1
|
Hoetger C, White A, Bono RS, Hall CJ, Hood KB, Everhart RS, Nana-Sinkam P, Barnes AJ, Cobb CO. Perceptions of African American Youth and Adults Regarding Tobacco Use-Related Factors in Their Community: A Mixed-Methods Approach in Richmond, Virginia. FAMILY & COMMUNITY HEALTH 2024; 47:176-190. [PMID: 38372334 PMCID: PMC10878718 DOI: 10.1097/fch.0000000000000398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
INTRODUCTION The US Food and Drug Administration is poised to restrict the availability of menthol cigarettes and flavored cigars, products disproportionately used by Black/African American (B/AA) individuals. We examined B/AA youth and adult perceptions regarding factors contributing to tobacco use, as well as prevention/cessation resources. METHODS In 2 mixed-methods studies in Richmond, Virginia, we conducted cross-sectional surveys among youth (n = 201) and adult (n = 212) individuals who were primarily B/AA and reported past 30-day cigar smoking or nontobacco use, followed by focus groups with a subset (youth: n = 30; adults: n = 24). Focus groups were analyzed using a thematic analysis framework, and descriptive survey data provided context to themes. RESULTS Among focus group participants, 20% of youth and 75% of adults reported current cigar smoking. Six themes emerged across the groups: advertising/brands, sensory experiences, costs, social factors, youth-related factors, and dependence/cessation. Youth and adults perceived cigars as popular; cigar use was attributed to targeted advertising, flavors, affordability, and accessibility. While adults expressed concern regarding youth tobacco use, youth did not perceive tobacco prevention programs as helpful. Adults and youth reported limited access to community tobacco prevention/cessation programs. DISCUSSION Expanded tobacco prevention and cessation resources for B/AA people who smoke could leverage federal regulatory actions to ban tobacco products targeted toward this group and decrease disparities in tobacco-related morbidity and mortality.
Collapse
Affiliation(s)
- Cosima Hoetger
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA
- Universitat of Witten/Herdecke, Institute for Integrative Health Care and Health Promotion, Witten, Germany
| | - Augustus White
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA
- Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA
| | - Rose S. Bono
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA
- Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA
| | - Calvin J. Hall
- Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | | | | | | | - Andrew J. Barnes
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA
- Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA
| | - Caroline O. Cobb
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA
- Psychology, Virginia Commonwealth University, Richmond, VA, USA
| |
Collapse
|
2
|
Nian Q, Cohen JE, Cui Y, Zhang S. Tobacco retailers around schools in 10 cities across China. Tob Control 2023; 33:74-85. [PMID: 35710747 PMCID: PMC10804017 DOI: 10.1136/tobaccocontrol-2022-057367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 05/24/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE This study explored the nature and extent of tobacco product availability at retailers near junior, senior and vocational high schools in rural and urban areas in 10 cities across China, including Shanghai, Beijing, Guangzhou, Chongqing, Shenyang, Jinan, Kunming, Guilin, Kaifeng and Baiyin. METHODS Tobacco sales at 1612 retailers around 904 schools (within 100 m for urban schools and within 250 m for rural schools) were observed by trained data collectors with an online observation form in 2021. Multistage sampling with simple random sampling at each stage was used to select schools from the city district-level/rural county-level divisions. χ2 tests and analyses of variance were used to analyse the data. FINDINGS Over half of urban schools (57.0%) and a large majority of rural schools (71.0%) had a cigarette retailer within a 100 m and a 250 m radius, respectively. Nearly all cigarette and electronic cigarette (e-cigarette) retailers displayed tobacco products inside. Majority of cigarette retailers (63.2%) sold flavoured cigarettes, of which 88.6% sold menthol/mint-flavoured cigarettes. Approximately half of these retailers did not display required signage prohibiting sales to minors. Overall, outcomes varied across cities and between urban and rural areas, but not by school type. CONCLUSION Display of tobacco products is very prevalent near schools in 10 cities across China. In contrast, compliance with posting 'no sales to minors' signs is low. Our findings suggest that effective enforcement of prohibiting tobacco retailers around schools and stronger restrictions on tobacco displays and flavoured cigarettes and e-cigarettes are needed to protect youth in China.
Collapse
Affiliation(s)
- Qinghua Nian
- Institute for Global Tobacco Control, Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Joanna E Cohen
- Institute for Global Tobacco Control, Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Yuxian Cui
- Department of Health, Behavior and Society, Johns Hopkins University, Baltimore, Maryland, USA
| | - Shuai Zhang
- The Research Center for Food and Drug Law, School of Law-based Government, China University of Political Science and Law, Beijing, China
| |
Collapse
|
3
|
Brown JL, Neptune E. Role of Menthol and Other Flavors on Tobacco and Nicotine Product Use. Respir Med 2023. [DOI: 10.1007/978-3-031-24914-3_12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
|
4
|
Rubenstein D, Sweitzer MM, Scroggs LB, Denlinger-Apte RL, Kozink R, McClernon FJ. Menthol preference moderates the relationship between cigarette nicotine content choice and reactions in young adults who smoke infrequently. Drug Alcohol Depend 2022; 238:109580. [PMID: 35908345 PMCID: PMC9648692 DOI: 10.1016/j.drugalcdep.2022.109580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 06/23/2022] [Accepted: 07/17/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Half of young adults who smoke use menthol cigarettes, which is associated with continued smoking and greater nicotine dependence. Additionally, early subjective reactions to cigarettes predict future use. Menthol may blunt the sensory effects of nicotine. We investigated the moderating role of menthol on subjective reactions to, and choice of varied nicotine content cigarettes in young adults who smoke infrequently. METHODS In three counterbalanced, double-blinded sessions, young adults who smoke ≤ 15 days/month smoked fixed doses from very low (VLNC), intermediate (INC), and normal (NNC) nicotine content cigarettes, which were menthol or non-menthol depending on preference. Participants chose their preferred cigarette in a final session. Positive and negative subjective reactions were measured in each session. ANOVA tests investigated the relationship between menthol preference, nicotine content, and subjective reactions. RESULTS Participants (N = 87) were 18-25 years old and reported smoking 15.2 cigarettes per month over 8 days (35 % menthol). Non-menthol preferring participants had increased negative reactions with greater nicotine content (F(1, 55)= 10.76, p < .001); menthol preferring participants did not. Choice of higher nicotine cigarettes was associated with having reported a greater difference in positive reactions to NNC and VLNC for non-menthol preferring participants (F(1, 55)= 12.72, p < .001) but not for menthol preferring participants. CONCLUSIONS Young adults who smoke infrequently are a priority tobacco control population given their high risk of transitioning to daily smoking. Results from this study in the form of subjective reactions indicate that a menthol ban is required for a nicotine reduction standard to be maximally effective in this vulnerable group.
Collapse
Affiliation(s)
- Dana Rubenstein
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27705, United States.
| | - Maggie M Sweitzer
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27705, United States
| | - Lauren B Scroggs
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27705, United States
| | - Rachel L Denlinger-Apte
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States
| | - Rachel Kozink
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27705, United States
| | - F Joseph McClernon
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27705, United States
| |
Collapse
|
5
|
MacLean RR, Gueorguieva R, DeVito EE, Peltier MR, Parida S, Sofuoglu M. The effects of inhaled flavors on intravenous nicotine. Exp Clin Psychopharmacol 2021; 29:615-624. [PMID: 32463279 PMCID: PMC7704548 DOI: 10.1037/pha0000394] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Menthol is the only available flavor in combusted tobacco cigarettes; however, e-cigarettes are available in thousands of flavors. Research on flavors and rewarding properties of nicotine is limited. The present study sought to examine the acute rewarding effects of flavors inhaled from an e-cigarette, in combination with intravenous (IV) nicotine among cigarette smokers. In the present study, 24 menthol-preferring young adult (aged 18 to 30) cigarette smokers were tested under 3 different e-cigarette flavor conditions (menthol, green apple, or menthol + green apple) in a within-subject cross-over design. During each test session, each participant received 3 IV infusions (saline, 0.25 mg/70 kg nicotine, 0.5 mg/70 kg nicotine) administered 1 hr apart. The main outcome measures assessed cardiovascular, subjective, and cognitive domains. Compared with green apple or green apple + menthol, menthol produced higher ratings of "cooling" (ps < 0.01). Craving was rated higher following administration of green apple and the combined menthol + apple flavor compared to menthol alone (ps < 0.05). As expected, IV-nicotine dose-dependently increased the ratings of subjective liking/disliking and peak heart rate, improved cognitive performance, and reduced smoking urges (all ps < 0.05). These subjective, cognitive, and physiological effects of nicotine were not affected by any flavor condition. The present findings did not support an interaction between IV-nicotine dose and inhaled flavor for acute effects of nicotine. Green apple flavor, alone or in combination with menthol, could result in higher craving or insufficiently alleviate craving, relative to menthol flavor alone. Additional research is warranted to examine extended exposure to inhaled flavors on the rewarding and addictive effects of nicotine. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Collapse
|
6
|
Menthol Smoking and Nicotine Dependence among Black/African American Women Smokers Living in Low-Resource, Rural Communities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010877. [PMID: 34682623 PMCID: PMC8535496 DOI: 10.3390/ijerph182010877] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 10/07/2021] [Accepted: 10/13/2021] [Indexed: 12/23/2022]
Abstract
Black/African American women from low-resource, rural communities bear a disproportionate burden of tobacco-related morbidity and mortality. This study examined associations between menthol smoking and socioeconomic deprivation with nicotine dependence and quitting behaviors among Black/African American women cigarette and/or little cigar/cigarillo smokers, aged 18–50 living in low-resource, rural communities. Baseline survey data from a randomized controlled behavioral/intervention trial (#NCT03476837) were analyzed (n = 146). Outcomes included time to first tobacco product (cigarette/little cigar/cigarillo) use within 5 min of waking, Fagerstrom Test for Nicotine Dependence (FTND) score, and ever attempting to quit cigarettes. Socioeconomic deprivation measures included education, income, and receiving supplemental nutritional assistance (SNAP) program benefits. In adjusted regression analyses, menthol smoking was associated with both greater FTND scores and time to first tobacco product use within 5 min of waking, but not ever attempting to quit cigarettes. Regardless of menthol status, only 25.0% of smokers reported that they would quit smoking if menthol cigarettes were banned. The proportion of smokers who smoked their first tobacco product within 5 min of waking increased slightly with greater socioeconomic deprivation. Additional research and targeted efforts are needed to reduce nicotine dependence among Black/African American women smokers living in rural, low-resource communities where access to cessation services is limited.
Collapse
|
7
|
Wang Y, Watkins SL, Sung HY, Yao T, Lightwood J, Max W. Health Care Utilization of Menthol and Non-menthol Cigarette Smokers. Nicotine Tob Res 2021; 23:195-202. [PMID: 32623471 DOI: 10.1093/ntr/ntaa122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 06/26/2020] [Indexed: 11/14/2022]
Abstract
INTRODUCTION To study the association between health care utilization and menthol cigarette use and whether the association differed between African American (AA) and non-AA smokers. METHODS We analyzed the three most recent 2005, 2010, and 2015 National Health Interview Survey Cancer Control Supplements. After incorporating propensity score weights adjusting for observed differences between menthol and non-menthol users, we estimated Zero-Inflated Poisson models on hospital nights, emergency department visits, doctor visits, and home visits as a function of menthol use status and other covariates separately for current cigarette smokers and recent quitters (former smokers quitting cigarette smoking ≤ 4 years). RESULTS Although current menthol smokers smoked fewer cigarettes per day than current non-menthol smokers, they did not differ from current non-menthol smokers in health care utilization. Among recent quitters, those who used to smoke menthol cigarettes had higher odds of having hospital nights than those who used to smoke non-menthol cigarettes. However, we did not find any significant association between menthol use and other health care utilization-emergency department visits, doctor visits, and home visits-among recent quitters. Moreover, compared with non-AA recent quitters, AA recent quitters had higher odds of having home visits, but fewer home visits, if they used to smoke menthol cigarettes. CONCLUSION Menthol use was associated with greater hospitalization among recent quitters, and the association between home visits and menthol use differed between AA and non-AA recent quitters. IMPLICATIONS This is the first study that used econometric models to study the association between health care utilization and menthol cigarette use and examine whether the association differed between AA and non-AA smokers. Our study found health care utilization did not differ by menthol use status for current smokers, although current menthol smokers smoked fewer cigarettes per day than current non-menthol smokers. However, we found menthol use was associated with higher odds of having hospital nights for recent quitters. We also found AA recent quitters had a different association between home visits and menthol use compared with non-AA recent quitters.
