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Powers JM, Zale EL, Deyo AG, Rubenstein D, Terry EL, Heckman BW, Ditre JW. Pain and Menthol Use Are Related to Greater Nicotine Dependence Among Black Adults Who Smoke Cigarettes at Wave 5 (2018-2019) of the Population Assessment of Tobacco and Health (PATH) Study. J Racial Ethn Health Disparities 2023; 10:2407-2416. [PMID: 36171497 PMCID: PMC10651305 DOI: 10.1007/s40615-022-01419-y] [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: 07/29/2022] [Revised: 09/19/2022] [Accepted: 09/20/2022] [Indexed: 12/01/2022]
Abstract
Burdens related to pain, smoking/nicotine dependence, and pain-smoking comorbidity disproportionately impact Black Americans, and menthol cigarette use is overrepresented among Black adults who smoke cigarettes. Menthol may increase nicotine exposure, potentially conferring enhanced acute analgesia and driving greater dependence. Therefore, the goal of the current study was to examine associations between pain, menthol cigarette use, and nicotine dependence. Data was drawn from Black adults who were current cigarette smokers (n = 1370) at Wave 5 (2018-2019) of the Population Assessment of Tobacco and Health Study. Nicotine dependence was assessed using the Wisconsin Inventory of Smoking Dependence Motives. ANCOVA revealed that moderate/severe pain (vs. no/low pain) was associated with greater overall nicotine dependence (p < .001) and greater negative reinforcement, cognitive enhancement, and affiliative attachment smoking motives (ps < .001). Menthol smokers with moderate/severe pain also endorsed greater cigarette craving and tolerance, compared to non-menthol smokers with no/low pain (ps < .05). Findings support the notion that among Black individuals who smoke cigarettes, the presence of moderate/severe pain (vs. no/low pain) and menthol use may engender greater physical indices of nicotine dependence relative to non-menthol use. Compared to no/low pain, moderate/severe pain was associated with greater emotional attachment to smoking and greater proclivity to smoke for reducing negative affect and enhancing cognitive function. Clinical implications include the need to address the role of pain and menthol cigarette use in the assessment and treatment of nicotine dependence, particularly among Black adults. These data may help to inform evolving tobacco control policies aimed at regulating or banning menthol tobacco additives.
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Affiliation(s)
- Jessica M Powers
- Department of Psychology, Syracuse University, Syracuse, NY, 13244, USA.
| | - Emily L Zale
- Department of Psychology, Binghamton University, Binghamton, NY, 13902, USA
| | - Alexa G Deyo
- Department of Psychology, Syracuse University, Syracuse, NY, 13244, USA
| | - Dana Rubenstein
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, 27705, USA
| | - Ellen L Terry
- Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, FL, 32610, USA
| | - Bryan W Heckman
- The Center for the Study of Social Determinants of Health, Meharry Medical College, Nashville, TN, USA
- Psychiatry and Behavioral Sciences, School of Medicine, Meharry Medical College, Nashville, TN, USA
- Division of Public Health, School of Graduate Studies and Research, Meharry Medical College, Nashville, TN, USA
| | - Joseph W Ditre
- Department of Psychology, Syracuse University, Syracuse, NY, 13244, USA
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Lee SS, Chang Y, Rigotti NA, Singer DE, Levy DE, Tyndale RF, Davis EM, Freiberg MS, King S, Wells QS, Tindle HA. Can Treatment Support Mitigate Nicotine Metabolism-Based Disparities in Smoking Abstinence? Secondary Analysis of the Helping HAND 4 Trial. Nicotine Tob Res 2023; 25:1575-1584. [PMID: 37209421 PMCID: PMC10439488 DOI: 10.1093/ntr/ntad079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 04/23/2023] [Accepted: 05/17/2023] [Indexed: 05/22/2023]
Abstract
INTRODUCTION The nicotine metabolite ratio (NMR), a biomarker of CYP2A6-mediated nicotine metabolism, predicts the efficacy of nicotine replacement therapy (NRT), with fast metabolizers benefiting less than slow metabolizers. Whether treatment support to optimize NRT use (henceforth "treatment support") modifies this pharmacogenetic relationship is unknown. METHODS Hospitalized adult daily smokers were assigned to one of two post-discharge smoking cessation interventions offering NRT and counseling: (1) Transitional Tobacco Care Management, which delivered enhanced treatment support via free combination NRT at discharge and automated counseling, and (2) a quitline-based approach representing usual care (UC). The primary outcome was biochemically verified 7-day point prevalence abstinence 6 months after discharge. Secondary outcomes were the use of NRT and counseling during the 3-month intervention period. Logistic regression models tested for interactions between NMR and intervention, controlling for sex, race, alcohol use, and BMI. RESULTS Participants (N = 321) were classified as slow (n = 80) or fast (n = 241) metabolizers relative to the first quartile of NMR (0.012-0.219 vs. 0.221-3.455, respectively). Under UC, fast (vs. slow) metabolizers had lower odds of abstinence at 6 months (aOR 0.35, 95% CI 0.13-0.95) and similar odds of NRT and counseling use. Compared to UC, enhanced treatment support increased abstinence (aOR 2.13, 95% CI 0.98-4.64) and use of combination NRT (aOR 4.62, 95% CI 2.57-8.31) in fast metabolizers, while reducing abstinence in slow metabolizers (aOR 0.21, 95% CI 0.05-0.87; NMR-by-intervention interaction p = .004). CONCLUSIONS Treatment support increased abstinence and optimal use of NRT among fast nicotine metabolizers, thereby mitigating the gap in abstinence between fast and slow metabolizers. IMPLICATIONS In this secondary analysis of two smoking cessation interventions for recently hospitalized smokers, fast nicotine metabolizers quit at lower rates than slow metabolizers, but providing fast metabolizers with enhanced treatment support doubled the odds of quitting in this group and mitigated the disparity in abstinence between fast and slow metabolizers. If validated, these findings could lead to personalized approaches to smoking cessation treatment that improve outcomes by targeting treatment support to those who need it most.
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Affiliation(s)
- Scott S Lee
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Yuchiao Chang
- Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Nancy A Rigotti
- Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Daniel E Singer
- Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Douglas E Levy
- Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Rachel F Tyndale
- Departments of Psychiatry, and Pharmacology and Toxicology, University of Toronto and Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Esa M Davis
- Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Matthew S Freiberg
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Stephen King
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Quinn S Wells
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Hilary A Tindle
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
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White AM, Barnes AJ, Garner W. Racial/ethnic differences in the association between menthol cigarette use and mental illness among adults who smoke in the United States. J Ethn Subst Abuse 2023:1-21. [PMID: 37052141 PMCID: PMC10570396 DOI: 10.1080/15332640.2023.2196645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
Data from the National Survey on Drug Use and Health (2012-2018) were used to characterize the association between menthol cigarette use and indicators of Any (AMI) and Serious (SMI) Mental Illness among adults who smoke in the United States. In general, people who smoke menthol cigarettes were more likely to have AMI (aOR = 1.123 [1.063-1.194]) than people who smoke non-menthol cigarettes, but not SMI (aOR = 1.065 [0.966-1.175]). However, among non-Hispanic African American/Black people who smoke, those that used menthol cigarettes had lower adjusted odds of both AMI (aOR = 0.740 [0.572-0.958]) and SMI (aOR = 0.592 [0.390-0.899]) than their counterparts who used non-menthol cigarettes. Results suggest there may be race/ethnicity-specific drivers of the association between menthol cigarette use and mental illness.
