Does menthol cigarette use moderate the effect of nicotine metabolism on short-term smoking cessation?

Abstract Introduction Understanding the population impact of e-cigarettes requires determining their effect on cigarette smoking cessation. Methods Using the US Population Assessment of Tobacco and Health cohort, we examined smoking cessation among adult current cigarette smokers at Wave 1 with follow-up data at Waves 2 and 3 (n = 9724). Results By Wave 3 (2015/2016), 17.3% of smokers had quit smoking. Smokers using e-cigarettes daily or who increased to daily use over the three waves were two to four times more likely to have quit in the short term (<1 year) and long term (1+ years) compared with never e-cigarette users (p < .001). E-cigarette use in the last quit attempt was associated with a higher likelihood of short-term (<1 year) quitting at Wave 3 (adjusted relative risk ratio: 1.33; 95% confidence interval: 1.04, 1.71) compared with smokers who did not use an e-cigarette in their last quit attempt. Noncurrent (no use in any wave) e-cigarette users and users who were unstable in use frequency were 33% and 47% less likely to quit in the short-term, respectively (p < .001). Flavored (vs nonflavored) and using a rechargeable (vs disposable) e-cigarette device was associated with an increased likelihood of both short- and long-term quitting. Conclusion Smoking cessation was more likely among frequent e-cigarette users, users of e-cigarettes in last quit attempt, and users of flavored and rechargeable devices. Less frequent, unstable, past, or never e-cigarette users were less likely to quit smoking. Monitoring the relationship between patterns of e-cigarette and cigarette use is complex but critical for gauging the potential of e-cigarettes as a harm reduction tool. Implications This study suggests that consistent and frequent e-cigarette use over time is associated with cigarette smoking cessation among adults in the United States. In addition, findings suggest that flavored e-cigarette use and use of rechargeable e-cigarette devices can facilitate smoking cessation. These results underscore the importance of carefully defining and characterizing e-cigarette exposure patterns, potential confounders, and use of e-cigarettes to quit smoking, as well as variations in length of the smoking cessation.

Download Full-text

Use of Mentholated Cigarettes and Likelihood of Smoking Cessation in the United States: A Meta-Analysis

Nicotine & Tobacco Research ◽

10.1093/ntr/ntz067 ◽

2019 ◽

Vol 22 (3) ◽

pp. 307-316 ◽

Cited By ~ 4

Author(s):

Philip H Smith ◽

Biruktawit Assefa ◽

Simranpreet Kainth ◽

Kaliris Y Salas-Ramirez ◽

Sherry A McKee ◽

...

Keyword(s):

United States ◽

Smoking Cessation ◽

African American ◽

Meta Analysis ◽

Health Benefit ◽

The United States ◽

Cigarette Use ◽

Black African ◽

Menthol Cigarette ◽

Marketing Influence

Abstract Introduction Previous qualitative reviews have summarized evidence of an association between menthol cigarette use and likelihood of smoking cessation. The objective of this meta-analysis was to provide a quantitative summary of effect sizes, their variability, and factors related to the variability in effect size for the association between menthol use and likelihood of smoking cessation. Methods We systematically searched Medline, PsycINFO, and Embase for prospective and cross-sectional studies of the association between menthol use and smoking cessation. We analyzed data with random effects meta-analyses and meta-regression. Results Our review identified 22 reports from 19 studies of the association between menthol use and cessation. All identified study samples included only US smokers, with one exception that included both Canadian and US smokers. Our overall model did not demonstrate a significant association between menthol use and cessation; however, menthol users were significantly less likely to quit among blacks/African American smokers (odds ratio = 0.88). Conclusions Among blacks/African Americans predominantly in the US menthol users have approximately 12% lower odds of smoking cessation compared to non-menthol users. This difference is likely the result of the tobacco industry’s ongoing marketing influence on the black/African American Community, suggesting that a menthol ban may have a unique public health benefit for black/African American smokers by encouraging quitting behavior. Implications This study adds a quantitative summary of the association between menthol cigarette use and smoking cessation in the United States. Findings of an association with lower likelihood of cessation among black/African American smokers, likely resulting from the tobacco industry’s marketing influence, support the ban of menthol flavoring as part of a comprehensive tobacco control effort to increase cessation among black/African American smokers.

