Shorter time to first cigarette of the day in menthol adolescent cigarette smokers

doi:10.1016/j.addbeh.2005.10.001

Addictive Behaviors

Volume 31, Issue 8, August 2006, Pages 1460-1464

https://doi.org/10.1016/j.addbeh.2005.10.001 Get rights and content

Abstract

Menthol smoking is thought to contribute to the addictiveness of smoking. Given the high prevalence of menthol smoking among youth, the aim of the current analysis was to examine differences in consumption and tobacco dependence, including smoking urgency among menthol and non-menthol adolescent smokers.

Data for the current analysis were collected from telephone interviews with adolescent smokers applying to a cessation treatment study. Of 572 adolescent smokers (mean age = 15.6 ± 1.6 years; 55.1% female; 46.9% African American, 48.2% European American), 531 smoked menthol cigarettes and 41 smoked non-menthol as their usual brand. Analysis using Fisher's Exact (one-tailed) Test revealed that menthol smokers had a significantly shorter time to first (TTF) cigarette of the day compared to non-menthol smokers (smoking within the first 5 min of the day, 45% vs. 29%, respectively; p < 0.04). Independent t tests revealed no significant difference in number of cigarettes per day (CPD) (mean = 12.2 ± 8.5 vs. 11.4 ± 8.8; p < 0.28) or Fagerstrom Test for Nicotine Dependence (FTND) scores (3.4 ± 1.4 vs. 3.2 ± 1.3; p < 0.23).

While preliminary, our findings suggest greater smoking urgency among menthol compared to non-menthol adolescent cessation-treatment seekers. Further study in a broader sample of adolescent smokers is warranted to elucidate the mechanisms underlying the effects of menthol smoking for youths.

Introduction

Menthol smoking is thought to contribute to the addictiveness of smoking by several mechanisms. Menthol cigarettes contain on average more nicotine than non-menthol cigarettes. Of the preferred brands smoked by the current youth sample, the average nicotine content for menthol cigarettes was 1.2 mg vs. 1.1 mg for non-menthol cigarettes (FTC File No. 992 3169). Menthol has also been shown to decrease the metabolism of nicotine, which results in greater nicotine exposure (Benowitz, Herrera, & Jacob, 2004). Additionally, both cooling and anesthetizing effects of menthol (resulting in decreased peripheral burn by inhaled smoke) and tobacco industry promotional messages contribute to the perception of less harm from smoking menthol compared to non-menthol cigarettes (Ahijevych and Parsley, 1999, Eccles, 1994).

Recent studies have documented the high prevalence of menthol smoking in youth (Giovino et al., 2004, Moolchan, 2004), a time when lifelong behaviors are being established. Given this and the concern of increased addictiveness of smoking associated with smoking mentholated cigarettes, the aim of the current analysis was to examine differences in consumption, commonly used markers of dependence, and morning smoking urgency between menthol and non-menthol adolescent smokers. Thus, we compared the number of cigarettes per day (CPD) and Fagerstrom Test for Nicotine Dependence (FTND) (Heatherton, Kozlowski, Frecker, & Fagerstrom, 1991) scores among menthol and non-menthol smokers requesting participation in a cessation trial. Various scoring systems have been applied to measures of consumption (such as CPD) in assessing dependence among adolescent smokers (e.g. Prokhorov et al., 1996, Rojas et al., 1998), with arguable validity (Colby, Tiffany, Shiffman, & Niaura, 2000). In a previous study, the Heavy Smoking Index (HSI) was the most valid measure of nicotine dependence self-report (Heatherton, Kozlowski, Frecker, Rickert, & Robinson, 1989). Smoking rates have also been shown to vary substantially according to ethnic and genetically determined differences in nicotine metabolism, thus impacting scores of all Fagerstrom-derived instruments. Hence, we also compared the two groups for time to first cigarette of the day (TTF), an item of both the FTND and the HSI (Heatherton et al., 1989), as a marker of smoking urgency after overnight abstinence.

Section snippets

Methods

All data for the current analysis were collected from a telephone interviewing process by trained staff to recruit volunteer adolescent smokers for a cessation treatment study. Items included, (1) “How soon after you get up in the morning do you smoke your first cigarette?”, (2) “Number of cigarettes smoked per day?”, (3) “Do you still smoke if you are sick and in bed for most of the day?”, (4) “Do you find it difficult to refrain from smoking in forbidden places?”, (5) “Would it bother you to

Results

Of 1347 interviews, 572 adolescent smokers had complete data on variables needed for this analysis. Demographic characteristics of the sample are shown in Table 1.