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Affiliation(s)
- Augustus M. White
- Department of Health Behavior and Policy, Virginia
Commonwealth University, 830 E. Main St., 9 Floor, Richmond, VA, 23219
USA
- Center for the Study of Tobacco Products, Virginia
Commonwealth University, 100 W. Franklin St., Suite 200, Richmond, VA, 23220
USA
| | - Andrew J. Barnes
- Department of Health Behavior and Policy, Virginia
Commonwealth University, 830 E. Main St., 9 Floor, Richmond, VA, 23219
USA
- Center for the Study of Tobacco Products, Virginia
Commonwealth University, 100 W. Franklin St., Suite 200, Richmond, VA, 23220
USA
| | - William Garner
- Department of Public Health, University of North Texas at
Dallas, 7300 University Hills Boulevard, Dallas, TX 75241, USA
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Arens Y, Bilker WB, Han X, Plankey M, Ware D, Friedman MR, D'Souza G, Stosor V, Shoptaw S, Schnoll RA, Tyndale RF, Ashare R, Gross R. Brief Report: HIV Infection Does Not Explain Higher Nicotine Metabolism in People Living With HIV. J Acquir Immune Defic Syndr 2022; 91:497-501. [PMID: 36083509 PMCID: PMC9649853 DOI: 10.1097/qai.0000000000003089] [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: 06/14/2022] [Accepted: 08/29/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Smoking contributes to significant morbidity and mortality in people with HIV. People with HIV have relatively high nicotine metabolism rates, as measured by the nicotine metabolite ratio (NMR, 3-hydroxycotinine/cotinine). A higher NMR is associated with difficulty quitting smoking. We hypothesized that HIV infection might upregulate nicotine metabolism. SETTING A retrospective study of male current smokers in the Multicenter AIDS Cohort Study who HIV seroconverted between 1985 and 1993. METHODS Eligibility included having plasma stored before and after confirmed HIV seroconversion and current tobacco use. Samples were selected from the closest available visits before (median 3.3 months) and after (median 9.4 months) seroconversion. Antiretroviral therapy use was exclusionary. Cotinine and 3-hydroxycotinine were measured using liquid chromatography-tandem mass spectrometry. We compared NMR from plasma pre-HIV and post-HIV infection using signed-rank tests. We targeted a sample size of 71 pairs to achieve 80% power to detect a 0.1 unit increase in NMR with P = 0.05. RESULTS We analyzed paired samples from 78 participants; the median age was 34.5 years [interquartile range (IQR 29-40 years)]. The median NMR pre-HIV and post-HIV was 0.45 (IQR 0.32-0.54) and 0.46 (IQR 0.34-0.56), respectively. The median change in NMR postseroconversion was +0.01 (IQR -0.05, +0.09), P = 0.25. Stratification of median change in NMR by timing between samples or time since HIV seroconversion did not alter this finding. CONCLUSIONS Acquiring HIV had no measurable effect on NMR. We postulate that upregulation of the NMR may be due to direct pharmacologic effects of HIV medications or metabolic changes in response to HIV infection.
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Affiliation(s)
- Yotam Arens
- Division of Infectious Diseases, Departments of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Warren B Bilker
- Departments of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Xiaoyan Han
- Departments of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Michael Plankey
- Department of Medicine, Division of General Internal Medicine, Georgetown University Medical Center, Washington, DC
| | - Deanna Ware
- Department of Medicine, Division of General Internal Medicine, Georgetown University Medical Center, Washington, DC
| | - M Reuel Friedman
- Department of Infectious Diseases and Microbiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Gypsyamber D'Souza
- Department of Epidemology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Valentina Stosor
- Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Steven Shoptaw
- Department of Family Medicine, University of California, Los Angeles, CA
| | - Robert A Schnoll
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
- Abramson Cancer Center, Penn Medicine, Philadelphia, PA
| | - Rachel F Tyndale
- Departments of Pharmacology and Toxicology, and Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Rebecca Ashare
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
- Department of Psychology, State University of New York at Buffalo, Buffalo, NY; and
| | - Robert Gross
- Division of Infectious Diseases, Departments of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
- Departments of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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Guo Y, Li S, Wang Z, Jiang F, Guan Y, Huang M, Zhong G. Nicotine Delivery and Pharmacokinetics of an Electronic Cigarette Compared With Conventional Cigarettes in Chinese Adult Smokers: A Randomized Open-Label Crossover Clinical Study. NICOTINE & TOBACCO RESEARCH : OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON NICOTINE AND TOBACCO 2022; 24:1881-1888. [PMID: 35690060 DOI: 10.1093/ntr/ntac143] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 05/10/2022] [Accepted: 06/10/2022] [Indexed: 01/03/2023]
Abstract
INTRODUCTION To evaluate the nicotine pharmacokinetics of a commercial electronic cigarette (e-cigarette) relative to conventional cigarettes in Chinese adult smokers. AIMS AND METHODS A randomized, open-label, crossover clinical study was conducted on 23 healthy adult Chinese smokers. In two sessions, subjects used either the e-cigarettes with 30 mg/g nicotine in e-liquid or conventional cigarettes of a given brand, at one puff every 30 seconds for a total of 10 puffs. Blood samples were collected at specified time points for 4 hours after the first puff. Subjective effects on desire-to-smoke and physiological parameters such as heart rate and oxyhemoglobin saturation levels were also examined before and after using the two products. RESULTS The baseline-adjusted maximum nicotine concentration (Cmax-BL), time-to-peak nicotine concentration (Tmax), and nicotine absorption rate (Cmax-BL divided by Tmax) were found to be similar for the e-cigarette versus those of conventional cigarettes (p > .05). Total nicotine exposure measured as the area-under-curve (AUC0-t-BL) was significantly lower for the e-cigarette relative to that of conventional cigarettes. In addition, the subjects found that e-cigarettes were well tolerated under controlled puffing conditions. CONCLUSIONS The test e-cigarettes achieved similar nicotine delivery and pharmacokinetic profiles to those of the comparator cigarettes, indicating that this e-cigarette could be a potential alternative to conventional cigarettes for those adult smokers. IMPLICATIONS There are no data in the published literature on the nicotine pharmacokinetics of e-cigarettes in Chinese smokers. To the best of our knowledge, this is the first study to evaluate the nicotine delivery and pharmacokinetic profile of a commercial e-cigarette brand compared with conventional cigarettes in Chinese adult smokers. After the use of test e-cigarettes, nicotine delivery and pharmacokinetic profile were similar to those of conventional cigarettes in Chinese adult smokers.
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Affiliation(s)
- Yi Guo
- Institute of Clinical Pharmacology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Shoufeng Li
- Institute of Clinical Pharmacology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Zhi Wang
- Institute of Clinical Pharmacology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, Guangdong, China.,Clinical Trial Center of Dongguan KangHua Hospital, Dongguan, Guangdong, China
| | - Fulin Jiang
- Institute of Clinical Pharmacology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yanping Guan
- Institute of Clinical Pharmacology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Min Huang
- Institute of Clinical Pharmacology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Guoping Zhong
- Institute of Clinical Pharmacology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, Guangdong, China.,Clinical Trial Center of Dongguan KangHua Hospital, Dongguan, Guangdong, China
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Jao NC, Gueorguieva R, Hitsman B, Sofuoglu M. Acute effects of inhaled menthol on cognitive effects of intravenous nicotine among young adult cigarette smokers. Addict Behav 2021; 122:107022. [PMID: 34174551 DOI: 10.1016/j.addbeh.2021.107022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 06/15/2021] [Accepted: 06/16/2021] [Indexed: 12/14/2022]
Abstract
Basic science studies indicate that menthol can enhance the cognitive effects of nicotine to increase nicotine dependence; however, the effect of menthol and nicotine on cognitive functioning among humans has been understudied. This double-blind, placebo-controlled study examined the dose-dependent effects of inhaled menthol flavoring and intravenous nicotine on cognitive task performance. Twenty menthol (MS) and 18 non-menthol (NMS) cigarette preferring, young-adult smokers (21% female; 7.9% Hispanic, 44.7% Non-Hispanic/White, 47.4% Non-Hispanic/Black) completed three sessions with randomized order of menthol flavoring (between-sessions: 0.0%/tobacco control, 0.5%/low, 3.2%/high) and intravenous nicotine (within-session: 0.0 mg/saline control, 0.25 mg/low, 0.5 mg/high). After each administration, participants completed three cognitive tasks: Continuous Performance Task (CPT), Mathematical Processing Task (MPT), and Stroop Task. Mixed effects models were used to examine interactive effects of cigarette type preference and menthol and nicotine doses. MS vs. NMS had decreased accuracy on CPT and MPT and efficiency during Stroop. No significant effects of cigarette type preference by menthol or nicotine were found for any task. Significant effects of nicotine by menthol were found during Stroop, where participants had greater accuracy for high nicotine compared to saline during the low menthol session. Significant effects of menthol by timepoint were seen during Stroop, where participants improved across timepoints during the low menthol session. Findings did not support significant effects of inhaled menthol, alone or with nicotine, on cognitive performance. Further research clarifying the impact of varying menthol and nicotine levels in nicotine products may help to elucidate menthol's role in smoking sustainment.