Download Full-text

Assessing the evidence on the differential impact of menthol versus non-menthol cigarette use on smoking cessation: A systematic review

10.21203/rs.3.rs-52105/v1 ◽

2020 ◽

Author(s):

Mimi Kim ◽

Geoffrey Curtin

Keyword(s):

Systematic Review ◽

Smoking Cessation ◽

Cigarette Use ◽

Qualitative Synthesis ◽

Differential Impact ◽

Menthol Cigarette ◽

Strength Of Evidence ◽

Quit Attempts ◽

Moderate Change ◽

Poor Individual

Abstract Background: This systematic review followed PRISMA guidelines to examine the Key Question: Does menthol cigarette use have a differential impact on smoking cessation compared with non-menthol cigarette use?Methods: The original protocol was registered on March 22, 2016 (updated January 10, 2019; PROSPERO: CRD42019119301). Six databases were queried from inception to December 14, 2018.Results: Fifty-seven studies (27 rated “good”, 27 rated as “fair”, and three studies rated as “poor” individual study quality) that compared menthol and non-menthol smokers were qualitatively synthesized across the following cessation measures (total adjusted studies; strength of evidence grade): duration of abstinence (2; low); quit attempts (14; insufficient); rate of abstinence/quitting (28; moderate); change in smoking quantity/frequency (3; insufficient); and return to smoking/relapse (2; insufficient). Overall, the qualitative synthesis failed to show a consistent trend for the association of menthol cigarette use and smoking cessation across the outcomes. Further, meta-analytic results found no difference between menthol and non-menthol cigarette use and the two measures of quit attempts and duration of abstinence.Implications: The overall strength of evidence for an association between menthol cigarette use and smoking cessation was graded as “low”, based on deficiencies of indirectness and inconsistency in the available body of evidence. Therefore, there is no consistent, significant, or differential association between menthol cigarette use and smoking cessation.

Download Full-text

Menthol cigarette use and pain reporting among African American adults seeking treatment for smoking cessation.

Experimental and Clinical Psychopharmacology ◽

10.1037/pha0000254 ◽

2019 ◽

Vol 27 (3) ◽

pp. 276-282 ◽

Cited By ~ 2

Author(s):

Jesse D. Kosiba ◽

Maura T. Hughes ◽

Lisa R. LaRowe ◽

Michael J. Zvolensky ◽

Peter J. Norton ◽

...

Keyword(s):

Smoking Cessation ◽

African American ◽

Cigarette Use ◽

Menthol Cigarette ◽

African American Adults ◽

Pain Reporting

Download Full-text

Assessing the evidence on the differential impact of menthol versus non-menthol cigarette use on smoking cessation in the U.S. population: a systematic review and meta-analysis

Substance Abuse Treatment Prevention and Policy ◽

10.1186/s13011-021-00397-4 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Mimi M. Kim ◽

Geoffrey M. Curtin

Keyword(s):

