scholarly journals A Longitudinal Examination of Behavioral Transitions among Young Adult Menthol and Non-Menthol Cigarette Smokers Using a Three-State Markov Model

2020 ◽  
Author(s):  
Dale S Mantey ◽  
Melissa B Harrell ◽  
Baojiang Chen ◽  
Steven H Kelder ◽  
Cheryl L Perry ◽  
...  
Keyword(s):  
Young Adults ◽  
Young Adult ◽  
Cigarette Smoking ◽  
Markov Model ◽  
Cigarette Smokers ◽  
Menthol Cigarette ◽  
Menthol Cigarettes ◽  
Increased Risk ◽  
Smoking Behaviors ◽  
Hispanic Latinos

Abstract Introduction Young adult cigarette smoking behaviors are complex and dynamic. Emerging research suggests a growing rate of switching from non-menthol to menthol cigarettes. Transitions across cigarette smoking states are not well understood. This research longitudinally explores transitions in cigarette smoking behaviors among 18-29 year olds. Methods We applied a Markov model to data collected biannually for 1,542 initially 18-29-year old young adults (mean age: 20.9 years; SD=2.6) in Texas, who provided 7,021 total observations from Fall 2014 – Spring 2017. All participants were past 30-day menthol or non-menthol cigarette smokers at first observation. We examined transitions across three states of cigarette smoking (menthol, non-menthol, and nonsmoking) and compared predictors of each transition, during young adulthood. Results Descriptively, 22.2% of menthol and 14.3% of non-menthol smokers switched products while 25.6% of menthol and 26.0% of non-menthol smokers quit smoking. Among quitters, 20.0% relapsed via menthol and 28.2% relapsed via non-menthol cigarettes. Results from Markov model indicated that Hispanic/Latinos (Hazard Ratio [HR]: 3.69) and Asians (HR: 2.85) were significantly more likely to switch from non-menthol to menthol cigarettes, relative to non-Hispanic whites. Among recent quitters, use of non-cigarette products was associated with increased risk of relapse via menthol (HR: 1.54) and non-menthol (HR: 1.85) cigarettes. Conclusion A substantial proportion of young adult cigarette smokers transitioned across cigarette smoking states over the course of 2.5-years. Other tobacco use and nicotine dependence were impediments to becoming and remaining a non-smoker. Hispanic/Latinos and Asians, relative to non-Hispanic Whites, had greater odds of transitioning from non-menthol smoking to both non-smoking and to menthol smoking. Findings suggest racial/ethnic differences in cigarette smoking transitions during young adulthood. Implications This paper examined multidirectional transitions across cigarette smoking, including switching between menthol and non-menthol cigarettes, among young adults. Results indicate that Hispanic/Latino and Asian young adults are at increased risk to transition to menthol cigarette smoking compared with non-Hispanic white young adults. Findings highlight need for further study of Hispanic/Latino and Asian young adult smoking behaviors.

Multiple tobacco product use among cigarette smokers: a longitudinal examination of menthol and non-menthol smokers during young adulthood

2021 ◽  
pp. tobaccocontrol-2020-055922
Author(s):  
Dale Mantey ◽  
Melissa Harrell ◽  
Baojiang Chen ◽  
Steven H Kelder ◽  
Cheryl Perry ◽  
...  
Keyword(s):  
Young Adult ◽  
Cigarette Smoking ◽  
Tobacco Product ◽  
Single Product ◽  
Cigarette Smokers ◽  
Tobacco Products ◽  
Menthol Cigarette ◽  
Product Use ◽  
Menthol Cigarettes ◽  
Study Participants