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Nicotine self-administration with menthol and audiovisual cue facilitates differential packaging of CYP2A6 and cytokines/chemokines in rat plasma extracellular vesicles. Sci Rep 2021; 11:17393. [PMID: 34462474 PMCID: PMC8405708 DOI: 10.1038/s41598-021-96807-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 08/10/2021] [Indexed: 11/16/2022] Open
Abstract
In this study, we investigated whether intravenously self-administered nicotine with menthol and audiovisual cue modulates nicotine-metabolizing CYP2A6, oxidative stress modulators, and cytokines/chemokines in plasma extracellular vesicles (EVs) in rats. We assigned rats to self-administered nicotine with: (a) audiovisual cue (AV), (b) menthol, and (c) menthol and AV cue. We found increased levels of CD9 in plasma EVs after self-administered nicotine with menthol and AV cue. Moreover, expression of CYP2A6 in plasma EVs was significantly increased after self-administered nicotine in response to menthol and AV cue. However, despite an upward trend on SOD1 and catalase, increase was not found to be statistically significant, while total antioxidant capacity was found to be significantly increased in plasma and plasma EVs obtained after self-administered nicotine with menthol and AV cue. Among cytokine and chemokine profiling, we found a significant increase in the levels of MCP-1 after self-administered nicotine with menthol and AV cue and complete packaging of IL-1β in EVs. Taken together, the study provides evidence that nicotine in response to menthol and AV cues can package altered levels of CYP2A6, and cytokines/chemokines in plasma EVs that may contribute to cell–cell communication, nicotine metabolism, and inflammation upon cigarette smoking.
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Bracken-Clarke D, Kapoor D, Baird AM, Buchanan PJ, Gately K, Cuffe S, Finn SP. Vaping and lung cancer - A review of current data and recommendations. Lung Cancer 2021; 153:11-20. [PMID: 33429159 DOI: 10.1016/j.lungcan.2020.12.030] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 12/15/2020] [Accepted: 12/19/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Lung cancer is the most common cause of cancer mortality worldwide and, while tobacco smoke remains the primary cause, there is increasing concern that vaping and E-cigarette use may also increase lung cancer risk. This review concentrates on the current data, scholarship and active foci of research regarding potential cancer risk and oncogenic mechanisms of vaping and lung cancer. MATERIALS AND METHODS We performed a literature review of current and historical publications on lung cancer oncogenesis, vaping device/e-liquid contents and daughter products, molecular oncogenic mechanisms and the fundamental, potentially oncogenic, effects of electronic cigarette smoke/e-liquid products. RESULTS E-cigarette devices and vaping fluids demonstrably contain a series of both definite and probable oncogens including nicotine derivatives (e.g. nitrosnornicotine, nitrosamine ketone), polycyclic aromatic hydrocarbons, heavy metals (including organometal compounds) and aldehydes/other complex organic compounds. These arise both as constituents of the e-liquid (with many aldehydes and other complex organics used as flavourings) and as a result of pyrolysis/complex organic reactions in the electronic cigarette device (including unequivocal carcinogens such as formaldehyde - formed from pyrolysis of glycerol). Various studies demonstrate in vitro transforming and cytotoxic activity of these derivatives. E-cigarette device use has been significantly increasing - particularly amongst the younger cohort and non-smokers; thus, this is an area of significant concern for the future. CONCLUSION Although research remains somewhat equivocal, there is clear reason for concern regarding the potential oncogenicity of E-Cigarettes/E-Liquids with a strong basic and molecular science basis. Given lag times (extrapolating from tobacco smoke data) of perhaps 20 years, this may have significant future public health implications. Thus, the authors feel further study in this field is strongly warranted and consideration should be made for tighter control and regulation of these products.
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Affiliation(s)
| | - Dhruv Kapoor
- Department of Medical Oncology, St James' Hospital, Dublin, Ireland
| | - Anne Marie Baird
- School of Medicine, Trinity Translational Medicine Institute, Trinity College Dublin, Ireland
| | - Paul James Buchanan
- DCU Cancer Research, Faculty of Science and Health, Dublin City University, Dublin, Ireland; National Institute of Cellular Biotechnology, Dublin City University, Dublin, Ireland
| | - Kathy Gately
- Department of Clinical Medicine, Trinity College School of Medicine and St James's Hospital, Dublin, Ireland
| | - Sinead Cuffe
- Department of Medical Oncology, St James' Hospital, Dublin, Ireland
| | - Stephen P Finn
- Department of Pathology, St James' Hospital and Trinity College School of Medicine, Dublin, Ireland
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Bagdas D, Jackson A, Carper M, Chen RYT, Akinola LS, Damaj MI. Impact of menthol on nicotine intake and preference in mice: Concentration, sex, and age differences. Neuropharmacology 2020; 179:108274. [PMID: 32827516 DOI: 10.1016/j.neuropharm.2020.108274] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 08/09/2020] [Accepted: 08/11/2020] [Indexed: 12/13/2022]
Abstract
Menthol has been shown to contribute to the appeal of tobacco products in humans. However, factors such as sex, age and menthol concentration remain unclear in the interaction between menthol and nicotine. To understand these factors, we utilized a mouse model to determine the impact of menthol on oral nicotine consumption. A range of menthol concentrations (oral and systemic) were tested with or without oral nicotine using the two-bottle choice paradigm in adolescent and adult female and male C57BL/6J mice. Moreover, genetically modified mice were used to investigate the role of α7 nicotinic acetylcholine receptors (nAChRs) on the effects of menthol. Menthol addition to nicotine solution increased oral nicotine consumption in C57BL/6J mice in a sex- and menthol concentration-dependent manner. At lower menthol concentrations, female mice demonstrated an enhancement of nicotine consumption and male mice showed a similar behavior at higher menthol concentrations. Menthol drinking alone was only significantly different by sex at 60 μg/ml menthol concentration where female mice had higher menthol intake than males. Menthol administered both orally and systemically (intraperitoneal) increased oral nicotine consumption. Adolescent female mice had a higher nicotine intake at lower menthol concentrations compared to their adult counterparts. While α7 nAChR wild type mice consumed more mentholated nicotine solution than nicotine only solution, this effect was abolished in KO mice. Effects of menthol are concentration-, sex-, age-, and α7 nAChR-dependent. Oral and intraperitoneal menthol increases nicotine intake, suggesting that sensory, peripheral, and/or central mechanisms are involved in effects of menthol on oral nicotine consumption.
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Affiliation(s)
- Deniz Bagdas
- Department of Psychiatry, School of Medicine, Yale University, New Haven, CT, USA; Yale Tobacco Center of Regulatory Science, Yale University, New Haven, CT, USA; The Center for the Study for Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA.
| | - Asti Jackson
- Department of Psychiatry, School of Medicine, Yale University, New Haven, CT, USA; Yale Tobacco Center of Regulatory Science, Yale University, New Haven, CT, USA
| | - Moriah Carper
- Department of Pharmacology and Toxicology, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA, USA
| | - Rita Yu-Tzu Chen
- Department of Pharmacology and Toxicology, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA, USA
| | - Lois S Akinola
- Department of Pharmacology and Toxicology, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA, USA
| | - M Imad Damaj
- Department of Pharmacology and Toxicology, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA, USA; The Center for the Study for Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA
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Kopa PN, Pawliczak R. Menthol additives to tobacco products. Reasons for withdrawing mentholated cigarettes in European Union on 20th may 2020 according to tobacco products directive (2014/40/EU). Toxicol Mech Methods 2020; 30:555-561. [PMID: 32746758 DOI: 10.1080/15376516.2020.1805662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Menthol, which is a natural cyclic monoterpene alcohol with a minty smell, is one of the main constituents of essential oils that naturally occur in some aromatic plants, such as Mentha × piperita L. This natural compound shows many biological properties, such as anesthetic, analgesic, antibacterial and antifungal, immunomodulating, and skin penetration-enhancing. It is added to a variety of goods, such as food, oral-care products, OTC products, cosmetics, and tobacco products. Menthol is not just a simple flavoring agent, especially when it comes to tobacco products. Its ability to 'mask' the negative effects of nicotine and its additional positive sensory effects makes it the most common additive in such products. For the customers, mentholated tobacco products may be mistakenly perceived as less harmful for health, which may increase their consumption. However, as the evidence shows, menthol cigarettes are no safer than conventional cigarettes and may lead to more frequent disease exacerbation during prolonged exposure to smoke from such products. In addition, because of its complex interactions with nicotine, menthol may affect smoking behavior and may increase addiction to nicotine. For those reasons, the European Union banned flavored cigarettes (whose sale size reached more than 3% of the total tobacco product market) by implementing the Tobacco Products Directive (2014/40/EU) on 20th May 2020. While the menthol ban was based on health concerns, the ultimate effect on consumers, regarding potential quitting, is yet to be determined.
