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

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.

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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

10.21203/rs.3.rs-842047/v1 ◽

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.

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

10.21203/rs.3.rs-578480/v1 ◽

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.

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Recent, national trends in US adolescent use of menthol and non-menthol cigarettes

Tobacco Control ◽

10.1136/tobaccocontrol-2021-056970 ◽

2021 ◽

pp. tobaccocontrol-2021-056970

Author(s):

Richard A Miech ◽

Adam M Leventhal ◽

Lloyd D Johnson

Keyword(s):

Cigarette Smoking ◽

Black Adolescents ◽

Cigarette Use ◽

Floor Effect ◽

Cross Sectional ◽

Menthol Cigarette ◽

Menthol Cigarettes ◽

Monitoring The Future ◽

Nationally Representative ◽

National Trends

ObjectiveIn light of the current U.S. Food and Drug Administration (FDA) proposal to ban menthol cigarettes, this study updates trends in menthol cigarette use among adolescents age 13–18 years up to the year 2020. The study considers a potential role for the ban to reduce black/non-black disparities in menthol cigarette use, as well as a counterargument that a ban is not necessary because menthol use is already diminishing.MethodsData are from annual, cross-sectional, nationally representative Monitoring the Future (MTF) surveys of 85 547 8th, 10th and 12th grade students surveyed between 2012 and 2020. Analyses include trends in past 30-day menthol and non-menthol cigarette smoking among the total adolescent population, as well as stratified by race/ethnicity.ResultsDeclines in adolescent menthol and non-menthol cigarette smoking continued through 2020 so that in 2018–2020 past 30-day prevalence for each was less than 1% for non-Hispanic black adolescents and less than 2.2% for non-black adolescents. For non-Hispanic black adolescents no smoking declines in mentholated or non-mentholated cigarette use from 2015–2017 to 2018–2020 were statistically significant, in part because prevalence levels approached a floor effect and had little room to fall further. Menthol levels were lower for non-Hispanic black versus all other adolescents in all study years.ConclusionsContinuing declines in adolescent menthol prevalence indicate that both menthol prevalence and also black/non-black disparities in its use are steadily decreasing. However, these decreases in adolescence will take decades to reach later ages through generational replacement. Efforts to accelerate menthol decreases will require new initiatives to increase cessation among adult menthol users.

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

Nicotine & Tobacco Research ◽

10.1093/ntr/ntaa240 ◽

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.

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

Tobacco Control ◽

10.1136/tobaccocontrol-2020-055922 ◽

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.

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National Support for a Menthol Cigarette Sales Ban

Public Health Reports ◽

10.1177/0033354920966004 ◽

2020 ◽

pp. 003335492096600

Author(s):

Lauren Czaplicki ◽

Barbara Schillo ◽

Shyanika W. Rose ◽

Yitong Zhou ◽

Donna Vallone

Keyword(s):

Political Ideology ◽

Smoking Status ◽

Significant Proportion ◽

Demographic Factors ◽

Geographic Region ◽

Policy Support ◽

Cross Sectional ◽

Cigarette Smokers ◽

Menthol Cigarette ◽

Menthol Cigarettes

Objectives The US Food and Drug Administration (FDA) and local jurisdictions have different authorities to regulate menthol cigarettes, and a growing number of localities and the FDA are considering these policy options. The objective of this study was to update previous research on public support for a menthol ban, including examining differences in support by demographic factors, geographic region, and smoking status. Methods We assessed policy support among a cross-sectional sample of 2871 adults aged 18-64 from a nationally representative online panel. We calculated weighted estimates of support by demographic factors, political ideology, region (Northeast, Midwest, South, West), and smoking status (never, former, current nonmenthol, current menthol). We used weighted adjusted logistic regression analysis to examine correlates of support for a menthol ban. Results Overall, 56.4% (95% CI, 54.4%-58.3%) of participants supported a government policy to ban menthol cigarette sales. Support was significantly higher among women than among men (62.5% vs 50.1%; P < .001); among Hispanic/Latino (69.3%), non-Hispanic African American (60.5%), and non-Hispanic other (65.8%) people than among non-Hispanic White people (50.4%; P < .001); and among never (64.8%) and former (47.0%) smokers than among current nonmenthol cigarette smokers (30.1%; P < .001). A significant proportion (28.5%; P < .001) of current menthol cigarette smokers supported a ban. After controlling for other factors, geographic region was not significantly associated with support for a ban. Conclusions Efforts are needed to further increase support for a ban among current menthol cigarette smokers. These findings can be used to assist policy makers and communities in efforts to ban menthol cigarettes in their jurisdictions.

