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

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.

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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.

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Assessing the evidence on the differential impact of menthol versus non-menthol cigarette use on initiation and progression to regular smoking: A systematic review

10.21203/rs.3.rs-59515/v1 ◽

2020 ◽

Author(s):

Mimi Kim ◽

Geoffrey M Curtin

Keyword(s):

Evidence Synthesis ◽

Smoking Initiation ◽

Daily Smoking ◽

Cigarette Use ◽

Differential Impact ◽

Menthol Cigarette ◽

Strength Of Evidence ◽

Menthol Cigarettes ◽

Evidence Grade ◽

Meta Analyses

Abstract BACKGROUND: This evidence synthesis followed PRISMA guidelines to examine the Key Question: Does menthol cigarette use have a differential impact on initiation and progression to regular smoking compared to non-menthol cigarette use?METHODS: The protocol was registered on March 22, 2016 (updated January 10, 2019; PROSPERO: CRD42019119301). Six databases were queried from inception to December 14, 2018.RESULTS: Thirty-eight studies (19 rated as “good” and 19 rated as “fair” individual study quality) compared menthol and non-menthol cigarette smokers, and were qualitatively synthesized across four outcomes: (total adjusted studies; strength of evidence grade): age at smoking initiation (6; low); smoking initiation with menthol cigarettes (4; insufficient); switching between menthol and non-menthol cigarettes (2; insufficient); and progression to regular smoking/increased smoking over time (7; low [4 studies comparing daily versus non-daily smoking]). Generally, limited strength of evidence grades were due to issues of temporality, using current menthol status as a proxy for use at initiation. Results from two meta-analyses suggested that non-menthol smokers are more likely to report daily versus non-daily smoking; and, non-menthol smokers report younger ages at smoking initiation.CONCLUSIONS: Based on the lack of longitudinal evidence coupled with the limited strength of evidence provided by the available studies, there is no clear, differential association between menthol (versus non-menthol) cigarette use and progression to regular smoking.

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Menthol Cigarettes, Tobacco Dependence, and Smoking Persistence: The Need to Examine Enhanced Cognitive Functioning as a Neuropsychological Mechanism

Nicotine & Tobacco Research ◽

10.1093/ntr/nty264 ◽

2018 ◽

Vol 22 (4) ◽

pp. 466-472 ◽

Cited By ~ 1

Author(s):

Nancy C Jao ◽

Marcia M Tan ◽

Phoenix A Matthews ◽

Melissa A Simon ◽

Robert Schnoll ◽

...

Keyword(s):

Public Health ◽

United States ◽

Cognitive Functioning ◽

Basic Science ◽

Tobacco Dependence ◽

The United States ◽

Science Literature ◽

Cigarette Use ◽

Menthol Cigarette ◽

Menthol Cigarettes

Abstract Introduction Despite the overall decline in the prevalence of cigarette use in the United States, menthol cigarette use among smokers is rising, and evidence shows that it may lead to more detrimental effects on public health than regular cigarette use. One of the mechanisms by which nicotine sustains tobacco use and dependence is due to its cognitive enhancing properties, and basic science literature suggests that menthol may also enhance nicotine’s acute effect on cognition. Aims and Methods The purpose of this review is to suggest that the cognitive enhancing effects of menthol may be a potentially important neuropsychological mechanism that has yet to be examined. In this narrative review, we provide an overview of basic science studies examining neurobiological and cognitive effects of menthol and menthol cigarette smoking. We also review studies examining menthol essential oils among humans that indicate menthol alone has acute cognitive enhancing properties. Finally, we present factors influencing the rising prevalence of menthol cigarette use among smokers and the importance of this gap in the literature to improve public health and smoking cessation treatment. Conclusions Despite the compelling evidence for menthol’s acute cognitive enhancing and reinforcing effects, this mechanism for sustaining tobacco dependence and cigarette use has yet to be examined and validated among humans. On the basis of the basic science evidence for menthol’s neurobiological effects on nicotinic receptors and neurotransmitters, perhaps clarifying menthol’s effect on cognitive performance can help to elucidate the complicated literature examining menthol and tobacco dependence. Implications Menthol cigarette use has continued to be a topic of debate among researchers and policy makers, because of its implications for understanding menthol’s contribution to nicotine dependence and smoking persistence, as well as its continued use as a prevalent flavoring in tobacco and nicotine products in the United States and internationally. As international tobacco regulation policies have begun to target menthol cigarettes, research studies need to examine how flavoring additives, specifically menthol, may acutely influence neurobiological and cognitive functioning as a potential mechanism of sustained smoking behavior to develop more effective treatments.

