Disparities in Retail Marketing for Menthol Cigarettes in the United States, 2015

Authors: Mills SD, Henriksen L, Golden SD, Kurtzman R, Kong AY, Queen TL, Ribisl KM

Category: Cancer Health Disparities, Behavioral Science & Health Communication
Conference Year: 2018

Abstract Body:
Low socioeconomic status groups and Blacks suffer from the highest rates of tobacco-related cancer mortality and also have disproportionately high prevalence of menthol cigarette smoking. Studies show that the tobacco industry disproportionately targets retail menthol cigarette marketing to youth, Blacks, and those with low income. Such studies are generally limited to samples in specific cities or states. This study describes retail marketing for menthol cigarettes and its relationship with neighborhood demographics in a nationally representative sample of tobacco retailers. In 2015, data collectors recorded the presence of any exterior menthol advertising, Newport pack price, and any advertised discounts for menthol versions of Newport, Camel and Marlboro at 2,124 tobacco retailers. Multilevel linear and generalized linear models were used to examine these outcomes as a function of census tract demographics, controlling for store type and US region. Tract characteristics were ranked into quartiles, ordered from lowest to highest percentage of youth, Black, Asian/Pacific Islander, and Hispanic residents; median household income was ordered from highest to lowest. More than one-third (38%) of retailers advertised menthol on their store exterior. This was more common in neighborhoods in the second (OR 1.5) and fourth (OR 1.9) quartiles of Black residents as compared to the lowest quartile. Similarly, menthol advertising was more common in the third (OR 1.4) and lowest (OR 1.6) income quartiles as compared to the highest quartile. More stores advertised discounts for menthol varieties of Marlboro (50%) and Camel (48%) than Newport (28%). Newport discounts were more common in neighborhoods with the highest quartile of Black residents (OR 1.8) and that pattern was unique to the brand. Newport cost less in neighborhoods in the highest quartiles of Black residents (B = -0.15), youth (B = -0.09), and in lower income quartiles (B = -0.16). In summary, a pattern of discounts in neighborhoods with more Black residents appears unique to Newport. This is the first national study to confirm lower price for Newport in neighborhoods with more youth. Menthol marketing studies should incorporate multiple brands, and flavor restrictions may address disparities in marketing.

Keywords: Disparities, Retail Marketing, Menthol Cigarettes