Collapse
Affiliation(s)
- Yingning Wang
- Institute for Health and Aging, School of Nursing, University of California-San Francisco, San Francisco, CA
| | - Shannon Lea Watkins
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, Iowa City, IA
| | - Hai-Yen Sung
- Institute for Health and Aging, School of Nursing, University of California-San Francisco, San Francisco, CA
| | - Tingting Yao
- Institute for Health and Aging, School of Nursing, University of California-San Francisco, San Francisco, CA
| | - Jim Lightwood
- Department of Clinical Pharmacy, School of Pharmacy, University of California-San Francisco, San Francisco, CA
| | - Wendy Max
- Institute for Health and Aging, School of Nursing, University of California-San Francisco, San Francisco, CA
| |
Collapse
|
8
|
Sawdey MD, Chang JT, Cullen KA, Rass O, Jackson KJ, Ali FRM, Odani S, Courtney-Long EA, Armour BS, Ambrose BK, Agaku IT. Trends and Associations of Menthol Cigarette Smoking Among US Middle and High School Students-National Youth Tobacco Survey, 2011-2018. Nicotine Tob Res 2020; 22:1726-1735. [PMID: 32347935 PMCID: PMC9679736 DOI: 10.1093/ntr/ntaa054] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 03/20/2020] [Indexed: 07/26/2023]
Abstract
INTRODUCTION Youth cigarette smoking decreased significantly over the last two decades in the United States. This study provides estimates and trends from 2011 to 2018 and factors associated with youth menthol and non-menthol smoking from 2016 to 2018. METHODS Using data from the 2011-2018 National Youth Tobacco Surveys, past 30-day (current) menthol and non-menthol cigarette smoking were estimated for all youth (prevalence) and youth smokers (proportions). Trends were examined using Joinpoint regression, calculating the annual percent change (APC). Multivariate logistic regression analyses identified factors associated with menthol smoking. RESULTS From 2011 to 2018, menthol cigarette smoking among current youth cigarette smokers significantly decreased from 57.3% to 45.7% (APC: -3.0%), while non-menthol (38.2% to 47.3% [APC: 2.9%]) and unknown menthol status (not sure\missing) (4.5% to 7.0% [APC: 7.1%]) significantly increased. Menthol cigarette smoking among high school, male, female, and non-Hispanic white current cigarette smokers decreased, but remained unchanged among middle school, non-Hispanic black, and Hispanic smokers. Significantly higher proportions of menthol cigarette smokers smoked on ≥20 days, ≥2 cigarettes per day, and ≥100 cigarettes in their lifetime compared to non-menthol smokers. Among current cigarette smokers, non-Hispanic blacks, Hispanics, flavored non-cigarette tobacco users, frequent smokers (≥20 days), those smoking 2-5 cigarettes per day, and those living with someone who uses tobacco had higher odds of menthol cigarette smoking. CONCLUSIONS In 2018, nearly half of current youth cigarette smokers smoked menthol cigarettes. While menthol cigarette smoking declined from 2011 to 2018 among all youth and among youth smokers, there was no change in menthol cigarette smoking among non-Hispanic black, Hispanic, and middle school cigarette smokers. IMPLICATIONS This study finds that overall cigarette and menthol cigarette smoking declined in youth from 2011 to 2018. However, menthol cigarette smoking among non-Hispanic black, Hispanic, and middle school youth cigarette smokers did not change. Information from this study can help inform efforts to reduce menthol cigarette smoking among US youth, particularly racial/ethnic minority populations.
Collapse
Affiliation(s)
- Michael D. Sawdey
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD
| | - Joanne T. Chang
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD
| | - Karen A. Cullen
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD
| | - Olga Rass
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD
| | - Kia J. Jackson
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD
| | - Fatma Romeh M. Ali
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - Satomi Odani
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - Elizabeth A. Courtney-Long
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - Brian S. Armour
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - Bridget K. Ambrose
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD
| | - Israel T. Agaku
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| |
Collapse
|
9
|
Cigarette Smoking Behavior Among Menthol and Nonmenthol Adolescent Smokers. J Adolesc Health 2020; 66:545-550. [PMID: 31964612 DOI: 10.1016/j.jadohealth.2019.11.307] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 11/08/2019] [Accepted: 11/18/2019] [Indexed: 11/22/2022]
Abstract
PURPOSE As cigarette rates have decreased, the proportion of menthol cigarette use among youth smokers has increased. Thus, it is important to monitor the menthol-associated behaviors among youth. The present study examined the associations between menthol cigarette use and smoking frequency, intention to continue smoking, and quit intention among youth. METHODS We used data from the 2017 and 2018 National Youth Tobacco Surveys. Separate multivariable logistic regression models were used to examine the associations between menthol cigarette use and smoking frequency, intention to continue smoking, and intention to quit. RESULTS Across both years, 1,707 youth reported past 30-day cigarette use, 50.7% of whom used menthol cigarettes. Menthol cigarette users had significantly higher odds of smoking at least 10 out of the 30 days before the survey than nonmenthol smokers (adjusted odds ratio [aOR] 1.48, 95% confidence interval [CI] 1.14-1.94). We found similar results in the stratified analysis by grade level. Menthol cigarette smokers in middle (aOR 2.36, 95% CI 1.01-5.49) and high school (aOR 1.41, 95% CI 1.09-1.82) were more likely to have smoked at least 10 out of the 30 days before the survey than nonmenthol smokers. Menthol cigarette users had higher odds of intention to continue smoking (aOR 1.54, 95% CI 1.08-2.19) than nonmenthol cigarette users. Menthol use was not significantly associated with intention to quit. CONCLUSIONS Compared with nonmenthol cigarette use, menthol cigarette use was associated with smoking more frequently as well as the intention to continue smoking among middle school and high school students.
Collapse
|
10
|
Frost-Pineda K, Heck JD, Curtin GM. Measures of dependence in menthol and nonmenthol smokers - A comprehensive narrative review. J Addict Dis 2020; 38:122-142. [PMID: 32286199 DOI: 10.1080/10550887.2020.1727286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Introduction. More than a decade ago, concerns were raised that menthol in cigarettes might enhance addiction to smoking. This article provides a comprehensive review of published studies examining cigarette dependence among menthol and nonmenthol smokers. The purpose of the review is to evaluate the scientific evidence to determine if menthol increases cigarette dependence. Materials and Methods. The published literature was searched in 2019 for studies that provide evidence on cigarette dependence among menthol compared to nonmenthol smokers. Included in this review are published studies that compare menthol and nonmenthol smokers based on widely accepted and validated measures of dependence, or other established predictors of dependence (age of smoking initiation [first cigarette]/age of progression [regular/daily smoking]) and indicators of dependence (smoking frequency, cigarettes smoked per day, time to first cigarette after waking, night waking to smoke, smoking duration). Results and Conclusion. Based on a review of the available studies, including those with adjusted results and large representative samples, reliable and consistent empirical evidence supports a conclusion that menthol smokers are not more dependent than nonmenthol smokers and thus menthol in cigarettes does not increase dependence.
Collapse
|
11
|
Cohn AM, Rose SW, Ilakkuvan V, Gray T, Curry L, Villanti AC, Mays D, Lindblom E, Tercyak K, Debnam C, Mayo A, Perreras L. Harm Perceptions of Menthol and Nonmenthol Cigarettes Differ by Brand, Race/Ethnicity, and Gender in US Adult Smokers: Results from PATH Wave 1. Nicotine Tob Res 2020; 21:439-449. [PMID: 29385527 DOI: 10.1093/ntr/ntx277] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 01/05/2018] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Harm perceptions of menthol cigarettes may contribute to their appeal and use. African-Americans, women, and younger smokers disproportionately use menthol cigarettes, and may misperceive harm of menthol cigarettes. METHODS Data were from Wave 1 of the Population Assessment of Tobacco and Health (PATH) Study. Weighted analyses of current adult smokers (18 and older) were used to estimate the correlates of menthol smoking among all cigarette brands and separately for the top three cigarette brands (Newport, Camel, and Marlboro). Adjusted models examined the main effect of menthol smoking on harm perceptions of one's own brand of cigarette and interactions with race/ethnicity, age, and gender. RESULTS Menthol cigarettes were used by nearly 40% of current smokers, although the prevalence of menthol smoking differed across the top three brands (94% Newport, 46% Camel, and 18% Marlboro). Among menthol smokers, 80% perceived their cigarette as equally harmful, 14% perceived their brand as more harmful, and 7% perceived their brand as less harmful. In adjusted models, menthol smokers were more likely than nonmenthol smokers to misperceive their own brand as more harmful than other brands (compared to no difference in harm). Race and gender emerged as moderators of the association between menthol brand preference and harm perceptions. CONCLUSIONS In adjusted analyses, menthol smokers were more likely than nonmenthol smokers to perceive their brand as more harmful than other brands, with differences by sub-groups who disproportionately use menthol. IMPLICATIONS Menthol cigarettes have been historically marketed with messages conveying lower harm than other cigarettes. Little is known about how contemporary adult menthol smokers perceive the harm of their usual brand, and potential differences by race, gender, and young adult versus older adult age group. After adjusting for other factors, menthol smokers were more likely than nonmenthol smokers to perceive their cigarette brand as more harmful than other brands. Further, the association between menthol smoking and harm perceptions differed by race and gender, but not by age group (young adult vs. older adult). This type of large-scale study identifies critical links between menthol smoking and harm perceptions among vulnerable smokers that will inform regulatory actions designed to decrease smoking-related harm.
Collapse
Affiliation(s)
- Amy M Cohn
- Battelle Memorial Institute, Arlington, VA.,Department of Oncology, Georgetown University Medical Center; Washington, DC, USA
| | | | - Vinu Ilakkuvan
- Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Tiffany Gray
- Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Laurel Curry
- Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Andrea C Villanti
- Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, Burlington, VT.,Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Darren Mays
- Department of Oncology, Georgetown University Medical Center; Washington, DC, USA
| | - Eric Lindblom
- O'Neill Institute for National and Global Health Law, Georgetown University, Washington, DC
| | - Kenneth Tercyak
- Department of Oncology, Georgetown University Medical Center; Washington, DC, USA
| | | | - Ashley Mayo
- Schroeder Institute at Truth Initiative, Washington, DC
| | | |
Collapse
|
12
|
Cwalina SN, Majmundar A, Unger JB, Barrington-Trimis JL, Pentz MA. Adolescent menthol cigarette use and risk of nicotine dependence: Findings from the national Population Assessment on Tobacco and Health (PATH) study. Drug Alcohol Depend 2020; 206:107715. [PMID: 31760252 PMCID: PMC6980659 DOI: 10.1016/j.drugalcdep.2019.107715] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 10/03/2019] [Accepted: 10/07/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND Menthol cigarettes appeal to adolescents because they mask the harsh taste and sensation of tobacco smoke thereby making it easier to inhale the smoke. As a result, menthol cigarette users expose themselves to higher levels of nicotine relative to non-menthol cigarettes and increase their risk for developing nicotine dependence. We examined whether adolescent menthol smokers (vs. non-menthol smokers) reported higher nicotine dependence. METHODS Data were from adolescent past 30-day cigarette smokers participating in Wave 2 of the Population Assessment of Tobacco and Health survey (n = 434). Nicotine dependence was assessed using eight items from the Wisconsin Inventory of Smoking Dependence Motives corresponding to individual subscale constructs. Linear regression models evaluated the association of past 30-day menthol (vs. non-menthol) cigarette use with each dependence outcome in separate models, adjusting for age, gender, race, and other tobacco product use. RESULTS 49.5% of past 30-day youth cigarette smokers reported smoking menthol cigarettes. In adjusted models, menthol smokers (vs. non-menthol smokers) reported significantly higher nicotine dependence for three constructs: craving (p = 0.005), affiliative attachment (p = 0.005), and tolerance (p = 0.003). No differences for menthol vs. non-menthol smokers were observed for loss of control, negative reinforcement, cognitive enhancement, automaticity, or social environment after correction for multiple comparisons. CONCLUSIONS Findings suggest that menthol cigarette smokers are not just more physically dependent on nicotine but also experience increased emotional attachments to cigarettes compared to their non-menthol smoking peers. Because adolescents are vulnerable to developing nicotine dependence, tobacco control policies that restrict youth access to menthol cigarettes are urgently needed.