BackgroundMultiple tobacco product (MTP) use is common among young adults. Most MTP users are combustible cigarette smokers that use one or more other tobacco products. This study aims to explore menthol as a risk factor for MTP use among a cohort of young adult cigarette smokers.MethodsParticipants were 18–29 years cigarette smokers at 24 Texas colleges in a 6-wave study. Participants (n=4700 observations) were classified as: single product users (ie, exclusive cigarette smoking); dual product users and poly product users. A multilevel, ordered logistic regression model was used to examine the association between menthol cigarette smoking and MTP use. Two longitudinal, multilevel, multinomial logistic regressions were used to examine the relationship between menthol cigarette smoking and number of tobacco products used.ResultsOverall, 40.7% of the sample were single product users, 33.7% were dual product users and 25.6% were poly product users. Menthol was associated with 1.28 greater odds of MTP use. Further, menthol was associated with 1.19 greater risk of dual and 1.40 greater risk of poly product use, relative to single product use. Lastly, menthol cigarette smoking was associated with 1.18 greater risk of poly product use, relative to dual product use.ConclusionsThere was a gradient relationship between menthol cigarette smoking and number of tobacco products used among young adult cigarette smokers. Findings provide for greater regulatory and programmatic efforts to reduce the use of menthol cigarettes.

scholarly journals The profile of menthol cigarette smokers in the months following the removal of these products from the market in England

2021 ◽  
Author(s):  
Loren Kock ◽  
Lion Shahab ◽  
Ilze Bogdanovica ◽  
Jamie Brown
Keyword(s):  
Cigarette Smoking ◽  
Age Groups ◽  
Transitional Period ◽  
Cross Sectional ◽  
Cigarette Smokers ◽  
Menthol Cigarette ◽  
Menthol Cigarettes ◽  
Chi Squared ◽  
Cigarette Dependence ◽  
The Impact

Abstract Introduction: In May 2020 the EU Tobacco Products Directive (TPD) ban on the sale of menthol cigarettes was implemented after a four-year transitional period. This study examined the prevalence of menthol cigarette smoking in the months following the ban, and according to sociodemographic and smoking characteristics.Methods: Cross-sectional data came from a representative survey of current smokers (18+) in England (unweighted n=1,577) during seven months (July-January) in 2020/2021. The weighted prevalence of menthol cigarette smoking as a proportion of total cigarette smoking was calculated, and chi-squared statistics assessed the relationship between menthol smoking, sociodemographic and smoking characteristics. Sources of purchase of menthol cigarettes were also explored.Results: The proportion of current smokers who smoked menthol cigarettes was similar in July to October 2020 (17.5%, 95% CI 15.3%-20.1%) compared with November 2020 to January 2021 (16.3%, 95% CI 13.9%-19.2%) (χ2(1)=0.38, P=0.56)). Menthol cigarette smoking was more common among younger age groups (16-24 = 29.0%; 25-34 = 23.3%) and women (21.1%). Menthol cigarette smokers showed lower cigarette dependence compared with other cigarette smokers. Purchases of menthol cigarettes from any illicit source in the past six months declined from 34.5% in July-October 2020 to 19.0% in November 2020–January 2021.Conclusions: A substantial proportion (just under a fifth) of current smokers in England reported menthol cigarette smoking between July-January 2020/2021 despite the ban. There was no decline in this proportion across the period, suggesting that smokers mitigated the impact of the ban by a variety of means, such as with legal menthol accessories.

scholarly journals The profile of menthol cigarette smokers in the months following the removal of these products from the market: a cross-sectional population survey in England

2021 ◽  
Author(s):  
Loren Kock ◽  
Lion Shahab ◽  
Ilze Bogdanovica ◽  
Jamie Brown
Keyword(s):  
Cigarette Smoking ◽  
Linear Trend ◽  
Cross Sectional ◽  
Cigarette Smokers ◽  
Change Models ◽  
Menthol Cigarette ◽  
Menthol Cigarettes ◽  
Binomial Regression ◽  
Chi Squared ◽  
Cigarette Dependence

