Introduction:
Some e-cigarette manufacturers have marketed e-cigarette flavors branded after popular menthol cigarette brands, such as Newport. Such targeted marketing has the potential to increase the likelihood of e-cigarette initiation among menthol cigarette smokers. This study examined the association between menthol cigarette smoking and e-cigarette use among US middle and high school students.

Material and Methods:
Data were from the 2014-2015 (N=39,718) National Youth Tobacco Survey, a school based survey of students in grades 6-12. Reasons for e-cigarette use by self-reported menthol status were compared using chi-squared tests. Association between menthol cigarette smoking and current (past 30 day) e-cigarette use was measured using a marginal structural logistic regression model.

Results:
Current e-cigarette use prevalence was higher among menthol (58.5%) than nonmenthol (47.5%) cigarette smokers (p<0.001). The following reasons for e-cigarette use were more prevalent among menthol versus nonmenthol cigarette smokers, respectively for: smoking cessation (26.2% vs. 18.4%, p=0.0163); imitation of celebrity role models (4.4% vs. 1.1%, p=0.0013); attractive flavors (45.8% vs. 34.5%, p=0.004); and situational use in areas with smoking prohibitions (29.5% vs. 21.7%, p=0.0109). Logistic regression analyses among all cigarette smokers revealed higher odds of current e-cigarette use among menthol than nonmenthol cigarette smokers (aOR=1.56, 95%CI=1.24-1.97); analyses restricted to cigarette smokers who first tried cigarettes before any other tobacco product yielded consistent results (aOR=1.40, 95%CI=1.06-1.85).

Conclusions:
Current e-cigarette use was significantly higher among menthol than nonmenthol cigarette smokers. These findings underscore the importance of efforts to reduce all forms of tobacco product use, including e-cigarettes, among youth.