Lower quit rates among African American and Latino menthol cigarette smokers at a tobacco treatment clinic

Division of Addiction Psychiatry, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA.
International Journal of Clinical Practice (Impact Factor: 2.54). 03/2009; 63(3):360-7. DOI: 10.1111/j.1742-1241.2008.01969.x
Source: PubMed

ABSTRACT Lower rates of smoking cessation and higher rates of lung cancer in African American (AA) smokers may be linked to their preference for mentholated cigarettes.
This study assessed the relationship between menthol smoking, race/ethnicity and smoking cessation among a diverse cohort of 1688 patients attending a specialist smoking cessation service.
46% of the patients smoked mentholated cigarettes, but significantly more AA (81%) and Latino (66%) patients than Whites (32%) smoked menthols. AA and Latino menthol smokers smoked significantly fewer cigarettes per day (CPD) than non-menthol smokers (15.7 vs. 20.3, for AA, and 17.0 vs. 22.1, for Latinos), with no differences among White menthol and non-menthol smokers. At 4-week follow up, AA, Latino and White non-menthol smokers had similar quit rates (54%, 50% and 50% respectively). In contrast, among menthol smokers, AAs and Latinos had lower quit rates (30% and 23% respectively) compared with Whites (43%, p < 0.001). AA and Latino menthol smokers had significantly lower odds of quitting [odds ratio (OR) = 0.34; 95% CI = 0.17, 0.69 for AA, and OR = 0.32; 95% CI = 0.16, 0.62 for Latinos] than their non-menthol counterparts. At 6-month follow up, a similar trend was observed for the race/ethnicity subgroups, with AA menthol smokers having half the odds of being abstinent compared with AA non-menthol smokers (OR = 0.48; 95% CI = 0.25, 0.9).
Despite smoking fewer CPD, AA and Latino menthol smokers experience reduced success in quitting as compared with non-menthol smokers within the same ethnic/racial groups.