Abstract IntroductionIn May 2020 the EU Tobacco Products Directive ban on the sale of menthol cigarettes was implemented in England. This study examined the prevalence of menthol cigarette smoking after the ban, according to sociodemographic and smoking characteristics.MethodsCross-sectional data came from a representative survey of current smokers (18+) in England (unweighted n = 2,681) between July/2020 and June/2021. The weighted prevalence of menthol cigarette smoking as a proportion of total cigarette smoking was calculated, log-binomial regression explored trends over time, and chi-squared statistics assessed the relationship between menthol smoking, sociodemographic and smoking characteristics. Sources of purchase of menthol cigarettes were explored.ResultsBetween July 2020 and June 2021, 15.7% (95%CI 14.5–17.1) of smokers reported smoking menthol cigarettes. The fitted non-linear trend supported no initial change followed by a possible reduction across April-June 2021 and fit the data better than linear and null (no change) models (χ2(2) = 2519.7, P = 0.06; χ2(3) = 2519.7, P = 0.006). Menthol cigarette smoking was more common among younger groups (16–24 = 25.2%; 25–34 = 19.9%) and women (19.4%). Menthol cigarette smokers showed lower cigarette dependence compared with other smokers. Past six-month purchases of menthol cigarettes from any illicit source declined from 30.1% in the last 6 months of 2020 to 17.5% in the first 6 months of 2021.ConclusionsA substantial minority of current smokers in England reported menthol cigarette smoking between July/2020 and June/2021, despite the ban, possibly reflecting mitigation of restrictions by a variety of licit means, such as legal menthol accessories. The reduction in menthol smoking across April-June 2021 warrants further monitoring.

scholarly journals Profile of menthol cigarette smokers in the months following the removal of these products from the market: a cross-sectional population survey in England

2021 ◽  
pp. tobaccocontrol-2021-057005
Author(s):  
Loren Kock ◽  
Lion Shahab ◽  
Ilze Bogdanovica ◽  
Jamie Brown
Keyword(s):  
Cigarette Smoking ◽  
Linear Trend ◽  
Cross Sectional ◽  
Cigarette Smokers ◽  
Change Models ◽  
Menthol Cigarette ◽  
Menthol Cigarettes ◽  
Binomial Regression ◽  
Trends Over Time ◽  
Cigarette Dependence

IntroductionIn May 2020, the EU Tobacco Products Directive ban on the sale of menthol cigarettes was implemented in England. This study examined the prevalence of menthol cigarette smoking after the ban, according to sociodemographic and smoking characteristics.MethodsCross-sectional data came from a representative survey of current smokers (18+) in England (unweighted n=2681) between July 2020 and June 2021. The weighted prevalence of menthol cigarette smoking as a proportion of total cigarette smoking was calculated, log-binomial regression explored trends over time, and χ2 statistics assessed the relationship between menthol smoking, sociodemographic and smoking characteristics. Sources of purchase of menthol cigarettes were explored.ResultsBetween July 2020 and June 2021, 15.7% (95% CI 14.5 to 17.1) of smokers reported smoking menthol cigarettes. The fitted non-linear trend supported no initial change followed by a possible reduction across April–June 2021 and fit the data better than linear and null (no change) models (χ2(2)=2519.7, p=0.06; χ2(3)=2519.7, p=0.006). Menthol cigarette smoking was more common among younger groups (16–24=25.2%; 25–34=19.9%) and women (19.4%). Menthol cigarette smokers showed lower cigarette dependence compared with other smokers. Past-6-month purchases of menthol cigarettes from any illicit or cross-border source declined from 30.1% in the last 6 months of 2020 to 17.5% in the first 6 months of 2021.ConclusionsA substantial minority of current smokers in England reported menthol cigarette smoking between July 2020 and June 2021, despite the ban, possibly reflecting mitigation of restrictions by a variety of licit means, such as legal menthol accessories. The reduction in menthol smoking across April–June 2021 warrants further monitoring.

scholarly journals Menthol cigarette smoking and obesity in young adult daily smokers in Hawaii

2015 ◽  
Vol 2 ◽  
pp. 946-952
Author(s):  
Alyssa Marie M. Antonio ◽  
Pebbles Fagan ◽  
Faith D. Hamamura ◽  
Ian Joseph N. Lagua ◽  
Jenny Liu ◽  
...  
Keyword(s):  
Young Adult ◽  
Cigarette Smoking ◽  
Menthol Cigarette

scholarly journals Heat-not-burn Tobacco Products and the Increased Risk for Poly-tobacco Use

2021 ◽  
Vol 45 (1) ◽  
pp. 195-204
Author(s):  
Pallav Pokhrel ◽  
Thaddeus A. Herzog ◽  
Crissy T. Kawamoto ◽  
Pebbles Fagan
Keyword(s):  
Smoking Cessation ◽  
Young Adults ◽  
Tobacco Use ◽  
Tobacco Product ◽  
Dual Use ◽  
Cigarette Smokers ◽  
Product Use ◽  
Increased Risk ◽  
Current Cigarette