Collapse
Affiliation(s)
- Sam N. Cwalina
- Corresponding author at: 2001 N. Soto Street, Los Angeles, CA 90089, United States. (S.N. Cwalina)
| | - Anuja Majmundar
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA 90089, United States.
| | | | | | - Mary Ann Pentz
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA 90089, United States.
| |
Collapse
|
13
|
Denlinger-Apte RL, Cassidy RN, Colby SM, Sokolovsky AW, Tidey JW. Effects of Cigarette Nicotine Content and Menthol Preference on Perceived Health Risks, Subjective Ratings, and Carbon Monoxide Exposure Among Adolescent Smokers. Nicotine Tob Res 2019; 21:S56-S62. [PMID: 31867646 PMCID: PMC6939772 DOI: 10.1093/ntr/ntz127] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 08/06/2019] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Minimal research exists on adolescent smokers' perceptions of very low-nicotine-content (VLNC) cigarettes. As approximately half of adolescent smokers prefer menthol cigarettes, it is important to consider the influence of menthol preference on VLNC cigarette perceptions and to what extent menthol preference may affect VLNC smoking behavior. This study examined the effects of cigarette nicotine content and menthol preference or menthol smoking on health risk perceptions, subjective ratings, and carbon monoxide (CO) boost in adolescent smokers. METHODS Across two counterbalanced sessions, adolescent smokers sampled VLNC and normal nicotine content (NNC) research cigarettes following overnight abstinence. Cigarettes were mentholated or non-mentholated consistent with participants' usual brand. In each session, participants smoked the research cigarette and then completed the Perceived Health Risk Scale and Cigarette Evaluation Scale. Breath CO readings were obtained pre- and post-smoking. Mixed-factor ANOVA tests compared outcomes with cigarette type (VLNC vs. NNC) as the within-subjects factor and menthol preference as the between-subjects factor. RESULTS Participants (N = 50) were M = 17.7 years old, smoked M = 8.2 cigarettes/day, and 56% typically smoked menthol cigarettes. Participants reported lower risk of developing lung cancer, other cancers, emphysema, bronchitis, and heart disease (ps ≤ .05) when smoking VLNC cigarettes relative to NNC cigarettes. Perceived risk of addiction and stroke did not differ by nicotine content. Menthol preference or menthol smoking did not moderate risk perceptions, subjective ratings, or CO boost. CONCLUSIONS Adolescents may incorrectly perceive that VLNC cigarettes are less harmful products. Health communication campaigns could help to correct VLNC misperceptions and potentially minimize unintended consequences of a nicotine reduction policy.
Collapse
Affiliation(s)
- Rachel L Denlinger-Apte
- Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI
| | - Rachel N Cassidy
- Center for Alcohol and Addiction Studies, School of Public Health, Brown University, Providence, RI
| | - Suzanne M Colby
- Center for Alcohol and Addiction Studies, School of Public Health, Brown University, Providence, RI
| | - Alexander W Sokolovsky
- Center for Alcohol and Addiction Studies, School of Public Health, Brown University, Providence, RI
| | - Jennifer W Tidey
- Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI
- Center for Alcohol and Addiction Studies, School of Public Health, Brown University, Providence, RI
| |
Collapse
|
14
|
King G, Moolchan ET, Bendel RB, Yerger VB. Tanning Capacity and Nicotine Dependence Among African Americans. J Natl Med Assoc 2018; 110:358-366. [PMID: 30126561 DOI: 10.1016/j.jnma.2017.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 07/05/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE Recent findings suggest a link between facultative melanin and nicotine dependence among African Americans. We hypothesized that tanning capacity is associated with the time to first cigarette (TTFC) of the day. METHODS Using a criterion based sample of 150 adult African American current smokers, reflectometer measures of constitutive and facultative melanin, tanning capacity, smoking status and history, saliva cotinine, sociodemographic characteristics, and stress and discrimination scales were recorded. TTFC was categorized as: 1) within the first 5 min versus more than 5 min; and 2) within the first 30 min versus more than 30 min. Descriptive and multivariate analyses were conducted. RESULTS Analysis revealed significantly higher tanning capacity among individuals who smoked their first cigarette of the day within the first 5 min of awakening (13.5) than among those who smoked after 5 min (10.3, p = 0.01) and among those who smoked within the first 30 min (12.8 vs. 9.6, p = 0.03) compared to those who initiated after this time point. Multivariate logistic regression indicated that tanning capacity was significantly and positively related (OR = 1.14, 95% CI = 1.05-1.22) to TTFC within the first 5 min and was also significantly related to TTFC within the first 30 min (OR = 1.13, CI = 1.03-1.23). CONCLUSION Tanning capacity was positively associated with a behavioral measure of nicotine dependence among African American smokers. This association was consistent whether comparing smokers at higher or lower levels of dependence. Future research should examine tanning capacity and other indicators of melanin content with smoking cessation rates and tobacco-attributable health disparities.
Collapse
Affiliation(s)
- Gary King
- Department of Behavioral Health, Pennsylvania State University, State College, PA, USA.
| | | | - Robert B Bendel
- School of Nursing, Washington State University, Spokane, WA, USA
| | - Valerie B Yerger
- Department of Social & Behavioral Sciences, University of California at San Francisco, San Francisco, CA, USA
| |
Collapse
|
15
|
Villanti AC, Collins LK, Niaura RS, Gagosian SY, Abrams DB. Menthol cigarettes and the public health standard: a systematic review. BMC Public Health 2017; 17:983. [PMID: 29284458 PMCID: PMC5747135 DOI: 10.1186/s12889-017-4987-z] [Citation(s) in RCA: 143] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 12/10/2017] [Indexed: 11/22/2022] Open
Abstract
Background Although menthol was not banned under the Tobacco Control Act, the law made it clear that this did not prevent the Food and Drug Administration from issuing a product standard to ban menthol to protect public health. The purpose of this review was to update the evidence synthesis regarding the role of menthol in initiation, dependence and cessation. Methods A systematic review of the peer-reviewed literature on menthol cigarettes via a PubMed search through May 9, 2017. The National Cancer Institute’s Bibliography of Literature on Menthol and Tobacco and the FDA’s 2011 report and 2013 addendum were reviewed for additional publications. Included articles addressing initiation, dependence, and cessation were synthesized based on study design and quality, consistency of evidence across populations and over time, coherence of findings across studies, and plausibility of the findings. Results Eighty-two studies on menthol cigarette initiation (n = 46), dependence (n = 14), and cessation (n = 34) were included. Large, representative studies show an association between menthol and youth smoking that is consistent in magnitude and direction. One longitudinal and eight cross-sectional studies demonstrate that menthol smokers report increased nicotine dependence compared to non-menthol smokers. Ten studies support the temporal relationship between menthol and reduced smoking cessation, as they measure cessation success at follow-up. Conclusions The strength and consistency of the associations in these studies support that the removal of menthol from cigarettes is likely to reduce youth smoking initiation, improve smoking cessation outcomes in adult smokers, and in turn, benefit public health. Electronic supplementary material The online version of this article (10.1186/s12889-017-4987-z) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Andrea C Villanti
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, USA. .,Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, Burlington, VT, USA. .,Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Lauren K Collins
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, USA
| | - Raymond S Niaura
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, USA.,Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Department of Oncology, Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, DC, USA
| | | | - David B Abrams
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, USA.,Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Department of Oncology, Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, DC, USA
| |
Collapse
|
16
|
Fait BW, Thompson DC, Mose TN, Jatlow P, Jordt SE, Picciotto MR, Mineur YS. Menthol disrupts nicotine's psychostimulant properties in an age and sex-dependent manner in C57BL/6J mice. Behav Brain Res 2017; 334:72-77. [PMID: 28743602 DOI: 10.1016/j.bbr.2017.07.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 06/28/2017] [Accepted: 07/18/2017] [Indexed: 11/26/2022]
Abstract
Menthol is a commonly used flavorant in tobacco and e-cigarettes, and could contribute to nicotine sensitivity. To understand how menthol could contribute to nicotine intake and addiction, it is important to determine whether specific mechanisms related to sex and age could underlie behavioral changes induced by menthol-laced nicotinic products. Using a validated paradigm of nicotine-dependent locomotor stimulation, adolescent and adult C57BL/6J mice of both sexes were exposed to nicotine, or nicotine laced with menthol, as their sole source of fluid, and psychostimulant effects were evaluated by recording home cage locomotor activity for ten days. Nicotine and cotinine blood levels were measured following exposure. Results show an interaction between treatment, age, and sex on liquid consumption, indicating that mice responded differently to menthol and nicotine based on their age and sex. Adult male mice greatly increased their nicotine intake when given menthol. In female mice of both age groups, menthol did not have this effect. Despite an increase in nicotine intake promoted by menthol, adult male mice showed a significant decrease in locomotion, suggesting that menthol blunted nicotine-induced psychostimulation. This behavioral response to menthol was not detected in adolescent mice of either sex. These data confirm that menthol is more than a flavorant, and can influence both nicotine intake and its psychostimulant effects. These results suggest that age- and sex-dependent mechanisms could underlie menthol's influence on nicotine intake and that studies including adolescent and adult menthol smokers of both sexes are warranted.
Collapse
Affiliation(s)
- Benjamin W Fait
- Department of Psychiatry, Yale University School of Medicine, 34 Park Street, 3rd Floor Research, New Haven, CT 06520, USA
| | - David C Thompson
- Department of Psychiatry, Yale University School of Medicine, 34 Park Street, 3rd Floor Research, New Haven, CT 06520, USA
| | - Tenna N Mose
- Department of Psychiatry, Yale University School of Medicine, 34 Park Street, 3rd Floor Research, New Haven, CT 06520, USA
| | - Peter Jatlow
- Department of Laboratory Medicine, Yale University School of Medicine, 330 Cedar Street, 4th floor, New Haven, CT 06520, USA
| | - Sven E Jordt
- Department of Cellular and Molecular Pharmacology University of California, San Francisco, CA 94143-2140, USA
| | - Marina R Picciotto
- Department of Psychiatry, Yale University School of Medicine, 34 Park Street, 3rd Floor Research, New Haven, CT 06520, USA
| | - Yann S Mineur
- Department of Psychiatry, Yale University School of Medicine, 34 Park Street, 3rd Floor Research, New Haven, CT 06520, USA.
| |
Collapse
|
17
|
Biswas L, Harrison E, Gong Y, Avusula R, Lee J, Zhang M, Rousselle T, Lage J, Liu X. Enhancing effect of menthol on nicotine self-administration in rats. Psychopharmacology (Berl) 2016; 233:3417-27. [PMID: 27473365 PMCID: PMC4990499 DOI: 10.1007/s00213-016-4391-x] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 07/08/2016] [Indexed: 01/19/2023]
Abstract
RATIONALE Tobacco smoking is a leading preventable cause of premature death in the USA. Menthol is a significant flavoring additive in tobacco products. Clinical evidence suggests that menthol may promote tobacco smoking and nicotine dependence. However, it is unclear whether menthol enhances the reinforcing actions of nicotine and thus facilitates nicotine consumption. This study employed a rat model of nicotine self-administration to examine the effects of menthol on nicotine-taking behavior. METHODS Male Sprague-Dawley rats were trained in daily 1-h sessions to press a lever for intravenous nicotine self-administration under a fixed-ratio 5 schedule of reinforcement. In separate groups, rats self-administered nicotine at four different doses (0.0075, 0.015, 0.03, and 0.06 mg/kg/infusion). Five minutes prior to the two test sessions, menthol (5 mg/kg) or its vehicle was administered intraperitoneally in all rats in a counterbalanced design within each group. In separate rats that self-administered 0.015 mg/kg/infusion nicotine, menthol dose-response function was determined. Menthol was also tested on food self-administration. RESULTS An inverted U-shaped nicotine dose-response curve was observed. Menthol pretreatment shifted the nicotine dose-response curve to the left. The facilitating effect of menthol on the self-administration of 0.015 mg/kg/infusion nicotine was dose-dependent, whereas it produced similar effects at doses above the threshold of 2.5 mg/kg. Menthol tended to suppress the self-administration of food pellets. CONCLUSIONS These data demonstrate that menthol enhances the reinforcing effects of nicotine, and the effect of menthol was specific to nicotine. The findings suggest that menthol directly facilitates nicotine consumption, thereby contributing to tobacco smoking.