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Affiliation(s)
- Paulina Natalia Kopa
- Faculty of Medicine, Department of Immunopathology, Division of Biomedical Science, Medical University of Lodz, Lodz, Poland
| | - Rafał Pawliczak
- Faculty of Medicine, Department of Immunopathology, Division of Biomedical Science, Medical University of Lodz, Lodz, Poland
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11
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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.
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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.
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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.
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Fowler CD, Gipson CD, Kleykamp BA, Rupprecht LE, Harrell PT, Rees VW, Gould TJ, Oliver J, Bagdas D, Damaj MI, Schmidt HD, Duncan A, De Biasi M. Basic Science and Public Policy: Informed Regulation for Nicotine and Tobacco Products. Nicotine Tob Res 2019; 20:789-799. [PMID: 29065200 DOI: 10.1093/ntr/ntx175] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 08/01/2017] [Indexed: 12/25/2022]
Abstract
Introduction Scientific discoveries over the past few decades have provided significant insight into the abuse liability and negative health consequences associated with tobacco and nicotine-containing products. While many of these advances have led to the development of policies and laws that regulate access to and formulations of these products, further research is critical to guide future regulatory efforts, especially as novel nicotine-containing products are introduced and selectively marketed to vulnerable populations. Discussion In this narrative review, we provide an overview of the scientific findings that have impacted regulatory policy and discuss considerations for further translation of science into policy decisions. We propose that open, bidirectional communication between scientists and policy makers is essential to develop transformative preventive- and intervention-focused policies and programs to reduce appeal, abuse liability, and toxicity of the products. Conclusions Through these types of interactions, collaborative efforts to inform and modify policy have the potential to significantly decrease the use of tobacco and alternative nicotine products and thus enhance health outcomes for individuals. Implications This work addresses current topics in the nicotine and tobacco research field to emphasize the importance of basic science research and provide examples of how it can be utilized to inform public policy. In addition to relaying current thoughts on the topic from experts in the field, the article encourages continued efforts and communication between basic scientists and policy officials.
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Affiliation(s)
- Christie D Fowler
- Department of Neurobiology and Behavior, University of California Irvine, Irvine, CA
| | | | | | - Laura E Rupprecht
- Center for Neuroscience at the University of Pittsburgh, Pittsburgh, PA
| | - Paul T Harrell
- Division of Community Health & Research, Department of Pediatrics, Eastern Virginia Medical School, Norfolk, VA
| | - Vaughan W Rees
- Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Thomas J Gould
- Department of Biobehavioral Health, Pennsylvania State University, University Park, PA
| | - Jason Oliver
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC
| | - Deniz Bagdas
- Department of Pharmacology and Toxicology, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA
| | - M Imad Damaj
- Department of Pharmacology and Toxicology, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA
| | - Heath D Schmidt
- Department of Biobehavioral Health Sciences, School of Nursing, University of Pennsylvania, Philadelphia, PA
| | - Alexander Duncan
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Mariella De Biasi
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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Ahijevych K, Szalacha LA, Tan A. Effects of Menthol Flavor Cigarettes or Total Urinary Menthol on Biomarkers of Nicotine and Carcinogenic Exposure and Behavioral Measures. Nicotine Tob Res 2019; 21:1189-1197. [PMID: 30137555 PMCID: PMC6698947 DOI: 10.1093/ntr/nty170] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 08/19/2018] [Indexed: 01/08/2023]
Abstract
INTRODUCTION The effects of either menthol flavor cigarettes or total urinary menthol on nicotine dependence, biomarkers of addictive and carcinogenic exposure, and behavioral measures may inform differences and similarities of these two approaches. METHODS Stratified recruitment by cigarette (menthol flavor or regular) and race (African American and white) yielded a balanced sample of 136 adult smokers in a 36-hour inpatient protocol. Exposure measures assessed during 24-hour data collection included urinary menthol, total NNAL [4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol], 10 polycyclic aromatic hydrocarbon metabolites, baseline plasma cotinine, plasma nicotine pre- and post-smoking, exhaled carbon monoxide pre- and post-smoking, and cigarette puff volumes. The latter three were measured at four specified timepoints throughout the day. RESULTS There were no significant differences between menthol flavor and regular cigarette smokers in measures of nicotine dependence, biomarkers of addictive and carcinogenic exposures, or behavioral measures. Significant race × cigarette type interaction effects were found for two biomarkers: plasma nicotine and 3-hydroxyphenanthrene. Total urinary menthol was significantly associated with higher levels of nearly all dependent variables including puff volume, exhaled carbon monoxide, plasma nicotine and cotinine, NNAL, and polycyclic aromatic hydrocarbons. The significant effects of total urinary menthol were sustained after adjusting for menthol flavor and regular cigarette type and other covariates (eg, number of cigarettes per day, baseline cotinine, and baseline nicotine). CONCLUSIONS Urinary menthol is an independent predictive biomarker for nicotine dependence, addictive and carcinogenic exposure, and behaviors. IMPLICATIONS Comparison of the effects of menthol flavor and total urinary menthol on nicotine dependence, biomarkers of addictive and carcinogenic exposure, and behavioral measures emphasizes the important significant contribution of total urinary menthol concentrations in contrast to no significant associations by dichotomous cigarette type with these biomarkers.
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Affiliation(s)
| | - Laura A Szalacha
- USF Health Morsani College of Medicine and College of Nursing, University of South Florida, Tampa, FL
| | - Alai Tan
- Ohio State University, Columbus, OH
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Nesil T, Narmeen S, Bakhti-Suroosh A, Lynch WJ. Effect of menthol on nicotine intake and relapse vulnerability in a rat model of concurrent intravenous menthol/nicotine self-administration. Psychopharmacology (Berl) 2019; 236:1219-1232. [PMID: 30483833 PMCID: PMC6536373 DOI: 10.1007/s00213-018-5128-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Accepted: 11/19/2018] [Indexed: 11/30/2022]
Abstract
RATIONALE Epidemiological data suggest that menthol may increase vulnerability to cigarette/nicotine use and relapse. While menthol's sensory properties are often attributed as the underlying cause of the enhanced vulnerability, an alternative possibility is that they are mediated via pharmacological interactions with nicotine. OBJECTIVE This study addressed the possibility that menthol enhances nicotine intake and relapse vulnerability via pharmacological interactions with nicotine using a concurrent intravenous menthol/nicotine self-administration procedure. METHODS Following acquisition, adolescent rats were given 23-h/day access to nicotine (0.01 mg/kg/infusion), nicotine plus menthol (0.16, 0.32, or 0.64 mg/kg/infusion), or menthol alone (0.16, 0.32, 0.64 mg/kg/infusion) for a total of 10 days. Nicotine-seeking was assessed using an extinction/cue-induced reinstatement procedure following 10 days of forced abstinence. We also assessed the effect of menthol (0.32 mg/kg/infusion) on progressive ratio responding for nicotine (0.01 mg/kg/infusion). RESULTS Menthol decreased PR responding for nicotine but did not affect self-administration under extended access conditions. The low dose of menthol tended to decrease subsequent extinction responding, and was not different from menthol alone, whereas the high dose decreased reinstatement responding. Although not significant, the highest levels of extinction responding were observed in a minority of rats in the moderate and high menthol-nicotine groups; rats in these groups also took longer to extinguish. CONCLUSIONS Taken together, these results demonstrate that pharmacological interactions of menthol with nicotine reduce, rather than increase, nicotine's reinforcing effects and some measures of relapse vulnerability. Importantly, however, moderate and high menthol doses may increase some aspects of relapse vulnerability in a minority of individuals.
