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Introduction: Research has shown that smoking menthol cigarettes induces smoking initiation and hinders cessation efforts especially among youth. The objective of this paper is to examine the association between menthol cigarette smoking and substance use among adolescent students in Canada. Methods: A nationally representative cross-sectional sample of 4466 Canadian students in grades 7 to 12 from the 2010–2011 Youth Smoking Survey is analyzed. A bivariate probit model is used jointly to examine the association of menthol smoking status with binge drinking and marijuana use. Results: 32% of the current smokers in grades 7 to 12 smoke mentholated cigarettes, 73% are binge drinkers and 79% use marijuana. Results of the bivariate probit regression analysis, controlling for other covariates, show statistically significant differences in the likelihood of binge drinking and marijuana use between menthol and non-menthol smokers. Menthol cigarette smokers are 6% (ME=0.06, 95% CI=0.03–0.09) more likely to binge drink and 7% (ME=0.07, 95% CI=0.05–0.10) more likely to use marijuana. Conclusion: Smoking menthol cigarettes is associated with a higher likelihood of binge drinking and marijuana use among Canadian adolescents. Banning menthol in cigarettes may be beneficial to public health. [Copyright &y& Elsevier]

Introduction: There is a substantial literature that graphic tobacco warnings are effective; however, there is limited evidence based on actual smoking behavior. The objective of this paper is to assess the effect of graphic cigarette warning labels on smoking prevalence and quit attempts. Methods: A nationally representative sample of individuals aged 15 years and older from the Canadian National Population Health Survey 1998–2008 is used. The sample consists of 4,853 individuals for the smoking prevalence regression and 1,549 smokers for quit attempts. The generalized estimating equation (GEE) model was used to examine the population-averaged (marginal) effects of tobacco graphic warnings on smoking prevalence and quit attempts. To assess the effect of graphic tobacco health warnings on smoking behavior, we used a scaled variable that takes the value of 0 for the first 6 months in 2001, then increases gradually to 1 from December 2001. Results: We found that graphic warnings had a statistically significant effect on smoking prevalence and quit attempts. In particular, the warnings decreased the odds of being a smoker (odds ratio [OR] = 0.875; 95% CI = 0.821–0.932) and increased the odds of making a quit attempt (OR = 1.330, CI = 1.187–1.490). Similar results were obtained when we allowed for more time for the warnings to appear in retail outlets. Conclusion: This study adds to the growing body of evidence on the effectiveness of graphic warnings. Our findings suggest that warnings had a significant effect on smoking prevalence and quit attempts in Canada. [ABSTRACT FROM AUTHOR]

Abstract: Objective: This paper examines whether adolescent students in Canada who have never smoked but who drink alcohol mixed with energy drinks (AmED) are more susceptible to smoking than those who do not consume AmED. Methods: A nationally representative sample of 15,875 never-smoking students in grades 9 to 12 from the 2010–2011 Canadian Youth Smoking Survey is used. The association between AmED and susceptibility to smoking is examined using a logistic regression. Results: About 28% of the never-smoking adolescents in grades 9 to 12 are susceptible to smoking, and 13% report using AmED. Results of the adjusted logistic regression analysis show a statistically significant positive association between consuming AmED and susceptibility to smoking. Never-smoking students who reported using AmED are more susceptible to smoking when compared with those who have not consumed AmED (OR=1.89; 95% CI=1.71–2.10). Similar results are obtained when the analysis is stratified by gender. Conclusions: The consumption of AmED is associated with higher odds of smoking susceptibility among Canadian adolescents. AmED use could be a potential marker for smoking susceptibility among never-smoking adolescents. [Copyright &y& Elsevier]