Collapse
Affiliation(s)
- Lisa Biswas
- Department of Pathology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
| | - Erin Harrison
- Department of Pathology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
| | - Yongzhen Gong
- Department of Pathology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
| | - Ramachandram Avusula
- Department of Pathology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
| | - Jonathan Lee
- Department of Pathology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
| | - Meiyu Zhang
- Department of Pathology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
| | - Thomas Rousselle
- Department of Pathology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
| | - Janice Lage
- Department of Pathology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
| | - Xiu Liu
- Department of Pathology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA.
| |
Collapse
|
18
|
Ross KC, Dempsey DA, St Helen G, Delucchi K, Benowitz NL. The Influence of Puff Characteristics, Nicotine Dependence, and Rate of Nicotine Metabolism on Daily Nicotine Exposure in African American Smokers. Cancer Epidemiol Biomarkers Prev 2016; 25:936-43. [PMID: 27030603 DOI: 10.1158/1055-9965.epi-15-1034] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Accepted: 03/16/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND African American (AA) smokers experience greater tobacco-related disease burden than Whites, despite smoking fewer cigarettes per day (CPD). Understanding factors that influence daily nicotine intake in AA smokers is an important step toward decreasing tobacco-related health disparities. One factor of interest is smoking topography, or the study of puffing behavior. AIMS (i) to create a model using puff characteristics, nicotine dependence, and nicotine metabolism to predict daily nicotine exposure, and (ii) to compare puff characteristics and nicotine intake from two cigarettes smoked at different times to ensure the reliability of the puff characteristics included in our model. METHODS Sixty AA smokers smoked their preferred brand of cigarette at two time points through a topography device. Plasma nicotine, expired CO, and changes in subjective measures were measured before and after each cigarette. Total nicotine equivalents (TNE) was measured from 24-hour urine collected during ad libitum smoking. RESULTS In a model predicting daily nicotine exposure, total puff volume, CPD, sex, and menthol status were significant predictors (R(2) = 0.44, P < 0.001). Total puff volume was significantly greater and inter-puff intervals were significantly shorter after ad lib smoking compared with the first cigarette of the day, but puffing behaviors for both cigarettes were highly correlated (r range = 0.69-0.89, P < 0.001) within-subjects. CONCLUSION This is the first study, to our knowledge, to show that puff characteristics of individual cigarettes are predictive of daily nicotine intake. IMPACT These findings enhance our understanding of the relationship between smoking behavior and nicotine intake in AA smokers. Cancer Epidemiol Biomarkers Prev; 25(6); 936-43. ©2016 AACR.
Collapse
Affiliation(s)
- Kathryn C Ross
- Center for Tobacco Control, Research, and Education, University of California, San Francisco, San Francisco, California. Division of Clinical Pharmacology and Experimental Therapeutics, Department of Medicine, University of California, San Francisco, San Francisco, California
| | - Delia A Dempsey
- Division of Clinical Pharmacology and Experimental Therapeutics, Department of Medicine, University of California, San Francisco, San Francisco, California. Departments of Pediatrics and Medicine, University of California, San Francisco, San Francisco, California
| | - Gideon St Helen
- Center for Tobacco Control, Research, and Education, University of California, San Francisco, San Francisco, California. Division of Clinical Pharmacology and Experimental Therapeutics, Department of Medicine, University of California, San Francisco, San Francisco, California
| | - Kevin Delucchi
- Department of Psychiatry, University of California, San Francisco, San Francisco, California
| | - Neal L Benowitz
- Center for Tobacco Control, Research, and Education, University of California, San Francisco, San Francisco, California. Division of Clinical Pharmacology and Experimental Therapeutics, Department of Medicine, University of California, San Francisco, San Francisco, California. Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, California.
| |
Collapse
|
19
|
Abstract
BACKGROUND Latino smokers are a rising public health concern who experience elevated tobacco-related health disparities. PURPOSE Additional information on Latino smoking is needed to inform screening and treatment. ANALYSIS Latent class analysis using smoking frequency, cigarette preferences, onset, smoking duration, cigarettes per day, and minutes to first cigarette was used to create multivariate latent smoking profiles for Latino men and women. RESULTS Final models found seven classes for Latinas and nine classes for Latinos. Despite a common finding in the literature that Latino smokers are more likely to be low-risk intermittent smokers, the majority of classes for both males and females described patterns of high-risk daily smoking. Gender variations in smoking classes were noted. CONCLUSIONS Several markers of smoking risk were identified among both male and female Latino smokers, including long durations of smoking, daily smoking, and preference for specialty cigarettes, all factors associated with long-term health consequences.
Collapse
Affiliation(s)
- Allison N Kristman-Valente
- Social Development Research Group, University of Washington, Box 358734 9725, Third Ave NE, Suite 401, Seattle, WA, 98115, USA.
| | - Brian P Flaherty
- Department of Psychology, University of Washington, Box 351525, Seattle, WA, 98195, USA.
| |
Collapse
|
20
|
van de Nobelen S, Kienhuis AS, Talhout R. An Inventory of Methods for the Assessment of Additive Increased Addictiveness of Tobacco Products. Nicotine Tob Res 2016; 18:1546-55. [PMID: 26817491 PMCID: PMC4902882 DOI: 10.1093/ntr/ntw002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 12/30/2015] [Indexed: 01/01/2023]
Abstract
BACKGROUND Cigarettes and other forms of tobacco contain the addictive drug nicotine. Other components, either naturally occurring in tobacco or additives that are intentionally added during the manufacturing process, may add to the addictiveness of tobacco products. As such, these components can make cigarette smokers more easily and heavily dependent.Efforts to regulate tobacco product dependence are emerging globally. Additives that increase tobacco dependence will be prohibited under the new European Tobacco Product Directive. OBJECTIVE This article provides guidelines and recommendations for developing a regulatory strategy for assessment of increase in tobacco dependence due to additives. Relevant scientific literature is summarized and criteria and experimental studies that can define increased dependence of tobacco products are described. CONCLUSIONS Natural tobacco smoke is a very complex matrix of components, therefore analysis of the contribution of an additive or a combination of additives to the level of dependence on this product is challenging. We propose to combine different type of studies analyzing overall tobacco product dependence potential and the functioning of additives in relation to nicotine. By using a combination of techniques, changes associated with nicotine dependence such as behavioral, physiological, and neurochemical alterations can be examined to provide sufficient information.Research needs and knowledge gaps will be discussed and recommendations will be made to translate current knowledge into legislation. As such, this article aids in implementation of the Tobacco Product Directive, as well as help enable regulators and researchers worldwide to develop standards to reduce dependence on tobacco products. IMPLICATIONS This article provides an overall view on how to assess tobacco product constituents for their potential contribution to use and dependence. It provides guidelines that help enable regulators worldwide to develop standards to reduce dependence on tobacco products and guide researches to set research priorities on this topic.
Collapse
Affiliation(s)
- Suzanne van de Nobelen
- Center for Health Protection (GZB), National Institute of Public Health and Environment (RIVM), Bilthoven, The Netherlands
| | - Anne S Kienhuis
- Center for Health Protection (GZB), National Institute of Public Health and Environment (RIVM), Bilthoven, The Netherlands
| | - Reinskje Talhout
- Center for Health Protection (GZB), National Institute of Public Health and Environment (RIVM), Bilthoven, The Netherlands
| |
Collapse
|
21
|
Fagan P, Pohkrel P, Herzog T, Pagano I, Vallone D, Trinidad DR, Sakuma KL, Sterling K, Fryer CS, Moolchan E. Comparisons of three nicotine dependence scales in a multiethnic sample of young adult menthol and non-menthol smokers. Drug Alcohol Depend 2015; 149:203-11. [PMID: 25744873 PMCID: PMC4865397 DOI: 10.1016/j.drugalcdep.2015.02.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 01/14/2015] [Accepted: 02/03/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Few studies have compared nicotine dependence among menthol and non-menthol cigarette smokers in a multiethnic sample of young adult daily cigarette smokers. This study examines differences in nicotine dependence among menthol and non-menthol daily smokers and the associations of nicotine dependence with quitting behaviors among Native Hawaiian, Filipino, and White cigarette smokers aged 18-35. METHODS Craigslist.org, newspaper advertisements, and peer-to-peer referrals were used to recruit daily smokers (n = 186) into a lab-based study. Nicotine dependence was assessed using the Fagerstrom Test of Nicotine Dependence (FTND), the Nicotine Dependence Syndrome Scale (NDSS), and the brief Wisconsin Inventory for Smoking Dependence Motives (WISDM). Multiple regression analyses were used to examine differences in nicotine dependence between menthol and non-menthol smokers and the relationship between each nicotine dependence scale with self-efficacy to quit, quit attempt in the past 12 months, and number of attempts. RESULTS Menthol smokers were more likely to report difficulty refraining from smoking in places where forbidden (p = .04) and had higher scores on social/environmental goads subscale of the WISDM (p = .0005). Two-way interaction models of the FTND and menthol status showed that menthol smokers with higher levels of dependence were more likely to have tried to quit smoking in the past 12 months (p = .02), but were less likely to have had multiple quit attempts (p = .01). CONCLUSIONS Components of the FTND and WISDM distinguish levels of dependence between menthol and non-menthol smokers. Higher FTND scores were associated with having a quit attempt, but fewer quit attempts among menthol smokers.
Collapse
Affiliation(s)
- Pebbles Fagan
- Cancer Prevention and Control Program, University of Hawaii Cancer Center, University of Hawaii at Manoa, 701 Ilalo Street, Honolulu, HI 96813, USA.
| | - Pallav Pohkrel
- Cancer Prevention and Control Program, University of Hawaii Cancer Center, University of Hawaii at Manoa, 701 Ilalo Street, Honolulu, HI 96813, USA.
| | - Thaddeus Herzog
- Cancer Prevention and Control Program, University of Hawaii Cancer Center, University of Hawaii at Manoa, 701 Ilalo Street, Honolulu, HI 96813, USA.
| | - Ian Pagano
- Cancer Prevention and Control Program, University of Hawaii Cancer Center, University of Hawaii at Manoa, 701 Ilalo Street, Honolulu, HI 96813, USA.
| | - Donna Vallone
- American Legacy Foundation, 1724 Massachusetts Avenue N.W., Washington, DC 20036, USA.
| | - Dennis R. Trinidad
- School of Community and Global Health, Claremont Graduate University, 675 West Foothill Boulevard, Suite 310, Claremont, CA 91711-3475, USA
| | - Kari-Lyn Sakuma
- Oregon State University, College of Public Health and Human Sciences, 412 Waldo, Corvallis, OR 97331, USA.
| | - Kymberle Sterling
- School of Public Health, Georgia State University, One Park Place, Suite 662, Atlanta, GA 30303, USA.
| | - Craig S. Fryer
- Department of Behavioral and Community Health, School of Public Health, Maryland Center for Health Equity, University of Maryland, 2324 SPH Building #255, College Park, MD 20742, USA
| | | |
Collapse
|
22
|
Frost-Pineda K, Muhammad-Kah R, Rimmer L, Liang Q. Predictors, indicators, and validated measures of dependence in menthol smokers. J Addict Dis 2015; 33:94-113. [PMID: 24738914 PMCID: PMC4104824 DOI: 10.1080/10550887.2014.909696] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This article presents a comprehensive review of the menthol cigarette dependence-related literature and results from an original analysis of the Total Exposure Study (TES), which included 1,100 menthol and 2,400 nonmenthol adult smokers. The substantial scientific evidence available related to age of first cigarette, age of regular use, single-item dependence indicators (smoking frequency, cigarettes per day, time to first cigarette, night waking to smoke), smoking duration, numerous validated and widely accepted measures of nicotine/cigarette dependence, and our analysis of the TES do not support that menthol smokers are more dependent than nonmenthol smokers or that menthol increases dependence.
Collapse
Affiliation(s)
- Kimberly Frost-Pineda
- a Altria Client Services Inc., Center for Research and Technology , Richmond , Virginia , USA
| | | | | | | |
Collapse
|
23
|
Besaratinia A, Tommasi S. The lingering question of menthol in cigarettes. Cancer Causes Control 2015; 26:165-169. [PMID: 25416451 DOI: 10.1007/s10552-014-0499-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 11/13/2014] [Indexed: 10/24/2022]
Abstract
Tobacco use is the single most important preventable cause of cancer-related deaths in the USA and many parts of the world. There is growing evidence that menthol cigarettes are starter tobacco products for children, adolescents, and young adults. Accumulating research also suggests that smoking menthol cigarettes reinforces nicotine dependence, impedes cessation, and promotes relapse. However, menthol cigarettes are exempt from the US Food and Drug Administration ban on flavored cigarettes due, in part, to the lack of empirical evidence describing the health consequences of smoking menthol cigarettes relative to regular cigarettes. Determining the biological effects of menthol cigarette smoke relative to regular cigarette smoke can clarify the health risks associated with the use of respective products and assist regulatory agencies in making scientifically based decisions on the development and evaluation of regulations on tobacco products to protect public health and to reduce tobacco use by minors. We highlight the inherent shortcomings of the conventional epidemiologic, clinical, and laboratory research on menthol cigarettes that have contributed to the ongoing debate on the public health impact of menthol in cigarettes. In addition, we provide perspectives on how future investigations exploiting state-of-the-art biomarkers of exposure and disease states can help answer the lingering question of menthol in cigarettes.
