Relationship between menthol cigarettes and smoking cessation among African American light smokers

Program in Health Disparities Research, University of Minnesota Medical School, Minneapolis, MN 55455, USA.
Addiction (Impact Factor: 4.74). 12/2007; 102(12):1979-86. DOI: 10.1111/j.1360-0443.2007.02010.x
Source: PubMed

ABSTRACT To determine whether African American light smokers who smoked menthol cigarettes had lower cessation when treated with nicotine replacement therapy and counseling.
Data were derived from a clinical trial that assessed the efficacy of 2 mg nicotine gum (versus placebo) and counseling (motivational interviewing counseling versus Health Education) for smoking cessation among African American light smokers (smoked < or = 10 cigarettes per day).
The sample consisted of 755 African American light smokers.
The primary outcome variable was verified 7-day point-prevalence smoking cessation at 26 weeks follow-up. Verification was by salivary cotinine.
Compared to non-menthol smokers, menthol smokers were younger and less confident to quit smoking (P = 0.023). At 26 weeks post-randomization, 7-day verified abstinence rate was significantly lower for menthol smokers (11.2% versus 18.8% for non-menthol, P = 0.015).
Among African American light smokers, use of menthol cigarettes is associated with lower smoking cessation rates. Because the majority of African American smokers use menthol cigarettes, a better understanding of the mechanism for this lower quit rate is needed.