Of this sample, 531 reported smoking menthol cigarettes and 41 reported smoking non-menthol as their usual brand (Fig. 1). Independent t tests showed no statistically significant difference in FTND score or CPD between the two groups. We then proceeded to compare groups on the various time categories of the FTND.

A one-tailed Fisher's

Discussion

The main finding of this study is that adolescent menthol cigarette smokers had shorter TTF cigarette of the day when compared to non-menthol adolescent cigarette smokers, despite a lack of group differences in FTND scores or smoking rates (CPD). Greater smoking urgency among adolescent menthol smokers may provide a clinical indication of dependence not captured by overall consumption or FTND because of metabolic differences. While the FTND was shown to be an effective tool in measuring tobacco

Acknowledgements

The authors wish to thank the dedicated staff of the Teen Tobacco Addiction Treatment Research Clinic for valiant efforts to assist teen smokers. We also thank Jennifer Schroeder, Ph.D. for statistical support. Supported by funds from the National Institute on Drug Abuse, Intramural Research Program.

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Half of young adults who smoke use menthol cigarettes, which is associated with continued smoking and greater nicotine dependence. Additionally, early subjective reactions to cigarettes predict future use. Menthol may blunt the sensory effects of nicotine. We investigated the moderating role of menthol on subjective reactions to, and choice of varied nicotine content cigarettes in young adults who smoke infrequently.
In three counterbalanced, double-blinded sessions, young adults who smoke ≤ 15 days/month smoked fixed doses from very low (VLNC), intermediate (INC), and normal (NNC) nicotine content cigarettes, which were menthol or non-menthol depending on preference. Participants chose their preferred cigarette in a final session. Positive and negative subjective reactions were measured in each session. ANOVA tests investigated the relationship between menthol preference, nicotine content, and subjective reactions.
Participants (N = 87) were 18–25 years old and reported smoking 15.2 cigarettes per month over 8 days (35 % menthol). Non-menthol preferring participants had increased negative reactions with greater nicotine content (F(1, 55)= 10.76, p < .001); menthol preferring participants did not. Choice of higher nicotine cigarettes was associated with having reported a greater difference in positive reactions to NNC and VLNC for non-menthol preferring participants (F(1, 55)= 12.72, p < .001) but not for menthol preferring participants.
Young adults who smoke infrequently are a priority tobacco control population given their high risk of transitioning to daily smoking. Results from this study in the form of subjective reactions indicate that a menthol ban is required for a nicotine reduction standard to be maximally effective in this vulnerable group.
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As cigarette rates have decreased, the proportion of menthol cigarette use among youth smokers has increased. Thus, it is important to monitor the menthol-associated behaviors among youth. The present study examined the associations between menthol cigarette use and smoking frequency, intention to continue smoking, and quit intention among youth.
We used data from the 2017 and 2018 National Youth Tobacco Surveys. Separate multivariable logistic regression models were used to examine the associations between menthol cigarette use and smoking frequency, intention to continue smoking, and intention to quit.
Across both years, 1,707 youth reported past 30-day cigarette use, 50.7% of whom used menthol cigarettes. Menthol cigarette users had significantly higher odds of smoking at least 10 out of the 30 days before the survey than nonmenthol smokers (adjusted odds ratio [aOR] 1.48, 95% confidence interval [CI] 1.14–1.94). We found similar results in the stratified analysis by grade level. Menthol cigarette smokers in middle (aOR 2.36, 95% CI 1.01–5.49) and high school (aOR 1.41, 95% CI 1.09–1.82) were more likely to have smoked at least 10 out of the 30 days before the survey than nonmenthol smokers. Menthol cigarette users had higher odds of intention to continue smoking (aOR 1.54, 95% CI 1.08–2.19) than nonmenthol cigarette users. Menthol use was not significantly associated with intention to quit.
Compared with nonmenthol cigarette use, menthol cigarette use was associated with smoking more frequently as well as the intention to continue smoking among middle school and high school students.
Adolescent menthol cigarette use and risk of nicotine dependence: Findings from the national Population Assessment on Tobacco and Health (PATH) study
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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.
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.
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.
Findings suggest that menthol cigarette smokers are not just more physically dependent on nicotine but also experience increased emotional attachments to cigarettes compared to their non-menthol smoking peers. Because adolescents are vulnerable to developing nicotine dependence, tobacco control policies that restrict youth access to menthol cigarettes are urgently needed.