Collapse
Affiliation(s)
- Ahmad Besaratinia
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, M/C 9603, Los Angeles, CA, 90033, USA.
| | - Stella Tommasi
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, M/C 9603, Los Angeles, CA, 90033, USA
| |
Collapse
|
24
|
Branstetter SA, Mercincavage M, Muscat JE. Predictors of the Nicotine Dependence Behavior Time to the First Cigarette in a Multiracial Cohort. Nicotine Tob Res 2014; 17:819-24. [PMID: 25431372 DOI: 10.1093/ntr/ntu236] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 10/25/2014] [Indexed: 11/14/2022]
Abstract
BACKGROUND The time to first cigarette of the day (TTFC) is a strong indicator of nicotine dependence behaviors such as nicotine uptake and quit success in young and older smokers. There are substantial differences in levels of nicotine dependence by race and ethnic group. METHODS Data from Wave III of the multiracial National Longitudinal Study of Adolescent Health were analyzed for young smokers between the ages of 21 and 28 (N = 1,425). Time to first cigarette data was compared between Hispanic, White, Black, Native American, and Asian smokers. RESULTS Black smokers were significantly more likely to smoke within 5min of waking than White, Hispanic, and Asian smokers. Lower personal income predicted smoking within 5min of waking for both White and Black smokers. For White smokers, increased number of cigarettes per day and increased years of smoking also predicted smoking within 5min of waking. The number of days smoked or number of cigarettes per day did not predict smoking within 5min of waking among smokers. CONCLUSIONS The higher prevalence of early TTFC among Blacks indicates increased nicotine and carcinogen exposure, and may help explain the increased lung cancer rates and failed cessation attempts among Black smokers. TTFC may be an important screening item, independent of cigarettes per day, for clinicians and interventions to identify those at highest risk for cessation failure and disease risk.
Collapse
Affiliation(s)
- Steven A Branstetter
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA;
| | - Melissa Mercincavage
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA
| | - Joshua E Muscat
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA
| |
Collapse
|
25
|
Curtin GM, Sulsky SI, Van Landingham C, Marano KM, Graves MJ, Ogden MW, Swauger JE. Primary measures of dependence among menthol compared to non-menthol cigarette smokers in the United States. Regul Toxicol Pharmacol 2014; 69:451-66. [PMID: 24852490 DOI: 10.1016/j.yrtph.2014.05.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Revised: 05/07/2014] [Accepted: 05/08/2014] [Indexed: 11/28/2022]
Abstract
Previously published studies provide somewhat inconsistent evidence on whether menthol in cigarettes is associated with increased dependence. The National Health and Nutrition Examination Survey, National Survey on Drug Use and Health, National Health Interview Survey, and Tobacco Use Supplement to the Current Population Survey collect data on current cigarette type preference and primary measures of dependence, and thus allow examination of whether menthol smokers are more dependent than non-menthol smokers. Analyses based on combined data from multiple administrations of each of these four nationally representative surveys, using three definitions for current smokers (i.e., smoked ⩾1day, ⩾10days and daily during the past month), consistently demonstrate that menthol smokers do not report smoking more cigarettes per day than non-menthol smokers. Moreover, two of the three surveys that provide data on time to first cigarette after waking indicate no difference in urgency to smoke among menthol compared to non-menthol smokers, while the third suggests menthol smokers may experience a greater urgency to smoke; estimates from all three surveys indicate that menthol versus non-menthol smokers do not report a higher Heaviness of Smoking Index. Collectively, these findings indicate no difference in dependence among U.S. smokers who use menthol compared to non-menthol cigarettes.
Collapse
Affiliation(s)
- Geoffrey M Curtin
- RAI Services Company, 401 North Main Street, P.O. Box 464, Winston-Salem, NC 27102, United States.
| | - Sandra I Sulsky
- ENVIRON International Corporation, 28 Amity Street, Suite 2A, Amherst, MA 01002, United States.
| | - Cynthia Van Landingham
- ENVIRON International Corporation, 1900 North 18th Street, Suite 804, Monroe, LA 71201, United States.
| | - Kristin M Marano
- RAI Services Company, 401 North Main Street, P.O. Box 464, Winston-Salem, NC 27102, United States.
| | - Monica J Graves
- RAI Services Company, 401 North Main Street, P.O. Box 464, Winston-Salem, NC 27102, United States.
| | - Michael W Ogden
- RAI Services Company, 401 North Main Street, P.O. Box 464, Winston-Salem, NC 27102, United States.
| | - James E Swauger
- RAI Services Company, 401 North Main Street, P.O. Box 464, Winston-Salem, NC 27102, United States.
| |
Collapse
|
26
|
Kasza KA, Hyland AJ, Bansal-Travers M, Vogl LM, Chen J, Evans SE, Fong GT, Cummings KM, O'Connor RJ. Switching between menthol and nonmenthol cigarettes: findings from the U.S. Cohort of the International Tobacco Control Four Country Survey. Nicotine Tob Res 2014; 16:1255-65. [PMID: 24984878 DOI: 10.1093/ntr/ntu098] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
INTRODUCTION This article examines trends in switching between menthol and nonmenthol cigarettes, smoker characteristics associated with switching, and associations among switching, indicators of nicotine dependence, and quitting activity. METHODS Participants were 5,932 U.S. adult smokers who were interviewed annually as part of the International Tobacco Control Four Country Survey between 2002 and 2011. Generalized estimating equations (GEEs) were used to examine the prevalence of menthol cigarette use and switching between menthol and nonmenthol cigarettes (among 3,118 smokers who participated in at least 2 consecutive surveys). We also evaluated characteristics associated with menthol cigarette use and associations among switching, indicators of nicotine dependence, and quitting activity using GEEs. RESULTS Across the entire study period, 27% of smokers smoked menthol cigarettes; prevalence was highest among Blacks (79%), young adults (36%), and females (30%). Prevalence of switching between menthol and nonmenthol cigarettes was low (3% switched to menthol and 8% switched to nonmenthol), and switchers tended to revert back to their previous type. Switching types was not associated with indicators of nicotine dependence or quit attempts. However, those who switched cigarette brands within cigarette types were more likely to attempt to quit smoking. CONCLUSIONS While overall switching rates were low, the percentage who switched from menthol to nonmenthol was significantly higher than the percentage who switched from nonmenthol to menthol. An asymmetry was seen in patterns of switching such that reverting back to menthol was more common than reverting back to nonmenthol, particularly among Black smokers.
Collapse
Affiliation(s)
- Karin A Kasza
- Division of Cancer Prevention and Population Sciences, Roswell Park Cancer Institute, Buffalo, NY;
| | - Andrew J Hyland
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY
| | | | - Lisa M Vogl
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY
| | - Jiping Chen
- Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD
| | - Sarah E Evans
- Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD
| | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada; Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Kenneth Michael Cummings
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - Richard J O'Connor
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY
| |
Collapse
|
27
|
Azagba S, Minaker LM, Sharaf MF, Hammond D, Manske S. Smoking intensity and intent to continue smoking among menthol and non-menthol adolescent smokers in Canada. Cancer Causes Control 2014; 25:1093-9. [PMID: 24913782 DOI: 10.1007/s10552-014-0410-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Accepted: 05/30/2014] [Indexed: 11/25/2022]
Abstract
PURPOSE Research suggests that menthol cigarette use is associated with nicotine dependence. However, findings on the relationship between menthol smoking status and quantity of cigarettes smoked are less clear. The objective of this paper was to examine whether menthol cigarette smoking is associated with higher smoking intensity and intention to continue smoking among adolescents. METHODS A nationally representative sample of 4,736 Canadian students in grades 9-12 was drawn from the 2010-2011 Canadian Youth Smoking Survey. Associations between smoking intensity and menthol smoking were examined using linear regression. A logistic regression was used to examine whether menthol smoking increased the odds that a student reported intention to continue smoking. RESULTS Thirty-two percentage of smokers in grades 9-12 smoked menthol cigarettes in the last 30 days. Unadjusted average number of cigarettes reported by menthol smokers was 6.86 compared with 4.59 among non-menthol smokers (p < 0.001). Multivariable results showed that the average number of cigarettes smoked by menthol smokers was greater than non-menthol smokers (β = 1.92; 95 % CI = 1.16-2.68). Similar results were found using the total number of cigarettes smoked in the past week. Additionally, menthol smokers had greater odds of reporting intent to continue smoking compared with non-menthol smokers (OR = 2.95; 95 % CI = 2.24-3.90). These results were similar when separate analyses were conducted for established smokers and experimental smokers. CONCLUSIONS The findings of this study along with existing evidence suggest the need for banning mentholated tobacco products in Canada, in part because of its significant effect on adolescent smoking.
Collapse
Affiliation(s)
- Sunday Azagba
- Propel Centre for Population Health Impact, Faculty of Applied Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada,
| | | | | | | | | |
Collapse
|
28
|
Giovino GA, Villanti AC, Mowery PD, Sevilimedu V, Niaura RS, Vallone DM, Abrams DB. Differential trends in cigarette smoking in the USA: is menthol slowing progress? Tob Control 2013; 24:28-37. [PMID: 23997070 DOI: 10.1136/tobaccocontrol-2013-051159] [Citation(s) in RCA: 168] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Mentholated cigarettes are at least as dangerous to an individual's health as non-mentholated varieties. The addition of menthol to cigarettes reduces perceived harshness of smoke, which can facilitate initiation. Here, we examine correlates of menthol use, national trends in smoking menthol and non-menthol cigarettes, and brand preferences over time. METHODS We estimated menthol cigarette use during 2004-2010 using annual data on persons ≥12 years old from the National Surveys on Drug Use and Health. We adjusted self-reported menthol status for selected brands that were either exclusively menthol or non-menthol, based on sales data. Data were weighted to provide national estimates. RESULTS Among cigarette smokers, menthol cigarette use was more common among 12-17 year olds (56.7%) and 18-25 year olds (45.0%) than among older persons (range 30.5% to 34.7%). In a multivariable analysis, menthol use was associated with being younger, female and of non-Caucasian race/ethnicity. Among all adolescents, the percentage who smoked non-menthol cigarettes decreased from 2004-2010, while menthol smoking rates remained constant; among all young adults, the percentage who smoked non-menthol cigarettes also declined, while menthol smoking rates increased. The use of Camel menthol and Marlboro menthol increased among adolescent and young adult smokers, particularly non-Hispanic Caucasians, during the study period. CONCLUSIONS Young people are heavy consumers of mentholated cigarettes. Progress in reducing youth smoking has likely been attenuated by the sale and marketing of mentholated cigarettes, including emerging varieties of established youth brands. This study should inform the Food and Drug Administration regarding the potential public health impact of a menthol ban.