21 Reads
  • Source
    • "While this finding is consistent with recent studies that enrolled both African American and White smokers (Heck, 2009; Signorello, Cai, Tarone, McLaughlin, & Blot, 2009), it contradicts another study conducted by Ahijevych and Parsley (1999) in which they found significant differences in serum cotinine between menthol and nonmenthol smokers, albeit in heavier smokers (Ahijevych & Parsley, 1999). Also, similar to our previous study (Okuyemi, Faseru, et al., 2007) confidence to quit was high in both menthol and non-menthol smokers (7.04–7.90 out of 10). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Smoking menthol cigarettes is more prevalent among African Americans (AA) compared to Whites. Menthol has been found to be inversely related to smoking cessation among AA, yet little is known about the factors associated with menthol smoking among AA light smokers. This study examines baseline demographic, psychological, and smoking factors associated with smoking menthol cigarettes among AA light smokers (≤10 cigarettes per day). Participants (n=540) were enrolled in a double blind, placebo-controlled randomized trial of bupropion in combination with health education counseling for smoking cessation. Bivariate differences between menthol and non-menthol smokers were explored and baseline factors associated with smoking menthol cigarettes were identified. Participants averaged 46.5 years in age, predominantly female (66.1%), and smoked an average of 8.0 cpd (SD=2.5). The majority (83.7%) smoked menthol cigarettes. In bivariate analysis, menthol cigarette smokers were younger (mean age: 45 vs. 52 years p<0.0001), were more likely to be female (68% vs. 52% p=0.003) and had smoked for shorter duration (28 vs. 34 years p<0.0001) compared to non-menthol smokers. While depression and withdrawal scores were slightly higher and exhaled carbon monoxide values were lower among menthol smokers, the differences were not statistically significant. Among AA light smokers, younger individuals and females were more likely to smoke menthol cigarettes and may be more susceptible to the health effects of smoking. Appropriately targeted health education campaigns are needed to prevent smoking uptake in this high-risk population.
    Addictive behaviors 07/2011; 36(12):1321-4. DOI:10.1016/j.addbeh.2011.07.015 · 2.76 Impact Factor
  • Source
    • "Five studies have compared age of starting to smoke in mentholated and non-mentholated cigarette smokers. No significant differences were seen in the largest study [46], which involved over 10,000 subjects and adjusted for race, in two studies in Black people [47,48], or in two other studies [49,50] which did not adjust for race. "
    [Show abstract] [Hide abstract]
    ABSTRACT: US mentholated cigarette sales have increased considerably over 50 years. Preference for mentholated cigarettes is markedly higher in Black people. While menthol itself is not genotoxic or carcinogenic, its acute respiratory effects might affect inhalation of cigarette smoke. This possibility seems consistent with the higher lung cancer risk in Black men, despite Black people smoking less and starting smoking later than White people. Despite experimental data suggesting similar carcinogenicity of mentholated and non-mentholated cigarettes, the lack of convincing evidence that mentholation increases puffing, inhalation or smoke uptake, and the similarity of lung cancer rates in Black and White females, a review of cigarette mentholation and lung cancer is timely given current regulatory interest in the topic. Epidemiological studies comparing lung cancer risk in mentholated and non-mentholated cigarette smokers were identified from MedLine and other sources. Study details were extracted and strengths and weaknesses assessed. Relative risk estimates were extracted, or derived, for ever mentholated use and for long-term use, overall and by gender, race, and current/ever smoking, and meta-analyses conducted. Eight generally good quality studies were identified, with valid cases and controls, and appropriate adjustment for age, gender, race and smoking. The studies afforded good power to detect possible effects. However, only one study presented results by histological type, none adjusted for occupation or diet, and some provided no results by length of mentholated cigarette use.The data do not suggest any effect of mentholation on lung cancer risk. Adjusted relative risk estimates for ever use vary from 0.81 to 1.12, giving a combined estimate of 0.93 (95% confidence interval 0.84-1.02, n = 8), with no increase in males (1.01, 0.84-1.22, n = 5), females (0.80, 0.67-0.95, n = 5), White people (0.87, 0.75-1.03, n = 4) or Black people (0.90, 0.73-1.10, n = 4). Estimates for current and ever smokers are similar. The combined estimate for long-term use (0.95, 0.80-1.13, n = 4) again suggests no effect of mentholation. Higher lung cancer rates in Black males cannot be due to their greater preference for mentholated cigarettes. While some study weaknesses exist, the epidemiological evidence is consistent with mentholation having no effect on the lung carcinogenicity of cigarettes.
    BMC Pulmonary Medicine 04/2011; 11(1):18. DOI:10.1186/1471-2466-11-18 · 2.40 Impact Factor
  • Source
    • "Few studies of smoking topography between AAW and African American men exist without menthol as a part of the investigation [see (Henningfield, et al., 2003; Okuyemi, Faseru, et al., 2007) for literature which also investigates differences related to mentholated smoking]. While research with mentholated cigarettes provide relevant information regarding brand preference and other sociocultural factors among African Americans (Allen & Unger, 2007; Richter, et al., 2008), there is conceivably more to understand about smoking topography patterns in AAW as compared to African American men who do not smoke mentholated cigarettes, especially given that mentholated cigarettes may provide a cooler smoke that can change smoking topography to increase tar, nicotine and carcinogenic absorption (Shields, 2000). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Tobacco smoking is a national public health problem that has been associated with numerous adverse health effects, including increased disease and cancer rates. Previous review articles on smoking in specific demographic populations have focused on smoking in women and on smoking in African Americans, but have not considered the dual roles of ethnicity and gender in smoking behavior. African American women (AAW) are an important subgroup to study because they are distinct from non-AAW and their male African American counterparts on biopsychosocial factors that are relevant to smoking behavior. The purpose of the present review paper is to integrate and summarize the current literature on the epidemiology, determinants, and consequences of cigarette smoking among AAW, by contrasting them to relevant comparison groups (non-AAW and African American men). Evidence suggests that AAW are generally more likely to be light smokers and initiate smoking later. The prevalence rates of AAW smokers have decreased over the past 25years, yet AAW are disproportionately affected by several smoking-related illnesses when compared to their ethnic and gender comparison groups. AAW smokers are distinct from relevant comparison groups in metabolic sensitivity to nicotine, aspects of smoking topography, and several psychosocial factors that influence smoking. Although a small literature on smoking in AAW is emerging, further empirical research of AAW smokers could inform the development of tailored interventions for AAW.
    Addictive behaviors 05/2010; 35(5):383-91. DOI:10.1016/j.addbeh.2009.12.014 · 2.76 Impact Factor
Show more


21 Reads
Available from