Objectives: In this study, we tested the use of ecigarette, cigarette, and dual use of both as predictors of heat-not-burn (HNB) tobacco product use onset among young adults, and examined common predictors of smoking cessation as predictors of HNB product use. Methods: We collected data from 2229 young adults [mean age = 21.1 (SD = 2.1); 55% women] in Hawaii, at 2 time-points 6 months apart. Results: Current cigarette-only use was the strongest concurrent predictor of HNB product use, followed by dual use, and ecigarette-only use. Among HNB product never users at Wave 1, dual and ecigarette-only use at Wave 1 significantly predicted HNB product use onset at Wave 2. Among cigarette smokers who had never used an HNB product at Wave 1, current use of ecigarette for help with smoking cessation predicted increased odds of HNB product use at 6-month follow-up. Conclusions: Although promoted as a safer alternative for exclusive cigarette smokers, HNB products may increase the risk of dual or poly-tobacco product use among young adults, including current exclusive e-cigarette users. Surveillance of HNB product use as a modified risk tobacco product may need to consider the effects of HNB products on poly-tobacco use among young people.

scholarly journals Examining Age as a Potential Moderator of Response to Reduced Nicotine Content Cigarettes in Vulnerable Populations

2019 ◽  
Vol 21 (Supplement_1) ◽  
pp. S49-S55
Author(s):  
Danielle R Davis ◽  
Maria A Parker ◽  
Andrea C Villanti ◽  
Joanna M Streck ◽  
Jeff S Priest ◽  
...  
Keyword(s):  
Older Adults ◽  
Young Adults ◽  
Young Adult ◽  
Cigarette Smoking ◽  
Subjective Effects ◽  
Age Groups ◽  
Reinforcing Efficacy ◽  
Smoking Topography ◽  
Nicotine Content ◽  
Nicotine Reduction

Abstract Introduction Young adults (aged 18–24 years) have a higher smoking prevalence than younger and older age groups and young adulthood is an important developmental period during which long-term behavior patterns like cigarette smoking are established. The aim of the current study was to examine how young adult smokers with additional vulnerabilities to smoking respond to reduced nicotine content cigarettes. Methods This is a secondary analysis of a double-blind, within-subject experiment conducted with 169 cigarette smokers recruited from populations with comorbid psychiatric conditions or socioeconomic disadvantage assessing acute effects of research cigarettes varying in nicotine content (0.4, 2.4, 5.2, 15.8 mg/g). Participants were dichotomized by chronological age (18–24 vs. ≥25 years). Across 14 laboratory sessions effects of nicotine content were examined on measures of relative reinforcing efficacy (Cigarette Purchase Task [CPT] and Concurrent Choice testing), subjective effects, craving/withdrawal, and smoking topography. Repeated measures analysis of variances were used to examine potential moderating effects of age. Results Young adults exhibited lower demand for reduced nicotine content cigarettes than older adults across three of five CPT indices (ps < .05). No differences by age were observed on other measures of reinforcing efficacy, subjective effects, craving/withdrawal, or smoking topography where effects generally decreased as an orderly function of decreasing nicotine content (ps <.05). Conclusion Overall, these findings suggest that reducing the nicotine content of cigarettes would decrease the addiction potential of cigarette smoking in young adult smokers as much or perhaps more than older adult smokers from populations at increased vulnerability to smoking, addiction, and smoking-related health consequences. Implications Reducing the nicotine content in cigarettes to lower addiction potential of smoking has been proposed as a means to improve overall population health. It is imperative to examine how young adults may respond to a nicotine reduction policy. We saw minimal evidence that age moderates acute response and where there was evidence it was in the direction of reduced nicotine content cigarettes having less addictive potential among young versus older adults (eg, steeper decreases in demand for very low nicotine content cigarettes among young versus older adults). Overall, a nicotine reduction policy has the potential to reduce smoking across age groups.

scholarly journals E-Cigarette Use and Future Cigarette Initiation Among Never Smokers and Relapse Among Former Smokers in the PATH Study