Collapse
Affiliation(s)
- Gary A Giovino
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, New York, USA
| | - Andrea C Villanti
- The Schroeder Institute for Tobacco Research and Policy Studies at Legacy, Washington, District of Columbia, USA Department of Health, Behavior and Society, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | | | - Raymond S Niaura
- The Schroeder Institute for Tobacco Research and Policy Studies at Legacy, Washington, District of Columbia, USA Department of Health, Behavior and Society, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Donna M Vallone
- Department of Health, Behavior and Society, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA Department of Research and Evaluation, Legacy, Washington, District of Columbia, USA
| | - David B Abrams
- The Schroeder Institute for Tobacco Research and Policy Studies at Legacy, Washington, District of Columbia, USA Department of Health, Behavior and Society, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA Department of Oncology, Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, District of Columbia, USA
| |
Collapse
|
29
|
Kong G, Singh N, Camenga D, Cavallo D, Krishnan-Sarin S. Menthol cigarette and marijuana use among adolescents. Nicotine Tob Res 2013; 15:2094-9. [PMID: 23884319 DOI: 10.1093/ntr/ntt102] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Menthol cigarette and marijuana use among adolescents is high; however, little is known about dual use in this age. Thus, we examined these rates among 2 samples of adolescents in Connecticut. METHODS Study 1 examined a school-wide survey assessing variables related to cigarettes and marijuana among high school students (N = 837 [13% smokers]), and Study 2 examined these factors using baseline data of high school-aged, treatment-seeking, daily cigarette smokers prior to quitting (N = 132). RESULTS In Study 1, lifetime marijuana use among all adolescents was 33% and past 30-day marijuana use was 21%. Among cigarette smokers, 55% reported smoking menthol cigarettes, 84% reported lifetime marijuana use, and 66% reported past 30-day marijuana use. Multivariate-adjusted logistic regression models indicated that cigarette smokers, when compared with nonsmokers, had greater rates of lifetime (odds ratio [OR] = 10.91) and past 30-day marijuana use (OR = 10.44). Among smokers, use of menthol cigarettes, when compared with use of nonmenthol cigarettes, was associated with greater lifetime (OR = 5.05) but not past 30-day marijuana use. In Study 2 with daily smokers, 59% of adolescents reported use of menthol cigarettes and 66% reported past 30-day marijuana use. Compared with nonmenthol cigarette smokers, menthol cigarette smokers were more likely to report past 30-day marijuana use (OR = 2.44). CONCLUSIONS Cigarette smoking is associated with marijuana use, and among smokers, menthol cigarette smoking further increased the odds of marijuana use. More research on the dual use of marijuana and tobacco is needed to inform prevention and treatment of substance use.
Collapse
Affiliation(s)
- Grace Kong
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
| | | | | | | | | |
Collapse
|
30
|
Mercincavage M, Branstetter SA, Muscat JE, Horn KA. Time to first cigarette predicts cessation outcomes in adolescent smokers. Nicotine Tob Res 2013; 15:1996-2004. [PMID: 23811009 DOI: 10.1093/ntr/ntt087] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION This study examined the relationship between the time to the first cigarette (TTFC) of the morning with quit status among adolescent smokers at the completion of a school-based smoking cessation program. Among those who did not quit, the relationship of TTFC with changes in cigarettes/day (CPD) was also examined. METHODS A total of 1,167 adolescent smokers (1,024 nonquitters and 143 quitters) from 4 states participating in efficacy and effectiveness studies of the Not-On-Tobacco (N-O-T) cessation program were assessed prior to entry into the program and again 3 months later at the end of treatment. Linear and logistic regression analyses determined the influence of treatment condition, age, gender, motivation to quit, confidence in quitting ability, baseline CPD, and TTFC on quit status and end-of-treatment CPD. RESULTS Adolescents with a TTFC of >30min of waking were twice as likely to quit at end of treatment. Additionally, among those who did not quit at end of treatment (n = 700 for TTFC ≤30min and n = 324 for TTFC for >30min), those with a TTFC within 30min of waking smoked a greater number of CPD. The relationships of TTFC with both of these outcomes remained when controlling for all other predictor variables. CONCLUSIONS Identifying adolescent smokers who smoke their first cigarette of the day within the first 30min of waking prior to a quit attempt may help to classify those individuals as having a greater risk for cessation failure. Thus, TTFC may be a behavioral indicator of nicotine dependence in adolescents.
Collapse
Affiliation(s)
- Melissa Mercincavage
- Department of Biobehavioral Health, Pennsylvania State University, University Park, PA
| | | | | | | |
Collapse
|
31
|
Nonnemaker J, Hersey J, Homsi G, Busey A, Allen J, Vallone D. Initiation with menthol cigarettes and youth smoking uptake. Addiction 2013; 108:171-8. [PMID: 22862154 DOI: 10.1111/j.1360-0443.2012.04045.x] [Citation(s) in RCA: 102] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2011] [Revised: 01/03/2012] [Accepted: 07/30/2012] [Indexed: 11/27/2022]
Abstract
AIMS We aimed to assess whether young people who first tried menthol cigarettes were at greater risk of becoming established smokers and dependent on nicotine than young people who started smoking non-menthol cigarettes. DESIGN Cohort study using data from the American Legacy Longitudinal Tobacco Use Reduction Study (ALLTURS), a three-wave longitudinal school-based survey of middle school and high school students. Regression methods were used to assess the association between initiation with menthol cigarettes on risk of transitioning to established smoking or quitting from a non-smoking state at baseline and on nicotine dependence score at wave 3. SETTING The study was conducted in 83 schools in seven communities and five states in the United States. PARTICIPANTS Analyses were restricted to youth who participated in all three waves of ALLTURS, were younger than age 17 at baseline, and had initiated smoking during waves 1 or 2 of the study. MEASUREMENTS Outcomes were indicators of a transition to established smoking or non-smoking from non-established smoking and a nicotine dependence score. The key explanatory variables were an indicator of initiation with menthol cigarettes and indicators for pattern of menthol use over time. FINDINGS Initiating smoking with menthol cigarettes was associated with progression to established smoking [odds ratio (OR) = 1.80, confidence interval (CI): 1.02-3.16] and higher levels of nicotine dependence (β = 1.25, CI: 0.1-2.4). CONCLUSION Young people in the United States who start smoking menthol cigarettes are at greater risk of progression to regular smoking and nicotine dependence than are young people who start smoking non-menthol cigarettes.
Collapse
|
32
|
Li J, Paynter J, Arroll B. A cross-sectional study of menthol cigarette preference by 14- to 15-year-old smokers in New Zealand. Nicotine Tob Res 2011; 14:857-63. [PMID: 22193580 DOI: 10.1093/ntr/ntr299] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION This study investigates the epidemiology of menthol cigarette preference, its association with smoking initiation, and nicotine addiction measured by loss of autonomy among New Zealand adolescent smokers. METHODS Data from the 2006-2009 national surveys among New Zealand Year 10 students (14-15 years old) were analyzed using multiple logistic regression. Menthol preference was an outcome variable; demographic factors and smoking status were covariates. Loss of autonomy and menthol preference were examined using multiple linear regression analysis. The Hooked on Nicotine Checklist measured loss of autonomy as an outcome variable. Menthol status, smoking status, and demographic factors were covariates. All analyses were controlled for clustering of data by school. RESULTS Overall, 17.7% of New Zealand 14- to 15-year-old smokers in this study indicated a preference for menthol cigarette, with greater odds of menthol cigarette preference among girls (odds ratio [OR] = 2.43; 95% CI = 2.15-2.75), ethnic minorities (Māori OR = 1.21; 95% CI = 1.07-1.36, Asians OR = 2.24; 95% CI = 1.79-2.82, Pacific Islanders OR = 1.83; 95% CI = 1.52-2.19), smokers from high socioeconomic status schools (OR = 1.24; 95% CI = 1.03-1.49), when parents smoked (OR = 1.16; 95% CI = 1.03-1.31), and newer smokers (smoked 11-100 cigarettes OR = 1.16; 95% CI = 1.03-1.31, smoking on a monthly OR = 1.17; 95% CI = 1.00-1.37, and a weekly basis OR = 1.29; 95% CI = 1.15-1.44). No significant correlation was found among those who smoked 1-10 cigarettes in total (OR = 1.02; 95% CI = 0.86-1.20) nor was any correlation found between menthol preference and nicotine addiction measured by loss of autonomy (coef. = -.21, p value = .165). CONCLUSION This study found inequalities in menthol cigarette preference among New Zealand adolescent smokers, consistent with patterns found in the United States but did not find any significant correlation between menthol preference and loss of autonomy.
Collapse
Affiliation(s)
- Jian Li
- School of Medicine, University of Auckland, Auckland, New Zealand.
| | | | | |
Collapse
|
33
|
Faseru B, Choi WS, Krebill R, Mayo MS, Nollen NL, Okuyemi KS, Ahluwalia JS, Cox LS. Factors associated with smoking menthol cigarettes among treatment-seeking African American light smokers. Addict Behav 2011; 36:1321-4. [PMID: 21816543 PMCID: PMC3179803 DOI: 10.1016/j.addbeh.2011.07.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2010] [Revised: 04/18/2011] [Accepted: 07/14/2011] [Indexed: 11/30/2022]
Abstract
BACKGROUND Smoking menthol cigarettes is more prevalent among African Americans (AA) compared to Whites. Menthol has been found to be inversely related to smoking cessation among AA, yet little is known about the factors associated with menthol smoking among AA light smokers. This study examines baseline demographic, psychological, and smoking factors associated with smoking menthol cigarettes among AA light smokers (≤10 cigarettes per day). METHODS Participants (n=540) were enrolled in a double blind, placebo-controlled randomized trial of bupropion in combination with health education counseling for smoking cessation. Bivariate differences between menthol and non-menthol smokers were explored and baseline factors associated with smoking menthol cigarettes were identified. RESULTS Participants averaged 46.5 years in age, predominantly female (66.1%), and smoked an average of 8.0 cpd (SD=2.5). The majority (83.7%) smoked menthol cigarettes. In bivariate analysis, menthol cigarette smokers were younger (mean age: 45 vs. 52 years p<0.0001), were more likely to be female (68% vs. 52% p=0.003) and had smoked for shorter duration (28 vs. 34 years p<0.0001) compared to non-menthol smokers. While depression and withdrawal scores were slightly higher and exhaled carbon monoxide values were lower among menthol smokers, the differences were not statistically significant. CONCLUSIONS Among AA light smokers, younger individuals and females were more likely to smoke menthol cigarettes and may be more susceptible to the health effects of smoking. Appropriately targeted health education campaigns are needed to prevent smoking uptake in this high-risk population.
Collapse
Affiliation(s)
- Babalola Faseru
- Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS 66160, USA.
| | | | | | | | | | | | | | | |
Collapse
|
34
|
Winickoff JP, McMillen RC, Vallone DM, Pearson JL, Tanski SE, Dempsey JH, Cheryl Healton, Klein JD, David Abrams. US attitudes about banning menthol in cigarettes: results from a nationally representative survey. Am J Public Health 2011; 101:1234-6. [PMID: 21566038 PMCID: PMC3110223 DOI: 10.2105/ajph.2011.300146] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2011] [Indexed: 11/04/2022]
Abstract
Menthol is a cigarette flavoring that makes smoking more appealing to smokers. The US Food and Drug Administration (FDA) has regulatory authority to ban mentholated cigarettes to reduce youth uptake and encourage adult cessation. Survey findings indicate that more than half of all Americans (56.1%) and of Blacks alone (68.0% in one sample and 75.8% in another) support banning menthol. Endorsement of a ban-especially by Blacks, who have the highest rates of menthol cigarette use-would support FDA action to ban menthol to protect the public's health.
Collapse
|
35
|
Abstract
Since tobacco use is driven by dependence on nicotine, the primary addictive substance in tobacco, much research has focused on nicotine dependence. Less well understood, however, is the role that menthol plays in nicotine dependence. This review seeks to examine what role, if any, menthol plays in nicotine addiction in adults and youth. Based on research examining several indicators of heaviness of nicotine addiction, including time to first cigarette upon waking, night waking to smoke, as well as some other indications of dependence, it is suggested that menthol cigarette smokers are more heavily dependent on nicotine. Although other indicators of nicotine dependence, including number of cigarettes per day and the Fagerstrom Test of Nicotine Dependence, failed to consistently differentiate menthol and non-menthol smokers, these indicators are thought to be less robust than time to first cigarette. Therefore, though limited, the existing literature suggests that menthol smokers may be more dependence on nicotine.
Collapse
Affiliation(s)
- Allison C Hoffman
- Center for Tobacco Products, Food and Drug Administration, Rockville, MD 20850, USA.
| | | |
Collapse
|
36
|
Benowitz NL, Dains KM, Dempsey D, Wilson M, Jacob P. Racial differences in the relationship between number of cigarettes smoked and nicotine and carcinogen exposure. Nicotine Tob Res 2011; 13:772-83. [PMID: 21546441 DOI: 10.1093/ntr/ntr072] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Black smokers are reported to have higher lung cancer rates and greater tobacco dependence at lower levels of cigarette consumption compared to non-Hispanic White smokers. We studied the relationship between cigarettes per day (CPD) and biomarkers of nicotine and carcinogen exposure in Black and White smokers. METHODS In 128 Black and White smokers, we measured plasma nicotine and its main proximate metabolite cotinine, urine nicotine equivalents, 4-(methylnitrosamino)-1-(3)pyridyl-1-butanol (NNAL), and polycyclic aromatic hydrocarbon (PAH) metabolites. RESULTS The dose-response between CPD and nicotine equivalents, and NNAL and PAH was flat for Black but positive for White smokers (Race × CPD interaction, all ps < .05). Regression estimates for the Race × CPD interactions were 0.042 (95% CI 0.013-0.070), 0.054 (0.023-0.086), and 0.028 (0.004-0.052) for urine nicotine equivalents, NNAL, and PAHs, respectively. In contrast there was a strong correlation between nicotine equivalents and NNAL and PAH independent of race. Nicotine and carcinogen exposure per individual cigarette was inversely related to CPD. This inverse correlation was stronger in Black compared to White smokers and stronger in menthol compared to regular cigarette smokers (not mutually adjusted). CONCLUSIONS Our data indicate that Blacks on average smoke cigarettes differently than White smokers such that CPD predicts smoke intake more poorly in Black than in White smokers.