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MESH Headings
- Animals
- Behavior, Addictive/chemically induced
- Behavior, Addictive/psychology
- Behavior, Animal/drug effects
- Behavior, Animal/physiology
- Conditioning, Operant/drug effects
- Conditioning, Operant/physiology
- Extinction, Psychological/drug effects
- Extinction, Psychological/physiology
- Infusions, Intravenous
- Male
- Menthol/administration & dosage
- Menthol/toxicity
- Nicotine/administration & dosage
- Nicotine/toxicity
- Nicotinic Agonists/administration & dosage
- Nicotinic Agonists/toxicity
- Rats
- Rats, Sprague-Dawley
- Recurrence
- Reinforcement, Psychology
- Self Administration
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Affiliation(s)
- Tanseli Nesil
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA, 22902, USA
| | - Syeda Narmeen
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA, 22902, USA
| | - Anousheh Bakhti-Suroosh
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA, 22902, USA
| | - Wendy J Lynch
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA, 22902, USA.
- Department of Psychiatry and Neurobehavioral Sciences, PO Box 801402, Charlottesville, VA, 22904, USA.
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16
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Ryan BM. Lung cancer health disparities. Carcinogenesis 2019; 39:741-751. [PMID: 29547922 DOI: 10.1093/carcin/bgy047] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 03/13/2018] [Indexed: 12/16/2022] Open
Abstract
Compared with all other racial and ethnic groups in the United States, African Americans are disproportionally affected by lung cancer, both in terms of incidence and survival. It is likely that smoking, as the main etiological factor associated with lung cancer, contributes to these disparities, but the precise mechanism is still unclear. This paper seeks to explore the history of lung cancer disparities and review to the literature regarding the various factors that contribute to them.
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Affiliation(s)
- Bríd M Ryan
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
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17
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Fowler CD, Turner JR, Imad Damaj M. Molecular Mechanisms Associated with Nicotine Pharmacology and Dependence. Handb Exp Pharmacol 2019; 258:373-393. [PMID: 31267166 DOI: 10.1007/164_2019_252] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Tobacco dependence is a leading cause of preventable disease and death worldwide. Nicotine, the main psychoactive component in tobacco cigarettes, has also been garnering increased popularity in its vaporized form, as derived from e-cigarette devices. Thus, an understanding of the molecular mechanisms underlying nicotine pharmacology and dependence is required to ascertain novel approaches to treat drug dependence. In this chapter, we review the field's current understanding of nicotine's actions in the brain, the neurocircuitry underlying drug dependence, factors that modulate the function of nicotinic acetylcholine receptors, and the role of specific genes in mitigating the vulnerability to develop nicotine dependence. In addition to nicotine's direct actions in the brain, other constituents in nicotine and tobacco products have also been found to alter drug use, and thus, evidence is provided to highlight this issue. Finally, currently available pharmacotherapeutic strategies are discussed, along with an outlook for future therapeutic directions to achieve to the goal of long-term nicotine cessation.
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Affiliation(s)
- Christie D Fowler
- Department of Neurobiology and Behavior, University of California Irvine, Irvine, CA, USA
| | - Jill R Turner
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Kentucky, Lexington, KY, USA
| | - M Imad Damaj
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA, USA. .,Translational Research Initiative for Pain and Neuropathy at VCU, Richmond, VA, USA.
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Valentine GW, DeVito EE, Jatlow PI, Gueorguieva R, Sofuoglu M. Acute effects of inhaled menthol on the rewarding effects of intravenous nicotine in smokers. J Psychopharmacol 2018; 32:986-994. [PMID: 29788802 PMCID: PMC6329876 DOI: 10.1177/0269881118773972] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE This double-blind, placebo controlled study examined whether menthol inhaled from an electronic cigarette (e-cigarette) would change subjective and withdrawal alleviating effects of intravenous nicotine in young adult smokers. METHODS A total of 32 menthol-preferring smokers and 25 non-menthol-preferring smokers participated in the study that consisted of a random sequence of three different inhaled menthol conditions (0.0%, 0.5%, and 3.2%) across three test sessions (a single menthol condition per session). In each test session (performed at least 24 hours apart), a random order of saline, and two different nicotine infusions of 0.25 mg and 0.5 mg/70 kg of bodyweight were administered, one hour apart, concurrent with menthol inhalation. RESULTS While menthol did not alter the positive subjective effects of nicotine, menthol significantly enhanced aversive effects of nicotine in non-menthol-preferring smokers and reduced smoking urges in menthol-preferring smokers. In addition, menthol-preferring smokers reported blunted positive subjective responses to nicotine and less severe nicotine withdrawal after overnight nicotine deprivation. Finally, compared to non-menthol-preferring smokers, menthol-preferring smokers had a significantly lower baseline nicotine metabolite ratio indicating slower nicotine metabolism within our sample of menthol-preferring smokers. CONCLUSIONS Our findings did not support an enhancement of nicotine's positive subjective effects from inhaled menthol. However, as compared to non-menthol-preferring smokers, menthol-preferring smokers had blunted positive subjective responses to nicotine and reduced overnight withdrawal severity that may be partly due to inhibition of nicotine metabolism from chronic exposure to inhaled menthol. Collectively, these results reveal a more complex and nuanced role of inhaled menthol in smokers than previously recognized.
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Affiliation(s)
- Gerald W Valentine
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA,VA Connecticut Healthcare System, West Haven, CT, USA
| | - Elise E DeVito
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA,VA Connecticut Healthcare System, West Haven, CT, USA
| | - Peter I Jatlow
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA,Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT USA
| | - Ralitza Gueorguieva
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
| | - Mehmet Sofuoglu
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA,VA Connecticut Healthcare System, West Haven, CT, USA
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Soeroso NN, Zain-Hamid R, Sinaga BYM, Sadewa AH, Syafiuddin T, Syahruddin E, Tann G, Mutiara E. Genetic Polymorphism of CYP2A6 and Its Relationship with Nicotine Metabolism in Male Bataknese Smokers Suffered from Lung Cancer in Indonesia. Open Access Maced J Med Sci 2018; 6:1199-1205. [PMID: 30087722 PMCID: PMC6062282 DOI: 10.3889/oamjms.2018.259] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 05/22/2018] [Accepted: 05/25/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Cytochrome P450 2A6 (CYP2A6) is known as an enzyme which is responsible for the metabolism of chemical compounds. AIM This study aimed to analyse the relationship between CYP2A6 gene polymorphism with nicotine metabolism rates and lung cancer incidence among smokers of Batak ethnic group in Indonesia. METHODS This study was a case-control study involving 140 research subjects through a purposive sampling technique from three hospitals in Medan, Indonesia. An examination of nicotine metabolism rates was conducted for all subjects using the 3HC/cotinine ratio parameter with LC-MS/MS technique. The examination of the CYP2A6 gene was performed with PCR-RFLP. Data were analysed with Conditional Logistic Regression test using Epi Info 7.0 software. RESULTS The allele frequencies of CYP2A6*1A, CYP2A6*1B, and CYP2A6*4A found were 44.3%, 48.9%, and 6.8%, respectively. The *1B allele showed the highest metabolism rate. It is found that slow metabolizer individuals were 5.49 times more likely to develop lung cancer (P = 0.01, 95%CI 1.2-24.8). CONCLUSION Among the Bataknese smokers studied, the CYP2A6*1B allele was found to be the most common allele and showed the highest rate of nicotine metabolism. However, the results show the insignificant relationship among CYP2A6 genetic polymorphism, nicotine metabolism, and lung cancer incidence.
