Menthol Cigarettes Research Articles

Menthol versus tobacco e-liquid flavor: Impact on acute subjective effects, puff patterns, and intentions for use among Black and White menthol smokers

BackgroundThe proposed FDA product standard to prohibit menthol as a characterizing flavor in combustible cigarettes has the potential to significantly reduce tobacco-related health disparities. Whether a menthol e-liquid product standard would improve or hinder public health is unknown. No known research has directly examined the impact of menthol vs. tobacco flavored e-liquid use on acute e-cigarette use patterns, subjective experience, behavioral intentions, and craving and withdrawal among menthol cigarette smokers. MethodsBlack (n = 47) and White (n = 4) nicotine-deprived menthol smokers with limited e-cigarette experience completed two counterbalanced in-laboratory 30-minute ad libitum vaping sessions with menthol and tobacco nicotine salt-based e-liquid in a randomized crossover pilot trial design. Questionnaires assessed reductions in craving and withdrawal and post-session subjective experience and behavioral intentions. Puff topography was measured continuously throughout each vaping session. ResultsMeasures of puff topography did not differ significantly by e-liquid flavor (all p > .40). Similarly, menthol and tobacco flavored e-cigarettes were both rated positively in terms of subjective effects and behavioral intentions (all p > .10) and about 40 % of participants reported a preference for the tobacco-flavored e-liquid. Finally, participants showed comparable reductions in craving (p = .210) and withdrawal (p = .671) from pre- and post-session regardless of e-liquid flavor. ConclusionsAmong menthol smokers in a lab-based setting, findings suggest that menthol vs tobacco e-liquid flavor has little impact on acute changes in puff patterns, subjective experience, behavioral intentions, or craving and withdrawal.

Developing a National Longitudinal Tobacco Cohort of Youth and Young Adults: The Tobacco Epidemic Evaluation Network (TEEN+) Study.

Timely and relevant data are critical to monitoring the rapidly changing youth vaping epidemic and for understanding the prevalence, patterns of use, knowledge, and perceptions of tobacco products. While e-cigarettes have been the most used tobacco product among youth for nearly a decade, new nicotine delivery products continue to be introduced to the US market. Flavored tobacco products, including flavored e-cigarettes, menthol cigarettes, and flavored cigars, drive disparities in use by young people. To examine tobacco use among youth and young adults, the Monitoring E-Cigarette Use among Youth project established a longitudinal cohort of youth and young adults (13-24)-the Tobacco Epidemic Evaluation Network (TEEN+) study. TEEN+ focuses on e-cigarette and other tobacco products use and also includes questions about other substance use (eg, marijuana, alcohol), physical health, mental health, and social determinants of health (eg, discrimination, poverty, sexual and gender identity). Geocoding of responses allows for the evaluation of local tobacco control policies. The cohort includes an oversample of California residents to generate reliable and representative state-level estimates. This manuscript provides an overview of methods and baseline demographics from Wave 1. The initial Wave 1 TEEN+ cohort included 10 255 in the national sample and 2761 in the California sample. TEEN+ study data complement nationally-representative cross-sectional studies and allow for rapid evaluation of local and state policies. This manuscript describes the study's probability-based sample recruitment. Furthermore, we identify this initiative as a resource for evaluating the impact of flavored tobacco restriction policies and informing policy implementation efforts. This manuscript provides an overview of the methodology and baseline characteristics for a new longitudinal cohort of youth and young adults, the Tobacco Epidemic Evaluation Network (TEEN+) study. The TEEN+ study data can be used to evaluate the impact of flavored tobacco product restriction policies and informing policy implementation efforts.

Prevalence of menthol cigarette use among adults who smoke from the United States by census division and demographic subgroup, 2002–2020: findings from the International Tobacco Control (ITC) project