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Use of Apps to Promote Childhood Vaccination: Protocol for a Systematic Review

JMIR Research Protocols ◽

10.2196/16929 ◽

2020 ◽

Vol 9 (2) ◽

pp. e16929

Author(s):

Michelle Helena Van Velthoven ◽

Madison Milne-Ives ◽

Caroline de Cock ◽

Mary Mooney ◽

Edward Meinert

Keyword(s):

Systematic Review ◽

Systematic Reviews ◽

Health Care Professionals ◽

English Language ◽

Search Strategy ◽

Grey Literature ◽

Information Storage ◽

Childhood Vaccination ◽

Cochrane Central Register ◽

Technical Standards

Background The decline in the uptake of routine childhood vaccinations has resulted in outbreaks of vaccine-preventable diseases. Vaccination apps can be used as a tool to promote immunization through the provision of reminders, dissemination of information, peer support, and feedback. Objective The aim of this review is to systematically review the evidence on the use of apps to support childhood vaccination uptake, information storage, and record sharing. Methods We will identify relevant papers by searching the following electronic databases: PubMed, Embase by Ovid, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.gov, and Education Resources Information Center (ERIC). We will review the reference lists of those studies that we include to identify relevant additional papers not initially identified using our search strategy. In addition to the use of electronic databases, we will search for grey literature on the topic. The search strategy will include only terms relating to or describing the intervention, which is app use. As almost all titles and abstracts are in English, 100% of these will be reviewed, but retrieval will be confined to papers written in the English language. We will record the search outcome on a specifically designed record sheet. Two reviewers will select observational and intervention studies, appraise the quality of the studies, and extract the relevant data. All studies will involve the use of apps relating to child vaccinations. The primary outcome is the uptake of vaccinations. Secondary outcomes are as follows: (1) use of app for sharing of information and providing vaccination reminders and (2) use of app for storage of vaccination information; knowledge and decision making by parents regarding vaccination (ie, risks and benefits of vaccination); costs and cost-effectiveness of vaccination apps; use of the app and measures of usability (eg, usefulness, acceptability, and experiences of different users: parents and health care professionals); use of technical standards for development of the app; and adverse events (eg, data leaks and misinformation). We will exclude studies that do not study an app. We anticipate a limited scope for meta-analysis and will provide a narrative overview of findings and tabular summaries of extracted data. Results This project was funded by the Sir David Cooksey Fellowship in Healthcare Translation at the University of Oxford, Oxford, United Kingdom. We will submit the full systematic review for publication in the Journal of Medical Internet Research. Conclusions This review will follow, where possible, the Cochrane Collaboration and the Centre for Review and Dissemination methodologies for conducting systematic reviews. We will report our findings based on guidelines from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The review results will be used to inform the development of a vaccination app. International Registered Report Identifier (IRRID) PRR1-10.2196/16929

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Balancing Consideration of the Risks and Benefits of E-Cigarettes

American Journal of Public Health ◽

10.2105/ajph.2021.306416 ◽

2021 ◽

pp. e1-e12

Author(s):

David J. K. Balfour ◽

Neal L. Benowitz ◽

Suzanne M. Colby ◽

Dorothy K. Hatsukami ◽

Harry A. Lando ◽

...