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Affiliation(s)
- Noni Novisari Soeroso
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, University of Sumatera Utara, Jl. Dr Mansyur No.5 Medan 20155, Indonesia
| | - Rozaimah Zain-Hamid
- Department of Pharmacology and Therapeutics, Faculty of Medicine, University of Sumatera Utara, Jl. Dr Mansyur No.5 Medan 20155, Indonesia
| | - Bintang Y M Sinaga
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, University of Sumatera Utara, Jl. Dr Mansyur No.5 Medan 20155, Indonesia
| | - Ahmad Hamim Sadewa
- Department of Biochemistry, Faculty of Medicine, Gadjah Mada University, Jl. Farmako Sekip Utara, Yogyakarta 55281, Indonesia
| | - Tamsil Syafiuddin
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, University of Sumatera Utara, Jl. Dr Mansyur No.5 Medan 20155, Indonesia
| | - Elisna Syahruddin
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, University of Indonesia, Jl. Persahabatan Raya No.1, Jakarta 13230, Indonesia
| | - Gino Tann
- Department of Clinical Pathology, Faculty of Medicine, University of Sumatera Utara, Jl. Dr Mansyur No.5 Medan 20155, Indonesia
| | - Erna Mutiara
- Department of Biostatistics, Faculty of Public Health, University of Sumatera Utara, Jl. Dr Mansyur No.5 Medan 20155, Indonesia
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Thompson MF, Poirier GL, Dávila-García MI, Huang W, Tam K, Robidoux M, Dubuke ML, Shaffer SA, Colon-Perez L, Febo M, DiFranza JR, King JA. Menthol enhances nicotine-induced locomotor sensitization and in vivo functional connectivity in adolescence. J Psychopharmacol 2018; 32:332-343. [PMID: 28747086 DOI: 10.1177/0269881117719265] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Mentholated cigarettes capture a quarter of the US market, and are disproportionately smoked by adolescents. Menthol allosterically modulates nicotinic acetylcholine receptor function, but its effects on the brain and nicotine addiction are unclear. To determine if menthol is psychoactive, we assessed locomotor sensitization and brain functional connectivity. Adolescent male Sprague Dawley rats were administered nicotine (0.4 mg/kg) daily with or without menthol (0.05 mg/kg or 5.38 mg/kg) for nine days. Following each injection, distance traveled in an open field was recorded. One day after the sensitization experiment, functional connectivity was assessed in awake animals before and after drug administration using magnetic resonance imaging. Menthol (5.38 mg/kg) augmented nicotine-induced locomotor sensitization. Functional connectivity was compared in animals that had received nicotine with or without the 5.38 mg/kg dosage of menthol. Twenty-four hours into withdrawal after the last drug administration, increased functional connectivity was observed for ventral tegmental area and retrosplenial cortex with nicotine+menthol compared to nicotine-only exposure. Upon drug re-administration, the nicotine-only, but not the menthol groups, exhibited altered functional connectivity of the dorsal striatum with the amygdala. Menthol, when administered with nicotine, showed evidence of psychoactive properties by affecting brain activity and behavior compared to nicotine administration alone.
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Affiliation(s)
- Matthew F Thompson
- 1 Center for Comparative NeuroImaging, University of Massachusetts Medical School, Worcester, MA, USA.,2 Department of Biology, Clark University, Worcester, MA, USA
| | - Guillaume L Poirier
- 1 Center for Comparative NeuroImaging, University of Massachusetts Medical School, Worcester, MA, USA
| | - Martha I Dávila-García
- 3 Department of Pharmacology, Howard University College of Medicine, Washington, DC, USA
| | - Wei Huang
- 1 Center for Comparative NeuroImaging, University of Massachusetts Medical School, Worcester, MA, USA
| | - Kelly Tam
- 1 Center for Comparative NeuroImaging, University of Massachusetts Medical School, Worcester, MA, USA
| | - Maxwell Robidoux
- 1 Center for Comparative NeuroImaging, University of Massachusetts Medical School, Worcester, MA, USA
| | - Michelle L Dubuke
- 4 Department of Biochemistry and Molecular Pharmacology, University of Massachusetts Medical School, Worcester, MA, USA.,5 Proteomics and Mass Spectrometry Facility, University of Massachusetts Medical School, Worcester, MA, USA
| | - Scott A Shaffer
- 4 Department of Biochemistry and Molecular Pharmacology, University of Massachusetts Medical School, Worcester, MA, USA.,5 Proteomics and Mass Spectrometry Facility, University of Massachusetts Medical School, Worcester, MA, USA
| | - Luis Colon-Perez
- 6 Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL, USA
| | - Marcelo Febo
- 6 Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL, USA
| | - Joseph R DiFranza
- 1 Center for Comparative NeuroImaging, University of Massachusetts Medical School, Worcester, MA, USA.,7 Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, MA, USA
| | - Jean A King
- 1 Center for Comparative NeuroImaging, University of Massachusetts Medical School, Worcester, MA, USA.,8 Department of Radiology, University of Massachusetts Medical School, Worcester, MA, USA.,9 Department of Neurology, University of Massachusetts Medical School, Worcester, MA, USA
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21
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Wagenknecht DR, BalHaddad AA, Gregory RL. Effects of Nicotine on Oral Microorganisms, Human Tissues, and the Interactions between Them. ACTA ACUST UNITED AC 2018. [DOI: 10.1007/s40496-018-0173-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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DeVito EE, Krishnan-Sarin S. E-cigarettes: Impact of E-Liquid Components and Device Characteristics on Nicotine Exposure. Curr Neuropharmacol 2018; 16:438-459. [PMID: 29046158 PMCID: PMC6018193 DOI: 10.2174/1570159x15666171016164430] [Citation(s) in RCA: 154] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 08/09/2017] [Accepted: 10/13/2017] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Electronic cigarette (e-cigarette) use has increased substantially in recent years. While e-cigarettes have been proposed as a potentially effective smoking cessation tool, dualuse in smokers is common and e-cigarettes are widely used by non-smokers, including youth and young-adult non-smokers. Nicotine, the primary addictive component in cigarettes, is present at varying levels in many e-liquids. E-cigarettes may lead to initiation of nicotine use in adult and youth non-smokers, re-initiation of nicotine dependence in ex-smokers or increased severity of nicotine dependence in dual-users of cigarettes and e-cigarettes. As such, there are important clinical and policy implications to understanding factors impacting nicotine exposure from e-cigarettes. However, the broad and rapidly changing range of e-liquid constituents and e-cigarette hardware which could impact nicotine exposure presents a challenge. Recent changes in regulatory oversight of e-cigarettes underscore the importance of synthesizing current knowledge on common factors which may impact nicotine exposure. METHODS This review focuses on factors which may impact nicotine exposure by changing e-cigarette use behavior, puff topography, altering the nicotine yield (amount of nicotine exiting the e-cigarette mouth piece including nicotine exhaled as vapor) or more directly by altering nicotine absorption and bioavailability. RESULTS Topics reviewed include e-liquid components or characteristics including flavor additives (e.g., menthol), base e-liquid ingredients (propylene glycol, vegetable glycerin), components commonly used to dissolve flavorants (e.g., ethanol), and resulting properties of the e-liquid (e.g., pH), e-cigarette device characteristics (e.g., wattage, temperature, model) and user behavior (e.g., puff topography) which may impact nicotine exposure. CONCLUSION E-liquid characteristics and components, e-cigarette hardware and settings, and user behavior can all contribute substantially to nicotine exposure from e-cigarettes.
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Affiliation(s)
- Elise E. DeVito
- Yale University School of Medicine, Department of Psychiatry, New Haven, CT, USA
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23
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Krishnan-Sarin S, Green BG, Kong G, Cavallo DA, Jatlow P, Gueorguieva R, Buta E, O’Malley SS. Studying the interactive effects of menthol and nicotine among youth: An examination using e-cigarettes. Drug Alcohol Depend 2017; 180:193-199. [PMID: 28915478 PMCID: PMC5659733 DOI: 10.1016/j.drugalcdep.2017.07.044] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 07/25/2017] [Accepted: 07/30/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Tobacco products containing menthol are widely used by youth. We used e-cigarettes to conduct an experimental evaluation of the independent and interactive effects of menthol and nicotine among youth. PROCEDURES Pilot chemosensory experiments with fourteen e-cigarette users identified low (barely perceptible, 0.5%) and high (similar to commercial e-liquid, 3.5%) menthol concentrations. Sixty e-cigarette users were randomized to a nicotine concentration (0mg/ml, 6mg/ml, 12mg/ml) and participated in 3 laboratory sessions. During each session, they received their assigned nicotine concentration, along with one of three menthol concentrations in random counterbalanced order across sessions (0, 0.5%, 3.5%), and participated in three fixed-dose, and an ad-lib, puffing period. Urinary menthol glucuronide and salivary nicotine levels validated menthol and nicotine exposure. We examined changes in e-cigarette liking/wanting and taste, coolness, stimulant effects, nicotine withdrawal and ad-lib use. RESULTS Overall, the high concentration of menthol (3.5%) significantly increased e-cigarette liking/wanting relative to no menthol (p<0.001); there was marginal evidence of nicotine* menthol interactions (p=0.06), with an increase in liking/wanting when 3.5% menthol was combined with 12mg/ml nicotine, but not 6mg/ml nicotine. Importantly, both 0.5% and 3.5% menthol concentrations significantly improved taste and increased coolness. We did not observe nicotine or menthol-related changes in stimulant effects, nicotine withdrawal symptoms or ad-lib use. CONCLUSIONS Menthol, even at very low doses, alters the appeal of e-cigarettes among youth. Further, menthol enhances positive rewarding effects of high nicotine-containing e-cigarettes among youth.