BackgroundTargeted marketing of menthol cigarettes in the US influences disparities in the prevalence of menthol smoking. There has been no analysis of sub-national data documenting differences in use across demographic subgroups. This study estimated trends in the prevalence of menthol use among adults who smoke in the nine US census divisions by sex, age, and race/ethnicity from 2002 to 2020.MethodsData from 12 waves of the US ITC Survey were used to estimate the prevalence of menthol cigarette use across census divisions and demographic subgroups using multilevel regression and post-stratification (n = 12,020). Multilevel logistic regression was used to predict the prevalence of menthol cigarette use in 72 cross-classified groups of adults who smoke defined by sex, age, race/ethnicity, and socioeconomic status; division-level effects were fit with a random intercept. Predicted prevalence was weighted by the total number of adults who smoke in each cross-classified group and aggregated to divisions within demographic subgroup. Estimates were validated against the Tobacco Use Supplement to the Current Population Survey (TUS-CPS).ResultsOverall modeled prevalence of menthol cigarette use was similar to TUS-CPS estimates. Prevalence among adults who smoke increased in each division from 2002 to 2020. By 2020, prevalence was highest in the Middle (46.3%) and South Atlantic (42.7%) and lowest in the Pacific (25.9%) and Mountain (24.2%) divisions. Prevalence was higher among adults aged 18–29 (vs. 50+) and females (vs. males). Prevalence among non-Hispanic Black people exceeded 80% in the Middle Atlantic, East North Central, West North Central, and South Atlantic in all years and varied most among Hispanic people in 2020 (Pacific: 26.5%, New England: 55.1%).ConclusionsSignificant geographic variation in the prevalence of menthol cigarette use among adults who smoke suggests the proposed US Food and Drug Administration (FDA) menthol cigarette ban will exert differential public health benefits and challenges across geographic and demographic subgroups.

Assessment of abuse liability and switching potential of menthol-flavored pod-based electronic nicotine delivery systems among US adults who smoke cigarettes

BackgroundMenthol-flavored electronic nicotine delivery systems (ENDS) are a focus of public health and regulatory policy considerations. The abuse liability of five menthol-flavored pod-based ENDS was compared to combustible cigarettes, and switching potential of ENDS was also evaluated. Methods215 US adults who smoke cigarettes (34.4% female; mean age[SD]=29.60[8.75]; 40.9% non-Hispanic White; mean cigarettes/day[SD]=12.04[8.52]) completed a randomized 6-arm within-person cross-over product-use study. Participants used five pod-based menthol-flavored ENDS (JUUL2 Polar Menthol 1.5%, JUUL2 Prototype Fresh Menthol 3.0%, JUUL Menthol 5.0%, Vuse Alto Menthol 5.0%, NJOY Ace Menthol 5.0%) and their usual brand (UB) cigarette for 20minutes ad libitum. After each product use, subjective reinforcing effects relevant to abuse liability and associated with switching away from cigarettes (e.g., satisfaction, product liking) were assessed. ResultsAll ENDS products were rated substantially and statistically significantly lower than UB cigarette on measures of subjective reinforcing effects (ps<0.001). Satisfying effects of JUUL2 1.5% were rated significantly higher than other ENDS products. JUUL2 Prototype 3.0% and Vuse Alto 5.0% did not significantly differ (ps>0.05), and both were rated significantly higher than JUUL 5.0% and NJOY Ace 5.0% (ps<0.05). Differences in subjective responses to study products did not significantly differ by preference for menthol cigarettes or by current ENDS use. ConclusionsAbuse liability of all menthol-flavored ENDS in this study was substantially lower than combustible cigarettes. Abuse liability of JUUL2 1.5% was within the range of currently marketed pod-based menthol-flavored ENDS products. JUUL2 1.5% likely has high potential for facilitating switching among US adults who smoke.

Perceptions of African American Youth and Adults Regarding Tobacco Use-Related Factors in Their Community: A Mixed-Methods Approach in Richmond, Virginia.

The US Food and Drug Administration is poised to restrict the availability of menthol cigarettes and flavored cigars, products disproportionately used by Black/African American (B/AA) individuals. We examined B/AA youth and adult perceptions regarding factors contributing to tobacco use, as well as prevention/cessation resources. In 2 mixed-methods studies in Richmond, Virginia, we conducted cross-sectional surveys among youth (n = 201) and adult (n = 212) individuals who were primarily B/AA and reported past 30-day cigar smoking or nontobacco use, followed by focus groups with a subset (youth: n = 30; adults: n = 24). Focus groups were analyzed using a thematic analysis framework, and descriptive survey data provided context to themes. Among focus group participants, 20% of youth and 75% of adults reported current cigar smoking. Six themes emerged across the groups: advertising/brands, sensory experiences, costs, social factors, youth-related factors, and dependence/cessation. Youth and adults perceived cigars as popular; cigar use was attributed to targeted advertising, flavors, affordability, and accessibility. While adults expressed concern regarding youth tobacco use, youth did not perceive tobacco prevention programs as helpful. Adults and youth reported limited access to community tobacco prevention/cessation programs. Expanded tobacco prevention and cessation resources for B/AA people who smoke could leverage federal regulatory actions to ban tobacco products targeted toward this group and decrease disparities in tobacco-related morbidity and mortality.