Collapse
Affiliation(s)
- Neal L Benowitz
- Department of Medicine, University of California, San Francisco, San Francisco, CA 94143-1220, USA.
| | | | | | | | | |
Collapse
|
37
|
Yerger VB. Menthol's potential effects on nicotine dependence: a tobacco industry perspective. Tob Control 2011; 20 Suppl 2:ii29-36. [PMID: 21504929 PMCID: PMC3088468 DOI: 10.1136/tc.2010.041970] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2010] [Accepted: 02/03/2011] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To examine what the tobacco industry knows about the potential effects menthol may have on nicotine dependence. METHODS A snowball strategy was used to systematically search the Legacy Tobacco Documents Library (http://legacy.library.ucsf.edu/) between 22 February and 29 April, 2010. Of the approximately 11 million documents available in the Legacy Tobacco Documents Library, the iterative searches returned tens of thousands of results. We qualitatively analysed a final collection of 309 documents relevant the effects of menthol on nicotine dependence. RESULTS The tobacco industry knows that menthol overrides the harsh taste of tobacco and alleviates nicotine's irritating effects, synergistically interacts with nicotine, stimulates the trigeminal nerve to elicit a 'liking' response for a tobacco product, and makes low tar, low nicotine tobacco products more acceptable to smokers than non-mentholated low delivery products. CONCLUSION Menthol is not only used in cigarettes as a flavour additive; tobacco companies know that menthol also has sensory effects and interacts with nicotine to produce tobacco products that are easier to smoke, thereby making it easier to expose smokers, especially those who are new and uninitiated, to the addictive power of nicotine.
Collapse
Affiliation(s)
- Valerie B Yerger
- Department of Social and Behavioral Sciences, Box 0612, University of California, San Francisco, San Francisco, CA 94143-0612, USA.
| |
Collapse
|
38
|
Lee PN. Systematic review of the epidemiological evidence comparing lung cancer risk in smokers of mentholated and unmentholated cigarettes. BMC Pulm Med 2011; 11:18. [PMID: 21501470 PMCID: PMC3103484 DOI: 10.1186/1471-2466-11-18] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2010] [Accepted: 04/18/2011] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND US mentholated cigarette sales have increased considerably over 50 years. Preference for mentholated cigarettes is markedly higher in Black people. While menthol itself is not genotoxic or carcinogenic, its acute respiratory effects might affect inhalation of cigarette smoke. This possibility seems consistent with the higher lung cancer risk in Black men, despite Black people smoking less and starting smoking later than White people. Despite experimental data suggesting similar carcinogenicity of mentholated and non-mentholated cigarettes, the lack of convincing evidence that mentholation increases puffing, inhalation or smoke uptake, and the similarity of lung cancer rates in Black and White females, a review of cigarette mentholation and lung cancer is timely given current regulatory interest in the topic. METHODS Epidemiological studies comparing lung cancer risk in mentholated and non-mentholated cigarette smokers were identified from MedLine and other sources. Study details were extracted and strengths and weaknesses assessed. Relative risk estimates were extracted, or derived, for ever mentholated use and for long-term use, overall and by gender, race, and current/ever smoking, and meta-analyses conducted. RESULTS Eight generally good quality studies were identified, with valid cases and controls, and appropriate adjustment for age, gender, race and smoking. The studies afforded good power to detect possible effects. However, only one study presented results by histological type, none adjusted for occupation or diet, and some provided no results by length of mentholated cigarette use.The data do not suggest any effect of mentholation on lung cancer risk. Adjusted relative risk estimates for ever use vary from 0.81 to 1.12, giving a combined estimate of 0.93 (95% confidence interval 0.84-1.02, n = 8), with no increase in males (1.01, 0.84-1.22, n = 5), females (0.80, 0.67-0.95, n = 5), White people (0.87, 0.75-1.03, n = 4) or Black people (0.90, 0.73-1.10, n = 4). Estimates for current and ever smokers are similar. The combined estimate for long-term use (0.95, 0.80-1.13, n = 4) again suggests no effect of mentholation. CONCLUSION Higher lung cancer rates in Black males cannot be due to their greater preference for mentholated cigarettes. While some study weaknesses exist, the epidemiological evidence is consistent with mentholation having no effect on the lung carcinogenicity of cigarettes.
Collapse
Affiliation(s)
- Peter N Lee
- P.N. Lee Statistics and Computing Ltd, Surrey, UK.
| |
Collapse
|
39
|
Davis SP, McClave-Regan AK, Rock VJ, Kruger J, Garrett BE. Perceptions of menthol cigarette use among U.S. adults and adult smokers: findings from the 2009 HealthStyles survey. Nicotine Tob Res 2011; 12 Suppl 2:S125-35. [PMID: 21177369 DOI: 10.1093/ntr/ntq205] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Perceptions of menthol cigarette use may have implications for smoking initiation and cessation. This study explores harm and health perceptions of menthol cigarette use among a national sample of U.S. adults and current smokers. METHODS We examined data from the 2009 HealthStyles survey (n = 4,556), an annual mail survey of adults ≥18 years of age that collects information on attitudes and behaviors, including smoking. Frequencies and weighted percentages were calculated by sex, race/ethnicity, age, education level, household income, and smoking status. Unadjusted odds ratios (OR) were used to compare perceptions of menthol cigarette use between demographic groups. RESULTS Close to half of adults (45.8%) believed that menthol cigarettes are just as harmful as nonmenthol cigarettes, and 40.9% of adults did not know whether menthol cigarettes are more or less harmful than nonmenthol cigarettes. Few adults (0.6%), including smokers, perceived menthol cigarettes to be less harmful than nonmenthol cigarettes. Blacks (OR = 3.22, 95% CI = 1.80-5.76) were more likely to believe that menthol cigarettes have health benefits when compared with Whites. Almost half of current smokers believed menthol cigarettes are equally addictive as nonmenthol cigarettes and 74.9% believed menthol and nonmenthol cigarettes are equally hard to quit. CONCLUSIONS Findings suggest directions for targeted public health messages for menthol cigarette use. Future research is needed among a nationally representative sample to capture more subtle differences in perceptions among menthol and nonmenthol smokers.
Collapse
Affiliation(s)
- Shane P Davis
- Epidemiology Branch, Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
| | | | | | | | | |
Collapse
|
40
|
Ahijevych K, Garrett BE. The role of menthol in cigarettes as a reinforcer of smoking behavior. Nicotine Tob Res 2011; 12 Suppl 2:S110-6. [PMID: 21177367 DOI: 10.1093/ntr/ntq203] [Citation(s) in RCA: 98] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION The World Health Organization has identified several additives such as menthol in the manufacturing of cigarettes to specifically reduce smoke harshness. These additives may have important implications for reinforcing smoking behavior and motivation to quit smoking. The purpose of this paper is to synthesize research related to the role of menthol's sensory characteristics in strengthening the reinforcing effects of nicotine in cigarettes and the impact on nicotine addiction and smoking behavior. METHODS Research reports from 2002 to 2010 on the addictive potential of menthol cigarettes were reviewed that included qualitative focus groups, self-reports and biomarkers of nicotine dependence, human laboratory, and epidemiological studies. RESULTS Positive sensory effects of menthol cigarette use were identified via reports of early smoking experiences and as a potential starter product for smoking uptake in youth. Menthol cigarettes may serve as a conditioned stimulus that reinforces the rewarding effects of smoking. Nicotine dependence measured by shorter time-to-first cigarette upon waking was increased with menthol cigarette use in most of the studies reviewed. Smoking quit rates provide additional indicators of nicotine dependence, and the majority of the studies reviewed provided evidence of lower quit rates or higher relapse rates among menthol cigarette smokers. CONCLUSIONS The effects of menthol cigarette use in increasing the reinforcing effects of nicotine on smoking behavior were evidenced in both qualitative and quantitative empirical studies. These findings have implications for enhanced prevention and cessation efforts in menthol smokers.
Collapse
Affiliation(s)
- Karen Ahijevych
- Ohio State University, College of Nursing, Columbus, OH 43210, USA.
| | | |
Collapse
|
41
|
Allen B, Cruz TB, Leonard E, Unger JB. Development and validation of a scale to assess attitudes and beliefs about menthol cigarettes among african american smokers. Eval Health Prof 2011; 33:414-36. [PMID: 21149394 DOI: 10.1177/0163278710383276] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
To develop more effective smoking cessation interventions for the 70% of African American smokers who smoke menthol cigarettes, it is important to understand smokers' reasons for choosing menthols verses nonmenthols. This study conducted a focus group of African American smokers about their attitudes and beliefs about menthol cigarettes. These attitudes and beliefs, along with others from the literature, were included in a survey of 720 African American smokers in Los Angeles County, California. Five common factors emerged-Medicinal Effects, Image, Less Harmful, Tradition, and Taste/Sensation. Menthol smokers had significantly higher scores on the Taste/Sensation, Medicinal Effects, and Less Harmful scales than nonmenthol smokers did. Men were significantly more likely than women to endorse Medicinal Effects, Image, and Tradition, whereas women were significantly more likely to endorse Taste/Sensation. Education was inversely associated with endorsement of Medicinal Effects, Image, Less Harmful, and Tradition. Respondents aged 40 years or older had significantly higher scores on Medicinal Effects, Image, and Less Harmful, compared with younger respondents. Smoking cessation interventions for African American menthol smokers should address commonly held myths that menthols have medicinal effects and are less harmful than nonmenthols, especially among smokers who are older, male, and/or have low levels of education. The new measures presented in this article could be useful for tailoring cessation interventions to individual smokers' attitudes and beliefs about menthol cigarettes.
Collapse
Affiliation(s)
- Bruce Allen
- Charles Drew University of Medicine and Science, Los Angeles, CA 90059, USA.
| | | | | | | |
Collapse
|
42
|
Rock VJ, Davis SP, Thorne SL, Asman KJ, Caraballo RS. Menthol Cigarette Use Among Racial and Ethnic Groups in the United States, 2004-2008. Nicotine Tob Res 2010; 12 Suppl 2:S117-24. [DOI: 10.1093/ntr/ntq204] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
43
|
Hersey JC, Nonnemaker JM, Homsi G. Menthol Cigarettes Contribute to the Appeal and Addiction Potential of Smoking for Youth. Nicotine Tob Res 2010; 12 Suppl 2:S136-46. [DOI: 10.1093/ntr/ntq173] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
|
44
|
Alexander LA, Crawford T, Mendiondo MS. Occupational status, work-site cessation programs and policies and menthol smoking on quitting behaviors of US smokers. Addiction 2010; 105 Suppl 1:95-104. [PMID: 21059140 DOI: 10.1111/j.1360-0443.2010.03227.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM This exploratory study sought to examine the relationships among occupational status, menthol smoking preference and employer-sponsored smoking cessation programs and policies on quitting behaviors. DESIGN Data for this cross-sectional study were obtained from the 2006 Tobacco Use Supplement to the Current Population Survey (TUS CPS), a large national survey representative of the civilian population, containing approximately 240,000 respondents. The total sample for the current study was 30,176. MEASUREMENTS The TUS CPS regularly collects data on cigarette prevalence, quitting behaviors, smoking history and consumption patterns. We performed a logistic regression with 'life-time quitting smoking for 1 day or longer because they were trying to quit' as outcome variable. Independent variables included type of occupation, employer-sponsored cessation programs and policies and menthol status. FINDINGS When controlling for occupational status and work-place policies, there were no differences for menthol versus non-menthol smokers on quitting behaviors [odds ratio (OR) = 0.98; 95% confidence interval (CI) = 0.83, 1.15]. Service workers were less likely to quit compared with white-collar workers (OR = 0.80; 95% CI = 0.69, 0.94), and those with no employer-sponsored cessation program were less likely to quit (OR = 0.70; 95% CI = 0.60, 0.83). White-collar workers, compared with blue-collar and service workers, were more likely to have a smoking policy in the work area (93% versus 86% versus 88%, respectively). CONCLUSIONS When occupational status and work-place smoking policies are controlled for, smokers of menthol cigarettes in the United States appear to have similar self-reported life-time rates of attempts to stop smoking to non-menthol smokers.