Public Health ◽

Systematic Review ◽

Smoking Cessation ◽

Systematic Reviews ◽

Cochrane Central Register ◽

Cigarette Use ◽

Differential Impact ◽

Menthol Cigarette ◽

Strength Of Evidence ◽

Quit Attempts

Abstract Background The potential impact of menthol versus non-menthol cigarette use on smoking behaviors is an intensely scrutinized topic in the public health arena. To date, several general literature reviews have been conducted, but findings and conclusions have been discordant. This systematic review followed PRISMA guidelines to examine the Key Question, “Does menthol cigarette use have a differential impact on smoking cessation compared with non-menthol cigarette use?” Methods Six databases—Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, MEDLINE, Embase and PsycInfo—were queried from inception to June 12, 2020. Articles comparing menthol versus non-menthol cigarette smokers in terms of at least one predefined smoking cessation outcome were included. Risk of bias was assessed using the Agency for Healthcare Research and Quality Evidence-Based Practice Center approach. A random-effects model utilizing the DerSimonian and Laird method to pool adjusted odds ratio was applied. Variations among pooled studies were assessed using Cochran’s Q statistic, and heterogeneity was quantified using the inconsistency index (I2). Results Forty-three demographically adjusted studies (22 rated “good”, 20 rated “fair”, and one study rated “poor” individual study quality) comparing menthol and non-menthol smokers were qualitatively synthesized across the following measures (study count; strength of evidence): duration of abstinence (2; low); quit attempts (15; insufficient); rate of abstinence/quitting (29; moderate); change in smoking quantity/frequency (5; insufficient); and, return to smoking/relapse (2; insufficient). Overall, the qualitative synthesis failed to show a consistent trend for an association between menthol cigarette use and smoking cessation across outcomes. Meta-analyses found no difference between menthol and non-menthol cigarette use and either quit attempts or abstinence. Conclusions Given the lack of consistency or statistical significance in the findings—combined with a “low” overall strength of evidence grade, based on deficiencies of indirectness and inconsistency—no consistent or significant associations between menthol cigarette use and smoking cessation were identified. Recommendations for future studies include increased focus on providing longitudinal, adjusted data collected from standardized outcome measures of cessation to better inform long-term smoking cessation and menthol cigarette use. Such improvements should also be further considered in more methodologically rigorous systematic reviews characterized by objectivity, comprehensiveness, and transparency with the ultimate objective of better informing public health and policy decision making.

Download Full-text

High Rates of Menthol Cigarette Use Among Pregnant Smokers: Preliminary Findings and Call for Future Research

Nicotine & Tobacco Research ◽

10.1093/ntr/ntz142 ◽

2019 ◽

Vol 22 (10) ◽

pp. 1711-1717 ◽

Cited By ~ 3

Author(s):

Laura R Stroud ◽

Chrystal Vergara-Lopez ◽

Meaghan McCallum ◽

Allison E Gaffey ◽

Alana Corey ◽

...

Keyword(s):

Smoking Cessation ◽

Pregnant Women ◽

Ethnic Minority ◽

Nicotine Dependence ◽

Low Income ◽

Cigarette Use ◽

Menthol Cigarette ◽

Pregnant Smokers ◽

Racial Ethnic ◽

In Pregnancy

Abstract Introduction Smoking during pregnancy remains widespread and is causally associated with infant morbidity and mortality. Despite links between menthol cigarette use and decreased smoking cessation, little is known regarding rates or characteristics of pregnant menthol cigarette smokers. Methods Participants were drawn from two low-income, racially/ethnically diverse cohorts of pregnant smokers recruited from 2006 to 2015 (N = 166, Mage = 25 ± 5). Demographics, menthol cigarette use, daily cigarette use, quit status, and consecutive weeks quit were assessed by prospective interviews. Nicotine dependence was assessed using the Fagerström Test of Nicotine Dependence. Nicotine levels were assessed via saliva cotinine. Results High rates of menthol use were found in both cohorts (85% and 87%). Across both cohorts, menthol smokers were more likely to identify as racial/ethnic minorities, were less educated, and reported lower income than non-menthol smokers (ps < .03). Menthol smokers also reported fewer continuous weeks quit (8.4 vs. 14.5 weeks quit; p < .03) and a tendency toward decreased likelihood of quitting smoking over pregnancy (29% vs. 48%; p < .08) in unadjusted but not in covariate-adjusted analyses. No differences emerged in cigarettes per day, nicotine dependence or nicotine exposure. Conclusions We found very high rates of menthol cigarette use in pregnant smokers—particularly among racial/ethnic minority and low socioeconomic status smokers—and some evidence for associations with reduced smoking cessation in pregnancy. Consideration of pregnant smokers as a uniquely vulnerable population is warranted in evaluating regulation of menthol in cigarettes. Further research is needed regarding the impact of menthol on smoking persistence in pregnancy and on maternal and infant health outcomes. Implications This study highlights high rates of menthol cigarette use in pregnant women in the Northeast, United States, with evidence for higher rates of menthol use among racial/ethnic minority, less educated and low-income pregnant smokers, and preliminary evidence for associations between menthol cigarette use and reduced smoking cessation. Consideration of the effects of menthol on smoking persistence in pregnant women and on the health of their offspring is warranted in the development of regulations regarding menthol in cigarettes.

Download Full-text