Keyword(s):

Smoking Cessation ◽

Media Coverage ◽

Attributable Mortality ◽

Cigarette Use ◽

The Public ◽

Health Community ◽

Smoking Policies ◽

Quit Attempts ◽

Quitting Smoking ◽

Potential Benefits

The topic of e-cigarettes is controversial. Opponents focus on e-cigarettes’ risks for young people, while supporters emphasize the potential for e-cigarettes to assist smokers in quitting smoking. Most US health organizations, media coverage, and policymakers have focused primarily on risks to youths. Because of their messaging, much of the public—including most smokers—now consider e-cigarette use as dangerous as or more dangerous than smoking. By contrast, the National Academies of Science, Engineering, and Medicine concluded that e-cigarette use is likely far less hazardous than smoking. Policies intended to reduce adolescent vaping may also reduce adult smokers’ use of e-cigarettes in quit attempts. Because evidence indicates that e-cigarette use can increase the odds of quitting smoking, many scientists, including this essay’s authors, encourage the health community, media, and policymakers to more carefully weigh vaping’s potential to reduce adult smoking-attributable mortality. We review the health risks of e-cigarette use, the likelihood that vaping increases smoking cessation, concerns about youth vaping, and the need to balance valid concerns about risks to youths with the potential benefits of increasing adult smoking cessation. (Am J Public Health. Published online ahead of print August 19, 2021: e1–e12. https://doi.org/10.2105/AJPH.2021.306416 )

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New global guidelines on sedentary behaviour and health for adults: broadening the behavioural targets

International Journal of Behavioral Nutrition and Physical Activity ◽

10.1186/s12966-020-01044-0 ◽

2020 ◽

Vol 17 (1) ◽

Cited By ~ 2

Author(s):

Paddy C. Dempsey ◽

Stuart J. H. Biddle ◽

Matthew P. Buman ◽

Sebastien Chastin ◽

Ulf Ekelund ◽

...

Keyword(s):

Public Health ◽

Physical Activity ◽

Systematic Review ◽

Sedentary Behaviour ◽

Systematic Reviews ◽

Cancer Mortality ◽

Sedentary Time ◽

Vigorous Physical Activity ◽

Public Health Practice ◽

World Health

Abstract Background In 2018, the World Health Organisation (WHO) commenced a program of work to update the 2010 Global Recommendations on Physical Activity for Health, for the first-time providing population-based guidelines on sedentary behaviour. This paper briefly summarizes and highlights the scientific evidence behind the new sedentary behaviour guidelines for all adults and discusses its strengths and limitations, including evidence gaps/research needs and potential implications for public health practice. Methods An overview of the scope and methods used to update the evidence is provided, along with quality assessment and grading methods for the eligible new systematic reviews. The literature search update was conducted for WHO by an external team and reviewers used the AMSTAR 2 (Assessment of Multiple Systematic Reviews) tool for critical appraisal of the systematic reviews under consideration for inclusion. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) method was used to rate the certainty (i.e. very low to high) of the evidence. Results The updated systematic review identified 22 new reviews published from 2017 up to August 2019, 14 of which were incorporated into the final evidence profiles. Overall, there was moderate certainty evidence that higher amounts of sedentary behaviour increase the risk for all-cause, cardiovascular disease (CVD) and cancer mortality, as well as incidence of CVD, cancer, and type 2 diabetes. However, evidence was deemed insufficient at present to set quantified (time-based) recommendations for sedentary time. Moderate certainty evidence also showed that associations between sedentary behaviour and all-cause, CVD and cancer mortality vary by level of moderate-to-vigorous physical activity (MVPA), which underpinned additional guidance around MVPA in the context of high sedentary time. Finally, there was insufficient or low-certainty systematic review evidence on the type or domain of sedentary behaviour, or the frequency and/or duration of bouts or breaks in sedentary behaviour, to make specific recommendations for the health outcomes examined. Conclusions The WHO 2020 guidelines are based on the latest evidence on sedentary behaviour and health, along with interactions between sedentary behaviour and MVPA, and support implementing public health programmes and policies aimed at increasing MVPA and limiting sedentary behaviour. Important evidence gaps and research opportunities are identified.

