menthol cigarettes are critical to uptake for some adolescents, they might be expected to remain popular among adolescents independent of promotional activity. We analyzed trends in the market share of menthol brands in Australia among both adolescents and adults to provide further insights into the determinants of menthol cigarette smoking. METHODS We used the Australian Secondary Students Alcohol and Drug Survey (1984-2008), the Smoking and Health Survey (1980-1998), and the International Tobacco Control Four Nations Survey (2002-2008) to estimate market share of brands. Measures were reported use of all menthol brands for adults and use of the Alpine brand for adolescents. RESULTS Menthol smoking was much more popular among female smokers of all age groups in the early 1980s. During the 1980s and 1990s, use declined markedly in the 18-29 age groups, while remaining relatively stable among older smokers. Use of Alpine declined markedly among adolescents in the 1980s and 1990s. However, during this period, Alpine remained more popular among experimenting than regular smokers. CONCLUSIONS Both Alpine and other menthol brands are now primarily "older women's cigarettes" in Australia. The trends in declining popularity among younger smokers suggest that targeted marketing plays a major role in determining menthol brand market share. Alpine has played a role as a "starter" cigarette in Australia but that role has decreased markedly since the 1980s. Within the Australian context, "light/mild" brands may have taken over the role of easier-to-smoke cigarettes that attract experimenting smokers.