Journal Digest: TMS for Psychomotor Symptoms, Effects of Menthol Cigarette Bans, and More

Journal Digest: TMS for Psychomotor Symptoms, Effects of Menthol Cigarette Bans, and More

Sociodemographic and Temporal Differences in Menthol Cigarette Use Among US Adults Who Smoke, 1999-2018.

Monitoring menthol cigarette use allows for identification of potential health disparities. We examined sociodemographic and temporal differences in menthol cigarette use among US adults who smoke. We analyzed data from the 1999-2018 National Health and Nutrition Examination Survey for adults aged 20 years or older who smoke (N = 11,431) using binary logistic regression. Among US adults who smoke, 28.8% used menthol cigarettes. After adjusting for age, sex, race and ethnicity, education, income-to-poverty ratio, and health status, the prevalence of menthol use among adults who smoke increased on average by 3.8% (95% CI, 2.7%-4.9%) annually. Non-Hispanic Black adults had the highest average prevalence of menthol cigarette use, 73.0% (95% CI, 70.9%-75.2%), and Mexican American adults had higher average annual increase in menthol cigarette use, 7.1% (95% CI, 4.0%-10.3%). Adults with fair or poor health status had a 4.3% annual increase in menthol cigarette use (95% CI, 2.5%-6.1%). The adjusted prevalence ratios of menthol cigarette use were 1.61 (95% CI, 1.39-1.83) for adults aged 20-29 years compared with those aged 65 years or older, 1.41 (95% CI, 1.32-1.49) for female adults compared with male adults, and 1.17 (95% CI, 1.07-1.27) for high school graduates or higher compared with those with no high school diploma. Non-Hispanic Black adults who smoke had the highest prevalence of menthol cigarette use among all racial and ethnic groups; the prevalence of menthol cigarette use among adults who smoke increased especially among Mexican American adults, younger adults, and adults who reported fair to poor health status.

Abstract 2154: Actívatexto:Feasibility and acceptability of a mobile intervention that promotes smoking cessation and physical activity among Latinos

Abstract The purpose of this study was to assess the feasibility and acceptability of a mobile intervention that promotes smoking cessation and physical activity among Latinos. Twenty Latino adults who smoked and did not meet recommended levels of physical activity were recruited using community-based recruitment strategies. Participants received Actívatexto, a theory-based, culturally accommodated, 12-week text messaging intervention (available in English and Spanish) that promotes both smoking cessation and physical activity. Actívatexto integrates four components: 1) a text messaging program that promotes both smoking cessation and physical activity, 2) a wearable device to monitor physical activity, 3) an online dashboard where the research team manages participants’ incoming and outgoing data from both the text messaging program and wearable devices, and 4) smoking cessation pharmacotherapy (i.e., nicotine replacement therapies). We assessed self-reported 7-day point prevalence smoking abstinence (not smoking any cigarettes in the past seven days) at Month 3, weekly minutes of moderate to vigorous physical activity (MVPA), pharmacotherapy adherence, self-efficacy, and satisfaction. At baseline, participants’ mean age was 47.3 years old (SD 16.0), 55% of participants were female, 80% had completed high school or lower educational level, and 60% indicated that Spanish was their language of preference. Most participants (75%) smoked 1-10 cigarettes daily, 35% smoked their first cigarette within five minutes after waking up, and 60% used menthol cigarettes. At Month 3, 14 participants (70%) self-reported 7-day point prevalence smoking abstinence (90% follow-up rate). Fitbit-assessed mean minutes of MVPA per week increased from 113 (SD 127; range 0-399) at Week 1 to 177 (SD 163; range 0-513) at Month 3, although the difference was not statistically significant (p=0.15). Sixteen participants (88.9%, 16/18) reported NRT use in the past 90 days. Mean scores of self-efficacy for smoking cessation increased from 31.2 (SD 10.6) at baseline to 47.8 (SD 13.0) at Month 3 (p&amp;lt;0.01). Mean scores of self-efficacy for physical activity increased from 12.3 (SD 3.9) at baseline to 14.6 (SD 4.4) at Month 3 (p=0.2). Most participants reported being satisfied or extremely satisfied with the intervention (88.9%, 16/18). In conclusion, Actívatexto resulted in a noteworthy cessation rate at Month 3 (70%), increased mean minutes of MVPA per week, produced high use of NRT, increased self-efficacy for smoking cessation and physical activity, and was well received by participants. Additional testing in a formal randomized clinical trial is warranted to assess the efficacy of the intervention. Citation Format: Daimarelys Lara, Edgar I. Alaniz-Cantu, Arlette Chávez-Iñiguez, Daniel Fuller, Scott McIntosh, Deborah J. Ossip, Ana Paula Cupertino, Francisco Cartujano-Barrera. Actívatexto:Feasibility and acceptability of a mobile intervention that promotes smoking cessation and physical activity among Latinos [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2154.