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The Pregnancy and Birth to 24 Months Project: a series of systematic reviews on diet and health

American Journal of Clinical Nutrition ◽

10.1093/ajcn/nqy372 ◽

2019 ◽

Vol 109 (Supplement_1) ◽

pp. 685S-697S ◽

Cited By ~ 20

Author(s):

Eve E Stoody ◽

Joanne M Spahn ◽

Kellie O Casavale

Keyword(s):

Public Health ◽

Systematic Review ◽

Dietary Intake ◽

Systematic Reviews ◽

Feeding Practices ◽

The Body ◽

Feeding Strategies ◽

Public Health Importance ◽

Review Team ◽

Pregnancy And Birth

ABSTRACTNutrition exposures during the earliest stages of life are integral to growth and development and may continue to affect health through adulthood. The purpose of the Pregnancy and Birth to 24 Months (P/B-24) Project was to conduct a series of systematic reviews on diet and health for women who are pregnant and for infants and toddlers from birth to 24 mo of age. The P/B-24 Project was a joint initiative led by the USDA and the US Department of Health and Human Services. The USDA's Nutrition Evidence Systematic Review team, previously known as the Nutrition Evidence Library, carried out the series of systematic reviews in collaboration with programmatic and scientific experts. Systematic review questions were prioritized based on federal policy, program, or guidance needs, potential to support the development of healthy dietary intake, and public health importance. Systematic reviews were conducted on specific topics related to dietary intake before and during pregnancy, infant milk feeding practices, complementary feeding, flavor exposures, and infant/toddler feeding practices. Across the reviews, relationships were observed between P/B-24 diet exposures and a variety of outcomes of public health importance. Evidence showed links between dietary intake before and during pregnancy, during the period of human milk or infant formula feeding, and through introduction of complementary foods and beverages and health outcomes. Additionally, the reviews on flavor exposure and infant/toddler feeding practices highlight the importance of maternal diet during pregnancy and lactation and caregiver feeding strategies and practices. Systematic reviews are an important tool to inform our understanding of the body of evidence related to diet and health, and scientists can use the P/B-24 Project reviews to continue to advance research in these areas.

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E-Cigarette Use and Adult Cigarette Smoking Cessation: A Meta-Analysis

American Journal of Public Health ◽

10.2105/ajph.2020.305999 ◽

2020 ◽

pp. e1-e17

Author(s):

Richard J. Wang ◽

Sudhamayi Bhadriraju ◽

Stanton A. Glantz

Keyword(s):

Public Health ◽

Smoking Cessation ◽

Observational Studies ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

Adult Population ◽

Consumer Products ◽

Cigarette Use ◽

Quit Smoking ◽

Meta Analyses

Objectives. To determine the association between e-cigarette use and smoking cessation. Methods. We searched PubMed, Web of Science Core Collection, and EMBASE and computed the association of e-cigarette use with quitting cigarettes using random effects meta-analyses. Results. We identified 64 papers (55 observational studies and 9 randomized clinical trials [RCTs]). In observational studies of all adult smokers (odds ratio [OR] = 0.947; 95% confidence interval [CI] = 0.772, 1.160) and smokers motivated to quit smoking (OR = 0.851; 95% CI = 0.684, 1.057), e-cigarette consumer product use was not associated with quitting. Daily e-cigarette use was associated with more quitting (OR = 1.529; 95% CI = 1.158, 2.019) and less-than-daily use was associated with less quitting (OR = 0.514; 95% CI = 0.402, 0.665). The RCTs that compared quitting among smokers who were provided e-cigarettes to smokers with conventional therapy found e-cigarette use was associated with more quitting (relative risk = 1.555; 95% CI = 1.173, 2.061). Conclusions. As consumer products, in observational studies, e-cigarettes were not associated with increased smoking cessation in the adult population. In RCTs, provision of free e-cigarettes as a therapeutic intervention was associated with increased smoking cessation. Public Health Implications. E-cigarettes should not be approved as consumer products but may warrant consideration as a prescription therapy. (Am J Public Health. Published online ahead of print December 22, 2020: e1–e17. https://doi.org/10.2105/AJPH.2020.305999 )

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