2019 ◽  
Vol 134 (5) ◽  
pp. 528-536 ◽  
Author(s):  
Robert McMillen ◽  
Jonathan D. Klein ◽  
Karen Wilson ◽  
Jonathan P. Winickoff ◽  
Susanne Tanski
Keyword(s):  
Cigarette Smoking ◽  
Harm Reduction ◽  
Electronic Cigarettes ◽  
Computer Assisted ◽  
Cigarette Use ◽  
Cigarette Smokers ◽  
Potential Harm ◽  
Increased Risk ◽  
Never Smokers

Objectives: Any potential harm-reduction benefit of electronic cigarettes (e-cigarettes) could be offset by nonsmokers who initiate e-cigarette use and then smoke combustible cigarettes. We examined correlates of e-cigarette use at baseline with combustible cigarette smoking at 1-year follow-up among adult distant former combustible cigarette smokers (ie, quit smoking ≥5 years ago) and never smokers. Methods: The Population Assessment of Tobacco and Health Study, a nationally representative, longitudinal study, surveyed 26 446 US adults during 2 waves: 2013-2014 (baseline) and 2014-2015 (1-year follow-up). Participants completed an audio computer-assisted interview in English or Spanish. We compared combustible cigarette smoking at 1-year follow-up by e-cigarette use at baseline among distant former combustible cigarette smokers and never smokers. Results: Distant former combustible cigarette smokers who reported e-cigarette past 30-day use (9.3%) and ever use (6.7%) were significantly more likely than those who had never used e-cigarettes (1.3%) to have relapsed to current combustible cigarette smoking at follow-up ( P < .001). Never smokers who reported e-cigarette past 30-day use (25.6%) and ever use (13.9%) were significantly more likely than those who had never used e-cigarettes (2.1%) to have initiated combustible cigarette smoking ( P < .001). Adults who reported past 30-day e-cigarette use (7.0%) and ever e-cigarette use (1.7%) were more likely than those who had never used e-cigarettes (0.3%) to have transitioned from never smokers to current combustible cigarette smokers ( P < .001). E-cigarette use predicted combustible cigarette smoking in multivariable analyses controlling for covariates. Conclusions: Policies and counseling should consider the increased risk for nonsmokers of future combustible cigarette smoking use as a result of using e-cigarettes and any potential harm-reduction benefits e-cigarettes might bring to current combustible cigarette smokers.

scholarly journals ‘It has candy. You need to press on it’: young adults’ perceptions of flavoured cigarettes in the Philippines

2020 ◽  
pp. tobaccocontrol-2019-055524
Author(s):  
Jennifer Brown ◽  
Meng Zhu ◽  
Meghan Moran ◽  
Connie Hoe ◽  
Ferdie Frejas ◽  
...  
Keyword(s):  
Young Adults ◽  
Young Adult ◽  
Smoking Prevalence ◽  
Smoking Status ◽  
The Philippines ◽  
Market Shares ◽  
Menthol Cigarettes ◽  
The World ◽  
High Smoking Prevalence ◽  
Green Packaging

BackgroundThe Philippines has a high smoking prevalence and one of the largest tobacco menthol market shares in the world. Flavour capsule cigarettes were introduced to the Philippines in 2013, most of which are menthol flavoured, and their market share is increasing. We explored perceptions of flavoured cigarette packaging among young adult Filipinos.MethodsWe conducted eight focus groups with 63 young adults ages 18–24 years in Manila in 2019, stratified by gender and smoking status. We conducted a thematic analysis of the transcripts.ResultsMost participants assessed relative harm of cigarettes based on strength, mainly determined by colour of the packaging. Menthol cigarettes with primarily blue packaging were considered less harmful than menthol cigarettes with primarily green packaging. Many participants considered flavour capsule packs most attractive, compared with non-flavoured and traditional menthol cigarettes, due to the colouring of the packs and expectations regarding taste. Some participants likened the capsules and the taste of flavour capsule cigarettes to candy, and many participants thought flavour capsule cigarettes would most likely be smoked by teenagers or young adults.ConclusionsYoung adult Filipinos believe that some menthol-flavoured cigarettes are less harmful than other flavoured cigarettes and non-flavoured cigarettes and find flavour capsule cigarettes attractive. A tobacco flavour ban and implementation of plain packaging might help reduce misperceptions of risk and make cigarettes less appealing.

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