Smoking prevalence and purchasing of menthol cigarettes since the menthol flavour ban in Great Britain: a population-based survey between 2020 and 2023

BackgroundMenthol cigarettes have been banned in Great Britain (GB) since May 2020. Still, menthol accessories and unlabelled cigarettes perceived as mentholated are available, and people can buy menthol cigarettes overseas...

A randomized controlled trial of potential tobacco policies prohibiting menthol flavor in cigarettes and e-cigarettes: a study protocol

BackgroundMenthol cigarette use remains a large public health problem and disproportionately affects Black adults in the United States. The Food and Drug Administration has proposed prohibiting menthol flavor in cigarettes to protect public health. However, e-cigarettes are available in menthol flavor and are a popular alternative product adults might switch to if menthol is prohibited in cigarettes. Research is needed to understand how availability of menthol (vs. tobacco) flavored e-cigarettes could impact cigarette use among adults who smoke menthol cigarettes.MethodsWe will recruit 150 adults who currently smoke menthol cigarettes and will randomize them to 1 of 3 conditions modeling different regulatory scenarios. We will recruit equal numbers of participants identifying as Black vs. non-Black and will stratify randomization by race. To promote standardization and adherence, cigarette and e-cigarette products will be provided for 8 weeks based on the assigned condition: (A) no menthol restriction (menthol cigarette and menthol flavored e-cigarette), (B) menthol prohibited in cigarettes only (non-menthol cigarette and menthol flavored e-cigarette), (C) menthol prohibited in both cigarettes and e-cigarettes (non-menthol cigarette and tobacco flavored e-cigarette). A follow-up visit will occur at week 12 to assess tobacco use status. The study aims are to (1) examine the impact of prohibiting menthol flavor in cigarettes and e-cigarettes on smoking behavior and (2) investigate whether outcomes differ by race to understand the impact of menthol policies on Black (vs. non-Black) individuals given high rates of menthol cigarette use in this population. The primary outcome will evaluate changes in the number of cigarettes smoked per day during the 8-week study period and will examine differences by regulatory scenario. Secondary outcomes will compare percent days smoke-free, changes in nicotine dependence, and motivation, confidence, and intentions to quit smoking by the regulatory scenarios. We will examine whether changes in the outcomes differ by Black vs. non-Black participants to compare the magnitude of the effect of the various menthol policy scenarios by race.DiscussionResults will contribute critical information regarding menthol in cigarettes and e-cigarettes to inform regulatory policies that maximize reductions in cigarette smoking and reduce tobacco-related health disparities.Trial registrationNCT05259566. Yale IRB protocol #2000032211, last approved 12/8/2023.

The Impact of Menthol Cigarette Bans: A Systematic Review and Meta-Analysis.