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Available from: Jonathan Foulds, Aug 15, 2015
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    • "Gandhi et al. (2009) reported statistically significantly lower odds of quitting at 4-weeks and 6-months follow-up among African– American menthol versus non-menthol cigarette smokers; no differences were indicated among White menthol versus nonmenthol smokers, with inconsistent findings among Latino smokers . These latter analyses (Gandhi et al., 2009) also suggested the potential for effect modification, whereby the strength of the ''menthol effect'' was related to socio-economic status. For example , the 4-week quit rate was statistically lower among African– American menthol versus non-menthol cigarette smokers who were unemployed, but not different among those who were employed full-time. "
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    ABSTRACT: The National Health and Nutrition Examination Survey, National Survey on Drug Use and Health, National Health Interview Survey and Tobacco Use Supplement to the Current Population Survey provide estimates of the proportions of U.S. smokers who currently use menthol cigarettes, overall and within demographic strata. Among adult past-month, regular and daily smokers, menthol cigarette use ranges from 26% to 30%, with statistically higher proportions of female versus male smokers (8-11 percentage points higher) currently using menthol cigarettes. Compared to adult smokers overall, statistically higher proportions of non-Hispanic Black smokers (72%-79%) and statistically lower proportions of non-Hispanic White smokers (19%-22%) currently use menthol cigarettes, with no differences among smokers of other race/ethnicity groups (18%-20% to 28%-30%, depending on the survey). Higher proportions of younger adult past-month, regular and daily smokers (aged 18-25 years) currently use menthol cigarettes compared to older adult smokers (aged 26-29 years and/or ⩾30 years); however, differences are small in magnitude, with the vast majority of adult smokers (70%-75%) who currently use menthol cigarettes being aged ⩾30 years. Comparisons between youth and adult smokers are provided, although data for youth smokers are less available and provide less consistent patterns of menthol cigarette use.
    Regulatory Toxicology and Pharmacology 07/2014; 70(1). DOI:10.1016/j.yrtph.2014.06.018 · 2.14 Impact Factor
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    • "The lack of a main effect of menthol use on cessation is consistent with a number of studies conducted among nonpregnant smokers (e.g., Fu et al., 2008; Hyland et al., 2002; Muscat et al., 2002). The significant relationship between menthol use and postpartum smoking relapse among White women in this sample was surprising, however, given that most previous studies found that the effect of menthol use on cessation was more salient among racial minority groups (e.g., Foulds et al., 2010; Gandhi et al., 2009; Gundersen et al., 2009; Stahre "
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    ABSTRACT: Little is known about the influence of prepartum menthol cigarette use on postpartum smoking abstinence or how race/ethnicity might moderate this relationship. The current study addressed that gap by testing these relationships among racially/ethnically diverse women who quit smoking during pregnancy (N = 244; 33% African American, 31% Latina, 36% White). Continuation ratio logit models were used to examine the effects of prepartum menthol cigarette use on biochemically confirmed, continuous abstinence through 26 weeks postpartum using an intent-to-treat approach. Analyses controlled for age, race/ethnicity, partner status, income, education, treatment, number of prequit cigarettes smoked per day, time to the first cigarette of the day, and time (Week 8 or 26 data collection timepoint). An additional model tested the moderating effects of race/ethnicity by including an interaction term. Prepartum menthol cigarette use was not significantly associated with postpartum smoking abstinence in the overall sample. However, the interaction between menthol use and race/ethnicity was significant (p = .02). Among White women, menthol use was associated with significantly lower odds of maintaining postpartum smoking abstinence (p = .03; odds ratio = .19 [.04-.89]), and the effect approached significance among African American women (p = .08). This study provides the first evidence that prepartum menthol cigarette use may increase the risk of postpartum smoking relapse among White, and possibly African American, women who quit smoking during or immediately before pregnancy. Results suggest that White and African American prepartum menthol users may require different or more intensive cessation services to aid in the maintenance of postpartum smoking abstinence. Replication with larger samples, and a focus on understanding the mechanisms that underlie these relationships, are warranted.
    Nicotine & Tobacco Research 05/2011; 13(12):1305-10. DOI:10.1093/ntr/ntr095 · 2.81 Impact Factor
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    • "While a few studies have found no statistically significant differences in rates of smoking cessation by menthol status [8] [9], a number of recent studies have. In particular, studies by Okuyemi and colleagues (2003, 2004, 2007), Harris et al. (2004), Foulds et al. (2006) and Gandhi et al. (2009) all found that individuals who smoke menthol cigarettes are significantly less successful in quitting than individuals who smoke non-menthol cigarettes [10] [11] [12] [13] [14] [15]. Given the sizeable market share of menthol cigarettes, the popularity of menthol cigarettes among certain subgroups in the United States and the potential role menthol plays in smoking initiation and cessation, a ban on menthol cigarettes would probably have both economic and public health implications. "
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    ABSTRACT: To examine the relationship between menthol and non-menthol prices and smoke-free air laws and the choice between menthol and non-menthol cigarettes among current smokers. Data were extracted from the nationally representative (USA) 2003 and 2006/07 Tobacco Use Supplements to the Current Population Survey. A total of 57,383 adult smokers (aged 18+) were examined. A regression model was used to estimate the probability of being a menthol smoker conditional on being a current smoker who had a distinct preference for either non-menthol or menthol cigarettes. Cigarette prices, smoke-free air laws and socio-economic and demographic characteristics were examined as covariates. The prices of menthol and non-menthol cigarettes were associated with the choice between menthol and non-menthol cigarettes. However, smokers did not find menthol and non-menthol cigarettes to be close substitutes for one another. Non-menthol cigarettes were found to be less of a substitute for menthol cigarettes than vice versa. Young adults and African Americans were less responsive to prices with respect to switching between menthol and non-menthol cigarettes than were older adults and non-African Americans, respectively. The US Food and Drug Administration (FDA) is grappling with the issue of whether or not to ban menthol cigarettes. The findings from this study suggest that smokers do not find menthol and non-menthol cigarettes to be close substitutes. The strong preference for mentholated cigarettes may serve as a lever to reduce smoking prevalence when combined with increased access to effective cessation treatments.
    Addiction 12/2010; 105 Suppl 1:115-23. DOI:10.1111/j.1360-0443.2010.03206.x · 4.60 Impact Factor
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