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COMPARING THE EFFECTS OF INSPIRATORY RESERVE VOLUME IN CIGARETTE AND SHISHA SMOKERS BY USING SPIROMETER

Pakistan Journal of Rehabilitation ◽

10.36283/pjr.zu.4.2/009 ◽

2015 ◽

Vol 4 (2) ◽

pp. 38-44

Author(s):

Muhammad Usman Khan ◽

Alisha Noreen ◽

Ramsha Kafeel ◽

Yusra Sabahat

Keyword(s):

Cigarette Smoking ◽

Sampling Technique ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Cigarette Smokers ◽

The Public ◽

Life Threatening ◽

Potential Risks ◽

College Of Nursing ◽

Functional Capacities

BACKGROUND Shisha and cigarette are the two most common type of tobacco smoking. Cigarette and shisha smoking have grown fast in different ages globally. Shisha and cigarette both contain chemicals that affect health badly and can cause common diseases such as cough and some life threatening diseases like cancer, emphysema and bronchitis also affect bones causing osteoporosis and decrease functional capacities of lung. There are no proper guidelines for the awareness of the public about the hazards of shisha smoking as they are present for cigarette smoking but it’s a fact that shisha smoking is as harmful as cigarette smoking. OBJECTIVES To compare the effect of Inspiratory Reserve Volume (IRV) on shisha and cigarette smokers by using spirometer. STUDY DESIGN AND SAMPLING TECHNIQUE Cross-sectional survey was steered, convenient sampling was used. STUDY SETTINGS & PARTICIPANTS The study was conducted on 50 participants of Ziauddin College of Nursing and Ziauddin College of Physical Therapy RESULTS IRV is more compromised in shisha smokers than in cigarette smokers. As far as deciding between health concerning effects of shisha and cigarette smokers, the shisha smoking effects are same as cigarette smoking. CONCLUSION Shisha smokers have more exposure to tobacco than cigarette smokers. IRV is disturbed by both means of smoking but shisha smoking has more potential risks. Keywords Inspiratory Reserve Volume, Spirometer, Cigarette, Smokers, Shisha, Emphysema, Bronchitis

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Predictors of Nicotine Dependence among Adult Male Midwakh and Cigarette Smokers

Sultan Qaboos University Medical Journal [SQUMJ] ◽

10.18295/squmj.4.2021.064 ◽

2021 ◽

Author(s):

Shatah Al Sharbatti ◽

Rizwana B. Shaikh ◽

Jayadevan Sreedharan ◽

Jayakumary Muttappallymyalil ◽

Michael Weizman

Keyword(s):

Carbon Monoxide ◽

Cigarette Smoking ◽

Nicotine Dependence ◽

United Arab Emirates ◽

Adult Male ◽

Sampling Strategy ◽

Exhaled Breath ◽

Addictive Behaviors ◽

Cross Sectional ◽

Cigarette Smokers

Objectives: Midwakh is a popular form of smoking in the Middle East. This study aimed to assess predictors of nicotine dependence among exclusive cigarette and midwakh smokers in the United Arab Emirates (UAE). Methods: This cross-sectional study was conducted from September to December 2015 in Ajman, UAE. A convenience sampling strategy was used to recruit adult male smokers aged ≥18 years who exclusively smoked either cigarettes or midwakh. A validated self-administered questionnaire was used to collect data from the participants, with nicotine dependence assessed using the Modified Fagerström Test for Nicotine Dependence. In addition, testing was performed to determine levels of salivary cotinine and exhaled breath carbon monoxide (CO). Results: A total of 88 adult male smokers were included in the study, of which 40 (45.5%) were cigarette smokers and 48 (54.5%) smoked midwakh. Most participants were 26–35 years of age (48.9%), followed by 18–25 years (30.7%) and ≥35 years (20.5%). Use of midwakh was associated with a more than three-fold increase in the risk of moderate to high nicotine dependence in comparison with cigarette smoking. Moreover, for each unit increase in CO level, there was a 10% increase in the risk of nicotine dependency. There was also a significant association between nicotine dependence level and depth of inhalation (P = 0.023). Conclusion: Type of smoking and CO levels were found to be significant predictors of nicotine dependence among adult male smokers. In particular, greater dependency was observed among midwakh smokers compared to those who smoked cigarettes. Keywords: Tobacco Use; Cigarette Smoking; Addictive Behaviors; Nicotine; Risk Assessment; Carbon Monoxide; Cotinine; United Arab Emirates.

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Cannabis use among a nationally representative cross-sectional sample of smokers and non-smokers in the Netherlands: results from the 2015 ITC Netherlands Gold Magic Survey

BMJ Open ◽

10.1136/bmjopen-2018-024497 ◽

2019 ◽

Vol 9 (3) ◽

pp. E024497 ◽

Cited By ~ 6

Author(s):

Brian Vincent Fix ◽

Danielle Smith ◽

Richard O’Connor ◽

Bryan W Heckman ◽

Marc C Willemsen ◽

...

