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: 2.57). 03/2009; 63(3):360-7. DOI: 10.1111/j.1742-1241.2008.01969.x
Source: PubMed


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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    • "Furthermore, menthol may have a role in smoking onset and elevated dependence (38, 39) though this has received mixed support in the literature (40-42). Gandhi (2009) found that Latino smokers who preferred mentholated cigarettes, compared to non-mentholated, were more likely to smoke sooner after waking and reported more interrupted sleep, two indicators of nicotine dependence. Smokers preferring menthol were also less likely to be abstinent at the 4 week and six month follow ups (37). "
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    ABSTRACT: Latino smokers are a rising public health concern who experience elevated tobacco-related health disparities. Additional information on Latino smoking is needed to inform screening and treatment. Latent class analysis using smoking frequency, cigarette preferences, onset, smoking duration, cigarettes per day, and minutes to first cigarette was used to create multivariate latent smoking profiles for Latino men and women. Final models found seven classes for Latinas and nine classes for Latinos. Despite a common finding in the literature that Latino smokers are more likely to be low-risk intermittent smokers, the majority of classes for both males and females described patterns of high-risk daily smoking. Gender variations in smoking classes were noted. Several markers of smoking risk were identified among both male and female Latino smokers, including long durations of smoking, daily smoking, and preference for specialty cigarettes, all factors associated with long-term health consequences.
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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.
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    • "Twelve studies potentially provide evidence on whether menthol compared to non-menthol cigarette use affects dependence; however, nine of these studies present analyses that are based on non-representative populations and that do not adjust for covariates (Brinkman et al., 2012; Brody et al., 2013; Collins and Moolchan, 2006; Gandhi et al., 2009; Hyland and Kasza, unpublished ; Okuyemi et al., 2004, 2003; Pletcher et al., 2006; Rosenbloom et al., 2012). Two of the remaining three studies present estimates of numbers of cigarettes smoked per day among menthol compared to non-menthol smokers based on data from the Tobacco Use Supplement to the Current Population Survey (TUS-CPS). "
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    ABSTRACT: Previously published studies provide somewhat inconsistent evidence on whether menthol in cigarettes is associated with increased dependence. 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 collect data on current cigarette type preference and primary measures of dependence, and thus allow examination of whether menthol smokers are more dependent than non-menthol smokers. Analyses based on combined data from multiple administrations of each of these four nationally representative surveys, using three definitions for current smokers (i.e., smoked ⩾1 day, ⩾10 days and daily during the past month), consistently demonstrate that menthol smokers do not report smoking more cigarettes per day than non-menthol smokers. Moreover, two of the three surveys that provide data on time to first cigarette after waking indicate no difference in urgency to smoke among menthol compared to non-menthol smokers, while the third suggests menthol smokers may experience a greater urgency to smoke; estimates from all three surveys indicate that menthol versus non-menthol smokers do not report a higher Heaviness of Smoking Index. Collectively, these findings indicate no difference in dependence among U.S. smokers who use menthol compared to non-menthol cigarettes.
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