This review investigates the impacts of banning the sale of menthol cigarettes at stores. A systematic search of studies published in English up to November 2022 was conducted. The following databases were searched: PubMed/Medline, CINAHL, PsycINFO, Web of Science, and Embase, as well as a non-indexed journal. Studies evaluating either the impact of real-world or hypothesized menthol cigarette bans were included. Primary outcomes include tobacco use behaviors. Secondary outcomes include cigarette sales, retailer compliance, and the tobacco industry's response to a menthol ban. Data on tobacco use behavior after a menthol ban were pooled using random-effects models. Two pairs of reviewers independently extracted data and assessed study quality. Of the 964 articles that were identified during the initial search, 78 were included in the review and 16 were included in the meta-analysis. Cessation rates among menthol cigarette smokers were high after a menthol ban. Pooled results show that 24% (95% confidence interval [95% CI]: 20%, 28%) of menthol cigarette smokers quit smoking after a menthol ban, 50% (95% CI: 31%, 68%) switched to non-menthol cigarettes, 12% (95% CI: 3%, 20%) switched to other flavored tobacco products, and 24% (95% CI: 17%, 31%) continued smoking menthol cigarettes. Hypothesized quitting and switching rates were fairly close to real-world rates. Studies found the tobacco industry attempts to undermine menthol bans. National menthol bans appear more effective than local or state menthol bans. Menthol cigarette bans promote smoking cessation suggesting their potential to improve public health. Findings from this review suggest that menthol cigarette bans promote smoking cessation among menthol cigarette smokers and have the potential to improve public health.

Exploring #MentholBan on TikTok: A Thematic and Semantic Network Analysis.

In April 2021, the U.S. Food and Drug Administration (FDA) announced its intention to ban the sale of menthol cigarettes and cigars. Decades of research support the premise that a menthol ban will reduce initiation and disparities in tobacco-related disease among menthol smokers. The tobacco industry opposed such a policy and worked for decades to shape public opposition. Social media discourse can inform our understanding of public opinion about the proposed ban and guide communication strategies and policy implementation. This research employed a mixed-methods design to explore TikTok posts discussing the announced menthol ban. Using a TikTok web scraper to extract all content in the #mentholban hashtag (n = 171), we coded for 11 themes, characterized content with descriptive statistics, and created a semantic network of co-occurring hashtags. We found primarily negative attitudes towards the U.S. ban announcement and a large volume of menthol "hacks" to circumvent the bans. Our semantic network analysis revealed strong co-occurrences between #mentholban and popularity-seeking hashtags. The metadata associated with each TikTok demonstrated that most posters in #mentholban are not "influencers" in the sense of having many followers, aside from a few niche organizations with multiple posts. We found that perceived political and racial motivations shaped posters' assessments of the menthol ban. Furthermore, we uncovered how individuals and organizational actors shaped menthol ban content on TikTok. Our study indicates targeted marketing from alternative menthol product companies and advocacy organizations. The latter of these organizations is more likely to saturate the TikTok landscape with multiple posts and strategic hashtags. This study pursued an exploration of tobacco policy discussion on TikTok, specifically related to the FDA-proposed menthol ban. TikTok is a newer platform and our study provides early evidence of policy discussion emerging there, including the types of accounts creating the content and their valence toward the policy.

The Scientific Basis for the Regulation of Flavors in Tobacco Products.

Effective tobacco policies are important for reducing the harm of tobacco use and can have a broad impact at the population level. This review provides an overview of how clinical science can inform tobacco policies with a focus on policies related to flavored tobacco products, using menthol cigarettes as an illustrative example. Specifically, this review summarizes the role of flavors in tobacco use and the history of regulation of flavored tobacco products by the US Food and Drug Administration (FDA), provides an overview of clinical research methods used to contribute to the scientific evidence to inform FDA tobacco policies, discusses key findings related to menthol tobacco products using these methods, and proposes future directions for clinical research. As the tobacco marketplace continues to evolve with new products and flavor chemicals, ongoing clinical science will be essential for establishing evidence-based policies to protect public health and reduce tobacco-related health disparities.

Effects of mint, menthol, and tobacco-flavored e-cigarettes on tobacco withdrawal symptoms in adults who smoke menthol cigarettes: A laboratory pilot study