Keyword(s):

Cigarette Smoking ◽

Cannabis Use ◽

Nicotine Exposure ◽

Cross Sectional ◽

Cigarette Smokers ◽

Current Cigarette ◽

Former Smokers ◽

Nationally Representative ◽

Never Smokers ◽

Current Tobacco

ObjectivesExisting evidence shows that co-occurring use of tobacco and cannabis is widespread. Patterns of co-use of tobacco and cannabis may change as more jurisdictions legalise medicinal and/or recreational cannabis sales. This analysis examined predictors of current cannabis use and characterised methods of consumption among smokers and non-smokers in a context where cannabis use is legal.SettingThe 2015 International Tobacco Control Netherlands—Gold Magic Survey conducted between July and August 2015.ParticipantsParticipants (n=1599; 1003 current smokers, 283 former smokers and 390 non-smokers) were asked to report their current (past 30-day) use of cigarettes and cannabis. Cigarette smokers reported whether they primarily used factory made of roll-your-own cigarettes. Those who reported any cannabis use in the last 30 days were asked about forms of cannabis used. X2and logistic regression analyses were used to assess relationships among combustible tobacco and cannabis use.ResultsPast 30-day cannabis use was somewhat higher among current tobacco (or cigarette) smokers (n=57/987=5.8%) than among former or never smokers (n=10/288=3.5% and n=6/316=1.9%, respectively). Joints were the most commonly used form of cannabis use for both current cigarette smokers (96.9%) and non-smokers (76.5%). Among those who smoked cannabis joints, 95% current smokers and 67% of non-smokers reported that they ‘always’ roll cannabis with tobacco.ConclusionsIn this Netherlands-based sample, most cannabis was reported to be consumed via smoking joints, most often mixed with tobacco. This behaviour may present unique health concerns for non-cigarette smoking cannabis users, since tobacco use could lead to nicotine dependence. Moreover, many non-cigarette smoking cannabis users appear to be misclassified as to their actual tobacco/nicotine exposure.

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Abstract P144: Smoking, Menthol Cigarettes and Peripheral Arterial Disease in the 1999– 2004 National Health and Nutrition Examination Survey (NHANES)

Circulation ◽

10.1161/circ.125.suppl_10.ap144 ◽

2012 ◽

Vol 125 (suppl_10) ◽

Author(s):

Miranda R Jones ◽

Benjamin J Apelberg ◽

Ana Navas-Acien

Keyword(s):

Peripheral Arterial Disease ◽

Odds Ratio ◽

Arterial Disease ◽

Cigarette Use ◽

Cigarette Smokers ◽

Menthol Cigarette ◽

Health And Nutrition ◽

Menthol Cigarettes ◽

Never Smokers ◽

Peripheral Arterial

Introduction: Cigarette flavorings, with the exception of menthol, have been banned under the Family Smoking Prevention and Tobacco Control Act. Previous studies have found strong associations between active smoking and peripheral arterial disease. While there is substantial interest in evaluating the health effects of menthol as compared to regular cigarette use, no information is available on the influence of cigarette type (non-menthol or menthol) on the risk of peripheral arterial disease. Objective: To investigate the association of cigarette smoking, menthol cigarette use and the prevalence of peripheral arterial disease in US adults Methods: We studied 5,978 adults 40 years of age and older who participated in the National Health and Nutrition Examination Survey (NHANES) from 1999–2004. Information on participant smoking status and cigarette type were derived from self-reported questionnaire data. Peripheral arterial disease was defined as an ankle-brachial blood pressure index <0.9 in at least one leg. Results: The weighted prevalence of peripheral arterial disease in the study population was 4.9%. Fifty percent of participants were never smokers compared to 31%, 14% and 5% of former, current non-menthol and current menthol cigarette smokers, respectively. After adjustment for demographics and cardiovascular risk factors, the odds ratio for peripheral arterial disease was 1.98 (95% CI: 1.41, 2.80), 5.24 (95% CI: 3.41, 8.05), 3.37 (95% CI: 1.86, 6.10) comparing former, current regular cigarette smokers and current menthol cigarette smokers to never smokers. After further adjustment for pack-years and serum cotinine, the odds ratio for peripheral arterial disease was 1.44 (95% CI: 0.97, 2.15), 3.65 (95% CI: 1.57, 8.50) and 2.51 (95% CI: 1.09, 5.80) comparing former, current regular cigarette smokers and current menthol cigarette smokers to never smokers. The significant association between smoking and peripheral arterial disease was similar for smokers of non-menthol and menthol cigarettes (p-value for heterogeneity= 0.53). Conclusions: In a representative sample of the US population, current menthol cigarette use was associated with increased prevalence of peripheral arterial disease with no difference compared to smoking non-menthol cigarettes.

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