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Affiliation(s)
| | - Barry G. Green
- The John B. Pierce Laboratory and Department of Surgery, Yale University School of Medicine
| | - Grace Kong
- Department of Psychiatry, Yale University School of Medicine
| | - Dana A. Cavallo
- Department of Psychiatry, Yale University School of Medicine
| | - Peter Jatlow
- Department of Laboratory Medicine, Yale University School of Medicine
| | | | - Eugenia Buta
- Department of Biostatistics, Yale University School of Public Health
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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.
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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.
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25
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Jao NC, Veluz-Wilkins AK, Smith MJ, Carroll AJ, Blazekovic S, Leone FT, Tyndale RF, Schnoll RA, Hitsman B. Does menthol cigarette use moderate the effect of nicotine metabolism on short-term smoking cessation? Exp Clin Psychopharmacol 2017; 25:216-222. [PMID: 28493744 PMCID: PMC5454571 DOI: 10.1037/pha0000124] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The nicotine metabolite ratio (NMR) has been shown to predict response to the transdermal nicotine patch, such that faster nicotine metabolism is associated with a lower abstinence rate. Menthol cigarette use, versus nonmenthol cigarette use, slows nicotine metabolism and therefore may attenuate the effect of NMR on smoking abstinence. In this study, we evaluated whether cigarette type (menthol vs. nonmenthol) modified the association between NMR and short-term abstinence. This was a secondary analysis examining treatment in the first 8 weeks of 21 mg/day nicotine patch therapy in a completed clinical trial (n = 474). Menthol cigarette use was based on self-report. NMR was defined dichotomously (0 = fast, 1 = slow) to distinguish between fast (≥0.47) versus slow NMR. Using logistic regression analysis, we tested whether cigarette type moderated the association between NMR and bioverified 7-day point prevalence abstinence at Week 8. Covariates include nicotine dependence, age, race, and gender. Three hundred two participants reported smoking menthol cigarettes, of which 234 (77%) were classified as slow NMR. Among the 172 nonmenthol smokers, 136 were classified as slow NMR (79%). Contrary to our expectations, the NMR ×Cigarette Type interaction effect on abstinence was not significant (odds ratio [OR] = 0.91, p = .86). Excluding the interaction variable, fast NMR was associated with decreased likelihood of abstinence (OR = 0.55, p = .03), but menthol cigarette use was not (OR = 1.15, p = .56). Further exploration of risk factors among menthol cigarette smokers, especially among racially diverse and light smokers, could clarify the association between menthol cigarette use and poorer smoking outcomes. (PsycINFO Database Record
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Affiliation(s)
- Nancy C. Jao
- Northwestern University Feinberg School of Medicine
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Watson CV, Richter P, de Castro BR, Sosnoff C, Potts J, Clark P, McCraw J, Yan X, Chambers D, Watson C. Smoking Behavior and Exposure: Results of a Menthol Cigarette Cross-over Study. Am J Health Behav 2017; 41:309-319. [PMID: 28376975 DOI: 10.5993/ajhb.41.3.10] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Our objective was to improve understanding of the differences in use behavior and exposure when smoking menthol and non-menthol cigarettes using a 2-part cross-over design. METHODS Adult daily smokers were assigned randomly to alternate between 2 weeks of exclusively smoking a menthol test cigarette or a non-menthol test cigarette. Urine and saliva were collected for biomarker measurements; carbon monoxide (CO) was measured, and participants smoked test cigarettes through a CreSS® smoking topography device during 3 clinic visits. Participants turned in their cigarette butts from the test periods for determination of mouth level nicotine and completed subjective questionnaires related to the test cigarettes. RESULTS Regardless of cigarette preference, participants had higher salivary cotinine when smoking the non-menthol test cigarette, but there were no significant differences detected in urine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol between the 2 test cigarettes. Mouth level nicotine, puff volume, and puff duration were significantly higher when smoking the menthol brand. Both menthol and non-menthol smokers reported significantly lower enjoyment and satisfaction scores for test cigarettes compared with their brand of choice. CONCLUSIONS Our results suggest that mentholation has an effect on measures of smoking behavior and that mouth level nicotine is a useful indicator of between-brand smoke exposure.
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Affiliation(s)
| | | | | | | | | | | | - Joan McCraw
- Centers for Disease Control and Prevention, Atlanta, GA
| | - Xizheng Yan
- Centers for Disease Control and Prevention, Atlanta, GA
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Abstract
OBJECTIVES Menthol, a flavoring agent, is found in approximately 90% of cigarettes, but at much higher levels in menthol than non-menthol cigarettes. Menthol is reportedly included in cigarettes for its cooling and soothing effects, but also additional actions that affect smokers' receipt and processing of nicotine. In this study we investigated the response to short-term abstinence and acute nicotine delivery in menthol-preferring and non-menthol-preferring smokers. METHODS Nicotine dependent participants (N = 134) participated in an intravenous nicotine delivery session following overnight smoking abstinence. Participants were intravenously administered a placebo and 2 escalating nicotine doses. We compare subjective and physiological responses to nicotine and smoking urges, withdrawal, and cognitive performance following overnight abstinence and post-nicotine between regular 'menthol' smokers and 'non-menthol' cigarette smokers. RESULTS Relative to non-menthol-preferring smokers, menthol-preferring smokers re a smaller reduction in smoking urges from overnight abstinence baseline to post-nicotine end-of-session and rated less subjective differences between nicotine doses. CONCLUSIONS Differences between menthol-preferring and non-menthol-preferring smokers' responses to abstinence or acute nicotine could reflect pre-existing individual differences that may have in initial development of menthol preferences, or could have arisen secondarily to pro use of menthol versus non-menthol cigarettes.
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28
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Allenby CE, Boylan KA, Lerman C, Falcone M. Precision Medicine for Tobacco Dependence: Development and Validation of the Nicotine Metabolite Ratio. J Neuroimmune Pharmacol 2016; 11:471-83. [PMID: 26872457 PMCID: PMC5479354 DOI: 10.1007/s11481-016-9656-y] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 02/08/2016] [Indexed: 10/22/2022]
Abstract
Quitting smoking significantly reduces the risk of tobacco-related morbidity and mortality, yet there is a high rate of relapse amongst smokers who try to quit. Phenotypic biomarkers have the potential to improve smoking cessation outcomes by identifying the best available treatment for an individual smoker. In this review, we introduce the nicotine metabolite ratio (NMR) as a reliable and stable phenotypic measure of nicotine metabolism that can guide smoking cessation treatment among smokers who wish to quit. We address how the NMR accounts for sources of variation in nicotine metabolism including genotype and other biological and environmental factors such as estrogen levels, alcohol use, body mass index, or menthol exposure. Then, we highlight clinical trials that validate the NMR as a biomarker to predict therapeutic response to different pharmacotherapies for smoking cessation. Current evidence supports the use of nicotine replacement therapy for slow metabolizers, and non-nicotine treatments such as varenicline for normal metabolizers. Finally, we discuss future research directions to elucidate mechanisms underlying NMR associations with treatment response, and facilitate the implementation of the NMR as biomarker in clinical practice to guide smoking cessation.