BackgroundMenthol cigarette smoking has remained stable or increased in certain groups, despite an overall decline in cigarette smoking rates in the U.S. Understanding whether e-cigarettes alter patterns of menthol cigarette use is critical to informing efforts for reducing the public health burden of menthol cigarette smoking. This 2019–2020 laboratory pilot study evaluated whether self-administration of mint-, menthol-, or tobacco-flavored e-cigarettes would differentially impact tobacco withdrawal symptoms in e-cigarette-naïve adults who smoke menthol cigarettes daily. MethodsParticipants (N=17; 35.3% Female; mean age=51.8) attended three laboratory sessions after 16-hours of tobacco abstinence. Participants self-administered a study-provided JUUL e-cigarette (0.7mL with 5% nicotine by weight) at each session in which flavor was manipulated (mint vs. menthol vs. tobacco; order randomized). Participants completed pre- and post-e-cigarette administration self-report assessments on smoking urges, nicotine withdrawal, and positive and negative affect states. Multilevel linear regression models tested differences between the three flavor conditions for individual study outcomes. ResultsFollowing overnight tobacco abstinence, vaping either a mint or menthol (vs. tobacco) flavored e-cigarette led to significantly greater reductions in smoking urges over time; menthol (vs. tobacco) flavored e-cigarettes also suppressed urges to smoke for pleasure. Notably, no differences in nicotine withdrawal, positive affect, or negative affect were observed. ConclusionsIn this laboratory pilot study, mint and menthol (vs. tobacco) flavored e-cigarettes provided some negative reinforcement effects via acute reductions in smoking urges during tobacco abstinence, yet only menthol flavored e-cigarettes demonstrated suppressive effects on smoking urges for pleasure in adults who smoke menthol cigarettes daily.

Understanding the Demand-Side of an Illegal Market: Prohibition of Menthol Cigarettes

Understanding the Demand-Side of an Illegal Market: Prohibition of Menthol Cigarettes

Responses to Real-World and Hypothetical Menthol Flavor Bans Among US Young Adults Who Smoke Menthol Cigarettes.

Menthol cigarette bans have been implemented in some US states and localities, and a federal ban is being proposed by the FDA. This study asks how young adults who use menthol cigarettes respond to changes in menthol cigarette availability. An online survey of young adults ages 18-34 who reported smoking menthol cigarettes on ≥7 of 30 days around Thanksgiving 2019 (n = 734), oversampling Massachusetts-the first state with a menthol ban. Participants reported their tobacco use behavior following real-world menthol cigarette bans or predicted their behavior under a hypothetical federal ban. Most respondents who exclusively smoked versus dual used with e-cigarettes continued smoking/using combustible tobacco following real-world bans (95.3% vs. 86.9%), accessing menthol cigarettes from other jurisdictions. Fewer who smoked exclusively responded by using e-cigarettes compared to those who dual used (3.9% vs. 43.7%). Quitting all tobacco use (ie, no smoking, vaping, or any tobacco use) was uncommon for both groups (3.6% vs. 9.0%). Under a hypothetical ban, majorities of those who exclusively smoke and who dual use predicted they would continue smoking (72.2% vs. 71.8%); fewer who smoke exclusively would use e-cigarettes compared to those who dual use (14.7% vs. 41.4%). Those who smoke exclusively were more likely to report quitting all tobacco compared to those who dual use (29.6% vs. 12.4%). Under real-world and hypothetical menthol cigarette bans, most respondents continued smoking. However, more young adults continued smoking following real-world bans, reflecting the limitations of local/state restrictions when menthol cigarettes are available in other jurisdictions. This survey asked young adults who use menthol cigarettes how they responded to real-world changes in the availability of menthol cigarettes; 89% reported continuing to smoke. Those who smoked exclusively were far less likely to respond by switching to e-cigarettes compared to people who dual used both products. Under a hypothetical federal menthol cigarette ban, 72% of young adults predicted that they would continue smoking. Quitting all tobacco was less common in the real-world scenario compared to the hypothetical ban. Access to menthol cigarettes in other jurisdictions and flavored cigars likely dampen the public health benefit of menthol cigarette bans.

Motivation to Quit Smoking Among Black Adults Residing in Los Angeles County Communities With Menthol Cigarette Sales Restrictions

Background : Research is needed to identify the determinants of motivation to quit smoking among non-Hispanic Black (NHB) adults who smoke menthol cigarettes and reside in communities covered by menthol cigarette bans. Objectives : This study examined the associations between motivation to quit smoking and a range of individual-level predictors, including measures of demographics, harm/risk perception of menthol cigarettes, and awareness of a ban on menthol cigarettes in Los Angeles County unincorporated communities. Self-identified NHB adults who currently smoke menthol cigarettes (N=50; M=47.2 years; SD=13.7; 46% female) were recruited in Los Angeles County unincorporated communities. Participants completed an interviewer-administered cross-sectional survey between January to September 2021. Results : Participants (74%) reported an annual household income of less than $25,000. Participants’ mean age at cigarette initiation was 15.7 years old (SD=5.68). Most (88%) were aware of the ordinance banning menthol cigarette sales. Employing multivariable linear regression analysis, harm/risk perception of menthol cigarettes (B=14.69, p<0.01) and awareness of the local menthol ban (B=26.18, p<0.05) were found to be independently associated with motivation to quit smoking. Conclusions : Findings from this community-based sample suggest that among NHB adults who smoke menthol cigarettes, motivation to quit smoking is influenced by their perception of menthol cigarettes as harmful and awareness of local policy banning the sale of menthol cigarettes. Findings underscore the need for community-centered and culturally grounded interventions to facilitate quitting among NHB adults who smoke in order for communities covered by menthol bans to achieve health equity in reducing preventable racial inequities due to menthol cigarettes.

