Adolescent menthol cigarette use and risk of nicotine dependence: Findings from the national Population Assessment on Tobacco and Health (PATH) study

Abstract

Background: Menthol cigarettes appeal to adolescents because they mask the harsh taste and sensation of tobacco smoke thereby making it easier to inhale the smoke. As a result, menthol cigarette users expose themselves to higher levels of nicotine relative to non-menthol cigarettes and increase their risk for developing nicotine dependence. We examined whether adolescent menthol smokers (vs. non-menthol smokers) reported higher nicotine dependence.Methods: Data were from adolescent past 30-day cigarette smokers participating in Wave 2 of the Population Assessment of Tobacco and Health survey (n = 434). Nicotine dependence was assessed using eight items from the Wisconsin Inventory of Smoking Dependence Motives corresponding to individual subscale constructs. Linear regression models evaluated the association of past 30-day menthol (vs. non-menthol) cigarette use with each dependence outcome in separate models, adjusting for age, gender, race, and other tobacco product use.Results: 49.5% of past 30-day youth cigarette smokers reported smoking menthol cigarettes. In adjusted models, menthol smokers (vs. non-menthol smokers) reported significantly higher nicotine dependence for three constructs: craving (p = 0.005), affiliative attachment (p = 0.005), and tolerance (p = 0.003). No differences for menthol vs. non-menthol smokers were observed for loss of control, negative reinforcement, cognitive enhancement, automaticity, or social environment after correction for multiple comparisons.Conclusions: Findings suggest that menthol cigarette smokers are not just more physically dependent on nicotine but also experience increased emotional attachments to cigarettes compared *

Exposure to fruit-flavoring during adolescence increases nicotine consumption and promotes dose escalation

“…Score on an SDM scale is less correlated with nicotine dependence than PDMs and is not correlated with daily cigarette count, but is still a significant predictor of cigarette craving (Tarantola et al, 2017). Menthol cigarette smokers show increased affiliative attachment to cigarettes compared to non-flavored cigarette smokers, illustrating the possibility of nicotine flavorants to affect SDMs (Cwalina et al, 2020). Therefore, it is possible that our CHOICE group maintains baseline nicotine dose during tapering due to increased SDMs causing increased craving without affecting physical withdrawal or baseline nicotine consumption, although further research would be necessary to identify the specific behavioral features underlying this finding.…”

Fresher with flavour: young women smokers’ constructions and experiences of menthol capsule cigarettes and regular cigarettes

“…There is a wealth of well documented problematic public health concerns surrounding the use of menthol flavour cigarettes (see [24][25][26][27][28]), however, the relative novelty of menthol flavour capsule cigarettes has meant that there is a dearth of research examining their use. Flavour capsule cigarette use is an area of research priority for the World Health Organisation [29], especially since menthol capsules are specifically targeted to, and used by, young people [30,31], with older people more likely to position capsules as a gimmick [32]. While age is consistently identified as a factor shaping capsule use, there is limited research on other identity factors that are associated with capsule use; specifically, gender.…”

“…Previous research has also highlighted differential preferences in relation to women's and men's smoking, including that females prefer menthol flavour more than their male counterparts, and that taste characteristics of cigarettes are of more importance to women than to men [34]. The few studies that have examined young women's use of menthol capsule cigarettes reveal a number of problematic health and gendered insights [31]. For example, in their focus group study, Moodie et al [32] found that young women ranked menthol cigarettes as more pleasant tasting, less smelly, and less harmful that regular cigarettes.…”

Recent, national trends in US adolescent use of menthol and non-menthol cigarettes

“…First, adolescent smokers use them at higher levels in comparison to older smokers,8–10 and adolescents report they are easier to smoke 11. Second, adolescents who use menthol versus non-menthol-flavoured cigarettes report higher levels of dependence and addiction symptoms, such as cravings,9 10 12 13 tolerance13 and reduced time until needing another cigarette 9 10 12. Consistent with these findings, adolescents who smoke menthol are later less successful in quitting smoking 14.…”