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Affiliation(s)
- Cheyenne E Allenby
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania, 3535 Market Street, Suite 4100, Philadelphia, PA, 19104, USA
| | - Kelly A Boylan
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania, 3535 Market Street, Suite 4100, Philadelphia, PA, 19104, USA
| | - Caryn Lerman
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania, 3535 Market Street, Suite 4100, Philadelphia, PA, 19104, USA
| | - Mary Falcone
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania, 3535 Market Street, Suite 4100, Philadelphia, PA, 19104, USA.
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29
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Alexander LA, Trinidad DR, Sakuma KLK, Pokhrel P, Herzog TA, Clanton MS, Moolchan ET, Fagan P. Why We Must Continue to Investigate Menthol's Role in the African American Smoking Paradox. Nicotine Tob Res 2016; 18 Suppl 1:S91-101. [PMID: 26980870 PMCID: PMC6367903 DOI: 10.1093/ntr/ntv209] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Accepted: 09/09/2015] [Indexed: 11/14/2022]
Abstract
BACKGROUND The disproportionate burden of tobacco use among African Americans is largely unexplained. The unexplained disparities, referred to as the African American smoking paradox, includes several phenomena. Despite their social disadvantage, African American youth have lower smoking prevalence rates, initiate smoking at older ages, and during adulthood, smoking rates are comparable to whites. Smoking frequency and intensity among African American youth and adults are lower compared to whites and American Indian and Alaska Natives, but tobacco-caused morbidity and mortality rates are disproportionately higher. Disease prediction models have not explained disease causal pathways in African Americans. It has been hypothesized that menthol cigarette smoking, which is disproportionately high among African Americans, may help to explain several components of the African American smoking paradox. PURPOSE This article provides an overview of the potential role that menthol plays in the African American smoking paradox. We also discuss the research needed to better understand this unresolved puzzle. METHODS We examined prior synthesis reports and reviewed the literature in PubMed on the menthol compound and menthol cigarette smoking in African Americans. RESULTS The pharmacological and physiological effects of menthol and their interaction with biological and genetic factors may indirectly contribute to the disproportionate burden of cigarette use and diseases among African Americans. CONCLUSIONS Future studies that examine taste sensitivity, the menthol compound, and their effects on smoking and chronic disease would provide valuable information on how to reduce the tobacco burden among African Americans. IMPLICATIONS Our study highlights four counterintuitive observations related to the smoking risk profiles and chronic disease outcomes among African Americans. The extant literature provides strong evidence of their existence and shows that long-standing paradoxes have been largely unaffected by changes in the social environment. African Americans smoke menthols disproportionately, and menthol's role in the African American smoking paradox has not been thoroughly explored. We propose discrete hypotheses that will help to explain the phenomena and encourage researchers to empirically test menthol's role in smoking initiation, transitions to regular smoking and chronic disease outcomes in African Americans.
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Affiliation(s)
- Linda A Alexander
- College of Public Health, University of Kentucky College of Public Health, Lexington, KY
| | - Dennis R Trinidad
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA
| | - Kari-Lyn K Sakuma
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR
| | - Pallav Pokhrel
- University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI
| | - Thaddeus A Herzog
- University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI
| | | | | | - Pebbles Fagan
- University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI;
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30
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Antonio AMM, Fagan P, Hamamura FD, Lagua IJN, Liu J, Park DJ, Pokhrel P, Herzog TA, Pagano I, Cassel K, Sy A, Jorgensen D, Lynch T, Kawamoto C, Boushey CJ, Franke A, Clanton MS, Moolchan ET, Alexander LA. Menthol cigarette smoking and obesity in young adult daily smokers in Hawaii. Prev Med Rep 2015; 2:946-52. [PMID: 26844173 PMCID: PMC4721282 DOI: 10.1016/j.pmedr.2015.10.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
This study investigates 1) the relationship between menthol cigarette smoking and obesity and 2) the association of body mass index with the nicotine metabolite ratio among menthol and non-menthol daily smokers aged 18–35 (n = 175). A brief survey on smoking and measures of height and weight, carbon monoxide, and saliva samples were collected from participants from May to December 2013 in Honolulu, Hawaii. Multiple regression was used to estimate differences in body mass index among menthol and non-menthol smokers and the association of menthol smoking with obesity. We calculated the log of the nicotine metabolite ratio to examine differences in the nicotine metabolite ratio among normal, overweight, and obese smokers. Sixty-eight percent of smokers used menthol cigarettes. Results showed that 62% of normal, 54% of overweight, and 91% of obese smokers used menthol cigarettes (p = .000). The mean body mass index was significantly higher among menthol compared with non-menthol smokers (29.4 versus 24.5, p = .000). After controlling for gender, marital status, educational attainment, employment status, and race/ethnicity, menthol smokers were more than 3 times as likely as non-menthol smokers to be obese (p = .04). The nicotine metabolite ratio was significantly lower for overweight menthol smokers compared with non-menthol smokers (.16 versus .26, p = .02) in the unadjusted model, but was not significant after adjusting for the covariates. Consistent with prior studies, our data show that menthol smokers are more likely to be obese compared with non-menthol smokers. Future studies are needed to determine how flavored tobacco products influence obesity among smokers. Young adult menthol smokers had a higher body mass index than non-menthol smokers. Nearly 91% of young adult obese daily smokers used menthol cigarettes. Daily menthol smokers were 3 times as likely to be obese than non-menthol smokers.
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Affiliation(s)
- Alyssa Marie M Antonio
- University of Hawaii Cancer Center, University of Hawaii at Manoa, 701 Ilalo Street, Honolulu, HI 96813, USA
| | - Pebbles Fagan
- University of Hawaii Cancer Center, University of Hawaii at Manoa, 701 Ilalo Street, Honolulu, HI 96813, USA
| | - Faith D Hamamura
- University of Hawaii Cancer Center, University of Hawaii at Manoa, 701 Ilalo Street, Honolulu, HI 96813, USA
| | - Ian Joseph N Lagua
- University of Hawaii Cancer Center, University of Hawaii at Manoa, 701 Ilalo Street, Honolulu, HI 96813, USA
| | - Jenny Liu
- University of Hawaii Cancer Center, University of Hawaii at Manoa, 701 Ilalo Street, Honolulu, HI 96813, USA
| | - Devin J Park
- University of Washington, Box 357630, H375 Health Science Building, Seattle, WA 98195-7630, USA
| | - Pallav Pokhrel
- University of Hawaii Cancer Center, University of Hawaii at Manoa, 701 Ilalo Street, Honolulu, HI 96813, USA
| | - Thaddeus A Herzog
- University of Hawaii Cancer Center, University of Hawaii at Manoa, 701 Ilalo Street, Honolulu, HI 96813, USA
| | - Ian Pagano
- University of Hawaii Cancer Center, University of Hawaii at Manoa, 701 Ilalo Street, Honolulu, HI 96813, USA
| | - Kevin Cassel
- University of Hawaii Cancer Center, University of Hawaii at Manoa, 701 Ilalo Street, Honolulu, HI 96813, USA
| | - Angela Sy
- University of Hawaii at Manoa, School of Nursing and Dental Hygiene, 2528 McCarthy Mall, Webster Hall, Honolulu, HI 96822, USA
| | - Dorothy Jorgensen
- University of Hawaii Cancer Center, University of Hawaii at Manoa, 701 Ilalo Street, Honolulu, HI 96813, USA
| | - Tania Lynch
- University of Hawaii Cancer Center, University of Hawaii at Manoa, 701 Ilalo Street, Honolulu, HI 96813, USA
| | - Crissy Kawamoto
- University of Hawaii Cancer Center, University of Hawaii at Manoa, 701 Ilalo Street, Honolulu, HI 96813, USA
| | - Carol J Boushey
- University of Hawaii Cancer Center, University of Hawaii at Manoa, 701 Ilalo Street, Honolulu, HI 96813, USA
| | - Adrian Franke
- University of Hawaii Cancer Center, University of Hawaii at Manoa, 701 Ilalo Street, Honolulu, HI 96813, USA
| | - Mark S Clanton
- TMF Health Quality Institute, 5918 W Courtyard Drive, Austin, TX 78730, USA
| | | | - Linda A Alexander
- University of Kentucky College of Public Health, 151 Bowman Hall 343, Lexington, KY 40506, USA
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