Menthol Smoking and Subjective Response To the First Cigarette Smoked

Abstract

Objectives: Using the Population Assessment of Tobacco and Health (PATH) study, this study examined whether pleasant and unpleasant subjective responses to the first cigarette smoked differed by initiation with a menthol versus non-menthol cigarette and whether subjective response was associated with current tobacco use behaviors, independent of, and in interaction with menthol initiation. Methods: Data were from youth and young adult ever smokers in Wave 2 (2014-2015) of the PATH study. Results: In adjusted multivariable logistic regression models, menthol initiators reported a more pleasant first smoking experience compared to non-menthol initiators and increased odds of past 30-day smoking, non-cigarette tobacco use, and menthol smoking. In adjusted models, pleasant experience was associated with increased odds of past 30-day smoking, non-cigarette tobacco use, and heavy smoking. Unpleasant experience was associated with decreased odds of past 30-day smoking. Interactions of menthol initiation with subjective response were not significant. Conclusions: Smokers who initiate with a menthol cigarette experience a more pleasant first smoking experience, and pleasant experience is associated with regular smoking and use of non-cigarette tobacco products. Findings underscore the potential abuse liability of menthol cigarettes and provide further evidence that a ban on menthol may help reduce tobacco use among young people.