Substitutability of menthol cigarette alternatives: a clinical trial

IntroductionThis study assessed the substitutability of plausible combustible menthol cigarette alternatives (MCAs) for usual brand menthol cigarettes (UBMCs) in adults who smoke menthol cigarettes.MethodsFollowing three in-lab sampling sessions, 80 adults...

Are menthol smokers different? An economic perspective

AbstractMore than 18.5 million current smokers in the United States usually smoke menthol cigarettes. The Food and Drug Administration recently proposed a tobacco product standard to prohibit menthol as a characterizing flavor in cigarettes. We explore whether there are internality‐based market failures that provide an applied welfare economics rationale to prohibit menthol. Our empirical approach provides descriptive evidence from the 2018 to 2019 Tobacco Use Supplement to the Current Population Survey on how menthol use is associated with smokers' market demand along multiple intensive and extensive margins. We also use measures of smoking‐related misinformation and internalities, and stated preference data, from a 2021 Cornell Online Survey. We acknowledge that the associations we document in observational data might reflect bias due to self‐selection into menthol use. We leave it to the reader whether there is convincing evidence that differential levels of internality‐based market failures are a sufficient justification for the proposed prohibition of menthol cigarettes.

Abstract 19102: E-Cigarettes Induce Persistent Cardiac Autonomic Dysfunction and Molecular Signatures of Dilated and Arrhythmogenic Cardiomyopathy

Introduction: Evidence is mounting that use of e-cigarettes (e-cigs) promotes cardiopulmonary injury and dysfunction, but the long-term consequences remain unclear. Consumption of menthol e-cigs has surged amid imminent bans on combustible menthol cigarettes and cigars. Recently, we found e-cig aerosols with menthol (but not tobacco) flavor acutely induced spontaneous ventricular arrhythmias in mice. Hypothesis: Menthol e-cigs induces persistent cardiac autonomic imbalance. Methods: Adult C57BL/6J male mice with electrocardiogram (ECG) and blood pressure (BP) telemeters were exposed for 4 weeks to menthol e-cig aerosols (JUUL, 180 puffs/day, 5 days/week; n=8) or filtered air (Air; n=7) and challenged with restraint stress to determine cardiovascular reactivity to stress. Hearts (n=5/group) were collected immediately after final exposure for phosphoproteomics. Results: Menthol e-cig exposures increased HR, decreased HR variability, and evoked ventricular premature beats only on exposure day 1, but consistently increased BP throughout the 20-day exposure (+16 mmHg systolic BP vs. Air). Additional exposures in females (n=4) recapitulated these acute effects. Pre-treatment with atenolol (n=4 males) abolished e-cig-induced arrhythmias, suggesting β 1 -adrenergic mediation of e-cig-induced arrhythmias. After 4-week JUUL Menthol exposure, mice had basal sinus bradycardia and impaired stress reactivity, characterized by reduced maximal HR and rapid recovery to baseline. All three effects persisted up to 3 weeks following cessation and were accompanied by prolonged ventricular repolarization (QT c ). Phosphoproteomic analysis revealed upregulation of protein kinase A signaling, and mitochondrial dysfunction in e-cig-exposed mice. Phosphoproteins associated with dilated &amp; arrhythmogenic cardiomyopathy (ATP2A2, FN1, CACNB2, PFKM, ADCY6, and PRKAR1A) were differentially regulated in e-cig-exposed mice. Conclusions: We demonstrate that menthol e-cigs induce persistent cardiac autonomic imbalance associated with molecular signatures of dilated &amp; arrhythmogenic cardiomyopathy. Autonomic imbalance and cardiac electrical dysfunction may contribute to the long-term health effects of repeated use of e-cigarettes.