Collapse
Affiliation(s)
- Linda A Alexander
- Department of Health Behavior, College of Public Health, University of Kentucky, USA.
| | | | | |
Collapse
|
45
|
Ahijevych K, Ford J. The relationships between menthol cigarette preference and state tobacco control policies on smoking behaviors of young adult smokers in the 2006-07 Tobacco Use Supplements to the Current Population Surveys (TUS CPS). Addiction 2010; 105 Suppl 1:46-54. [PMID: 21059136 DOI: 10.1111/j.1360-0443.2010.03201.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
AIM To examine relationships between the preference for menthol cigarettes and young adult smoking behaviors, including the extent to which state tobacco control policies moderate these relationships. DESIGN Cross-sectional design using secondary data from the 2006-07 Tobacco Use Supplements to the Current Population Surveys (TUS CPS) surveys appended with 2006 state-policy data. SETTING United States nationally representative survey. PARTICIPANTS A total of 2241 young adult daily smokers and 688 young adult non-daily smokers. MEASUREMENTS The two dependent variables of smoking behaviors were smoking first cigarette within 30 minutes of waking (TTF) and number of cigarettes smoked per day (cpd). Primary independent variables included menthol brand preference and state tobacco control policies (youth access laws, clean indoor air laws and cigarette excise taxes), adjusting for controls. FINDINGS Among daily smokers, there were no significant associations between menthol brand preference and TTF or cpd. However, lower educational attainment, not being in the labor force and the lack of home smoking rules were associated positively with shorter TTF, being white and the lack of home smoking rules were associated positively with cpd. Among daily smokers, state excise taxes were associated negatively with higher cpd. Among non-daily smokers, menthol brand preference was associated positively with shorter TTF, but associations did not vary with state tobacco control policies. Menthol brand preference was not associated significantly with cpd, but male gender, unmarried status and the lack of home smoking rules were associated positively with greater cpd among non-daily smokers. CONCLUSIONS Young adult non-daily smokers who preferred menthol cigarettes were significantly more dependent than those who preferred non-menthol cigarettes, as shown through the shorter TTF. Associations between menthol brand preference and smoking behaviors did not vary with state tobacco control policies.
Collapse
Affiliation(s)
- Karen Ahijevych
- The Ohio State University, College of Nursing, Columbus, Ohio 43210, USA.
| | | |
Collapse
|
46
|
Fagan P, Moolchan ET, Hart A, Rose A, Lawrence D, Shavers VL, Gibson JT. Nicotine dependence and quitting behaviors among menthol and non-menthol smokers with similar consumptive patterns. Addiction 2010; 105 Suppl 1:55-74. [PMID: 21059137 DOI: 10.1111/j.1360-0443.2010.03190.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS This study examines the associations between usual cigarette brand (i.e. menthol, non-menthol) and markers for nicotine dependence and quitting behaviors. DESIGN The 2003 and 2006/07 Tobacco Use Supplements to the Current Population Surveys were pooled to conduct secondary data analysis. SETTING National data were collected using in-person and telephone computer-assisted interviews by the United States Census Bureau among civilian, non-institutionalized people aged 15 years and older. PARTICIPANTS Data were analyzed among daily current smokers aged 18+ (n = 46,273). MEASUREMENTS The associations between usual cigarette brand and time to first cigarette within 5 and 30 minutes after waking, quit attempts in the past 12 months and length of smoking abstinence in the past 12 months were examined. Bivariate and multivariate logistic regression models were stratified by smoking intensity: ≤5, 6-10, 11-19 and 20+ cigarettes per day. FINDINGS Menthol smokers reported a mean of 13.05 compared with 15.01 cigarettes per day among non-menthol smokers (P < 0.001). Multivariate results showed that among smokers consuming 6-10 cigarettes per day, menthol smokers were significantly more likely than non-menthol smokers to consume their first cigarette within 5 minutes after waking (odds ratio = 1.22, 95% confidence interval = 1.05,1.43). The multivariate models did not show significant associations between usual cigarette brand and quit attempts in past 12 months or duration of smoking abstinence >2 weeks in the past 12 months. CONCLUSIONS Findings from this national survey of daily smokers demonstrate that menthol smokers in the United States who report consuming 6-10 cigarettes per day show greater signs of nicotine dependence than comparable non-menthol smokers.
Collapse
Affiliation(s)
- Pebbles Fagan
- National Cancer Institute, Tobacco Control Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD 20892-7337, USA.
| | | | | | | | | | | | | |
Collapse
|
47
|
Lawrence D, Rose A, Fagan P, Moolchan ET, Gibson JT, Backinger CL. National patterns and correlates of mentholated cigarette use in the United States. Addiction 2010; 105 Suppl 1:13-31. [PMID: 21059133 DOI: 10.1111/j.1360-0443.2010.03203.x] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM To examine the patterns and correlates of mentholated cigarette smoking among adult smokers in the United States. DESIGN Cross-sectional data on adult current smokers (n = 63,193) were pooled from the 2003 and 2006/07 Tobacco Use Supplements to the Current Population Survey. MEASUREMENTS The associations between socio-demographic and smoking variables were examined with gender- and race/ethnicity-stratified multivariate logistic regression models predicting current use of mentholated cigarettes. FINDINGS Multivariate logistic regression analyses demonstrated that black smokers were 10-11 times more likely to smoke mentholated cigarettes than white smokers men: odds ratio (OR): 11.59, 99% confidence interval (CI): 9.79-13.72; women: OR: 10.12, 99% CI: 8.45-12.11). With the exception of American Indian/Aleut/Eskimo smokers, non-white smokers were significantly more likely to smoke mentholated cigarettes than were white smokers. Additional significant factors associated with mentholated cigarette smoking included being unmarried (never married: OR: 1.21, 99% CI: 1.09-1.34; divorced/separated: OR: 1.13, 99% CI: 1.03-1.23), being born in a US territory (OR: 2.01, 99% CI: 1.35-3.01), living in a non-metropolitan area (OR: 0.87, 99% CI: 0.80-0.96), being unemployed (OR: 1.24, 99% CI: 1.06-1.44) and lower levels of education. Race/ethnicity-stratified analyses showed that women were more likely than men to smoke mentholated cigarettes. Among black smokers, young adults (aged 18-24 years) were four times more likely to smoke mentholated cigarettes compared with individuals aged 65+. CONCLUSIONS Race/ethnicity, gender and age are significant correlates of mentholated cigarette smoking among current smokers. Given the importance of menthol in the cigarette market and the potential untoward health effects of this additive, continued surveillance of the prevalence and correlates of mentholated cigarette use among diverse socio-demographic groups is warranted to inform appropriate interventions.
Collapse
Affiliation(s)
- Deirdre Lawrence
- National Cancer Institute, Tobacco Control Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA.
| | | | | | | | | | | |
Collapse
|
48
|
Unger JB, Allen B, Leonard E, Wenten M, Cruz TB. Menthol and non-menthol cigarette use among Black smokers in Southern California. Nicotine Tob Res 2010; 12:398-407. [PMID: 20167636 DOI: 10.1093/ntr/ntq016] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Menthol cigarette smoking is more prevalent among Blacks than among other groups in the United States. This study examined associations between demographic, psychological, attitudinal, social, and cultural factors and menthol smoking among Black adults. METHODS This study recruited 720 Black smokers from community intercept locations throughout Los Angeles County, California, and surveyed them by telephone. RESULTS Fifty-seven percent of respondents were menthol-only smokers, 15% were regular-only smokers, and 28% smoked both menthols and regular cigarettes (combined smokers). In bivariate models, menthol-only and combined smokers had stronger beliefs in the medicinal effects of menthols relative to regular-only smokers. Menthol-only smokers held stronger beliefs, relative to regular-only smokers, that menthols were less harmful than regular cigarettes. Menthol-only smokers preferred the menthol taste/sensation more than combined smokers, who preferred the menthol taste/sensation more than regular-only smokers. Menthol-only and combined smokers had more menthol smokers in their current social networks compared with regular-only smokers. In multivariate analyses, preference for menthol taste/sensation, belief in medicinal effects of menthols, and menthol smokers in current social network differentiated menthol-only and combined smokers from regular-only smokers, controlling for confounding variables. Correlates of menthol smoking varied across genders and age groups. DISCUSSION Health education efforts are needed to dispel the myth that menthol cigarettes are more medicinal and less harmful than regular cigarettes. Prevention and cessation efforts in Black communities can be tailored to reflect predictors of menthol smoking to reduce tobacco-related morbidity and mortality. In the era of Food and Drug Administration regulation of cigarettes, research is needed to prevent health disparities associated with menthol cigarette smoking.
Collapse
Affiliation(s)
- Jennifer B Unger
- School of Community and Global Health, Claremont Graduate University, 180 E. Via Verde, Suite 100, San Dimas, CA 91773, USA.
| | | | | | | | | |
Collapse
|
49
|
Heck JD. A review and assessment of menthol employed as a cigarette flavoring ingredient. Food Chem Toxicol 2010; 48 Suppl 2:S1-38. [PMID: 20113860 DOI: 10.1016/j.fct.2009.11.002] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2009] [Revised: 10/21/2009] [Accepted: 11/01/2009] [Indexed: 10/19/2022]
Abstract
Cigarette smoking is established as a substantial contributor to risks for cancer, cardiovascular and respiratory diseases. Less is known about the potential of cigarette composition to affect smoking risks. The use of cigarette flavoring ingredients such as menthol is currently of worldwide public health and regulatory interest. The unique conditions of menthol inhalation exposure that occur coincident with that of the complex cigarette smoke aerosol require specialized studies to support an assessment of its safety in cigarette flavoring applications. The present state of knowledge is sufficient to support an assessment of the safety of the use of menthol in cigarettes. Scientific, smoking behavioral and epidemiological data available through mid-2009 is critically reviewed and a broad convergence of findings supports a judgment that menthol employed as a cigarette tobacco flavoring ingredient does not meaningfully affect the inherent toxicity of cigarette smoke or the human risks that attend smoking. There remains a need for well-designed studies of the potential of menthol to affect smoking initiation, cessation and addiction in order to differentiate any independent effects of menthol in cigarettes from those imposed by socioeconomic, environmental and peer influences on these complex human behaviors.
Collapse
Affiliation(s)
- J Daniel Heck
- Scientific Affairs, AW Spears Research Center, Lorillard Tobacco Company, PO Box 21688, Greensboro, NC 27420-1688, USA.
| |
Collapse
|
50
|
Gundersen DA, Delnevo CD, Wackowski O. Exploring the relationship between race/ethnicity, menthol smoking, and cessation, in a nationally representative sample of adults. Prev Med 2009; 49:553-7. [PMID: 19850064 DOI: 10.1016/j.ypmed.2009.10.003] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2009] [Revised: 10/09/2009] [Accepted: 10/09/2009] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To explore the relationship between race/ethnicity, menthol smoking, and cessation in a nationally representative sample of adults. METHODS Data from the 2005 U.S. National Health Interview Survey was analyzed. Our analyses were restricted to 7815 white, black, and Hispanic current and former cigarette smokers who indicated that they do not currently use other tobacco products and have made a quit attempt. We used multiple logistic regressions to test the relationship of menthol smoking and cessation controlling for various factors. RESULTS Significant interaction effects were found indicating that the association between menthol smoking and cessation differs between whites and blacks, and whites and Hispanics. When blacks and Hispanics are collapsed as non-white, we found that non-white menthol smokers were significantly less likely to have quit smoking (adjusted odds ratio=0.55, p<0.01) compared to their non-menthol smoking counterparts. In contrast, among whites, menthol smokers were more likely to be former smokers than nonmenthol smokers (adjusted odds ratio=1.17, p<0.05). CONCLUSION Our findings provide some support for the hypothesis that menthol smoking can lead to poorer cessation outcomes, but only for non-white smokers.
Collapse
Affiliation(s)
- Daniel A Gundersen
- Center for Tobacco Surveillance and Evaluation Research, University of Medicine and Dentistry of New Jersey-School of Public Health, New Brunswick, NJ 08903, USA.
| | | | | |
Collapse
|