Utilizing Reach Ratios to Assess Menthol Cigarette Smoker Enrollment in Quitline Services

Increasing the reach of evidence-based cessation services is a longstanding public health priority, especially for subgroups who may be most at risk. Little research has examined whether quitlines are reaching menthol cigarette smokers who may have increased difficulty quitting compared with nonmenthol cigarette smokers. This study aims to understand whether quitline services are reaching menthol cigarette smokers.

The study sample included adult smokers enrolled in Minnesota's quitline program, QUITPLAN Services, between May 2017 and April 2018 (N=10,999). Cigarette smokers were asked about the usual cigarette type (menthol versus nonmenthol). Reach ratios were calculated by dividing the percentage of program enrollees who are menthol smokers by the percentage of Minnesota smokers who are menthol smokers. Differences in demographic, tobacco use, and utilization characteristics between menthol and nonmenthol smokers were assessed using chi-square and t-tests. Analyses were conducted in March 2019.

Among QUITPLAN Services enrollees, 30.7% of smokers reported using menthol cigarettes. The reach ratio was 1.12 (95% CI=0.99, 1.25). Menthol smokers were more likely to be younger, be female, be Black/African American, be Hispanic, and live in an urban area than nonmenthol smokers. Although menthol smokers were more likely than nonmenthol smokers to enroll in text messaging, no other significant differences in service utilization were found.

The findings suggest that menthol smokers are proportionately represented among quitline enrollees. State quitlines should assess menthol smoking status at intake and allocate resources to reach and better serve menthol smokers.