Tanning Capacity and Nicotine Dependence Among African Americans
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Recent findings suggest a link between facultative melanin and nicotine dependence among African Americans. We hypothesized that tanning capacity is associated with the time to first cigarette (TTFC) of the day.
Using a criterion based sample of 150 adult African American current smokers, reflectometer measures of constitutive and facultative melanin, tanning capacity, smoking status and history, saliva cotinine, sociodemographic characteristics, and stress and discrimination scales were recorded.
TTFC was categorized as: 1) within the first 5 min versus more than 5 min; and 2) within the first 30 min versus more than 30 min. Descriptive and multivariate analyses were conducted.
Analysis revealed significantly higher tanning capacity among individuals who smoked their first cigarette of the day within the first 5 min of awakening (13.5) than among those who smoked after 5 min (10.3, p = 0.01) and among those who smoked within the first 30 min (12.8 vs. 9.6, p = 0.03) compared to those who initiated after this time point.
Multivariate logistic regression indicated that tanning capacity was significantly and positively related (OR = 1.14, 95% CI = 1.05–1.22) to TTFC within the first 5 min and was also significantly related to TTFC within the first 30 min (OR = 1.13, CI = 1.03–1.23).
Tanning capacity was positively associated with a behavioral measure of nicotine dependence among African American smokers. This association was consistent whether comparing smokers at higher or lower levels of dependence. Future research should examine tanning capacity and other indicators of melanin content with smoking cessation rates and tobacco-attributable health disparities.
Menthol disrupts nicotine's psychostimulant properties in an age and sex-dependent manner in C57BL/6J mice
2017, Behavioural Brain Research
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Many smokers express the desire to quit, but relapse is observed in 70–80% of quit attempts, even with treatment to aid in smoking cessation [2]. Mentholated cigarettes are used more frequently by populations more vulnerable to tobacco addiction including adolescent and female smokers [3–5] but the underlying reasons remain unclear. Although nicotine is the primary psychoactive component of cigarettes, 90% of tobacco products also contain menthol – often at levels not detectable by taste [6].
Menthol is a commonly used flavorant in tobacco and e-cigarettes, and could contribute to nicotine sensitivity. To understand how menthol could contribute to nicotine intake and addiction, it is important to determine whether specific mechanisms related to sex and age could underlie behavioral changes induced by menthol-laced nicotinic products. Using a validated paradigm of nicotine-dependent locomotor stimulation, adolescent and adult C57BL/6J mice of both sexes were exposed to nicotine, or nicotine laced with menthol, as their sole source of fluid, and psychostimulant effects were evaluated by recording home cage locomotor activity for ten days. Nicotine and cotinine blood levels were measured following exposure. Results show an interaction between treatment, age, and sex on liquid consumption, indicating that mice responded differently to menthol and nicotine based on their age and sex. Adult male mice greatly increased their nicotine intake when given menthol. In female mice of both age groups, menthol did not have this effect. Despite an increase in nicotine intake promoted by menthol, adult male mice showed a significant decrease in locomotion, suggesting that menthol blunted nicotine-induced psychostimulation. This behavioral response to menthol was not detected in adolescent mice of either sex. These data confirm that menthol is more than a flavorant, and can influence both nicotine intake and its psychostimulant effects. These results suggest that age- and sex-dependent mechanisms could underlie menthol’s influence on nicotine intake and that studies including adolescent and adult menthol smokers of both sexes are warranted.
Comparisons of three nicotine dependence scales in a multiethnic sample of young adult menthol and non-menthol smokers
2015, Drug and Alcohol Dependence
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Our findings suggest the need to carefully examine the multidimensional nature of nicotine dependence measures and their ability to discriminate and characterize aspects of nicotine dependence among different groups of smokers. Prior studies have used the FTND total scale or select items to assess differences in levels of dependence among adults and differences in dependence among menthol and non-menthol smokers (Collins and Moolchan, 2006; Fagan et al., 2010; Okuyemi et al., 2004). The average FTND score was 3.6 (SD = 2.6).
Few studies have compared nicotine dependence among menthol and non-menthol cigarette smokers in a multiethnic sample of young adult daily cigarette smokers. This study examines differences in nicotine dependence among menthol and non-menthol daily smokers and the associations of nicotine dependence with quitting behaviors among Native Hawaiian, Filipino, and White cigarette smokers aged 18–35.
Craigslist.org, newspaper advertisements, and peer-to-peer referrals were used to recruit daily smokers (n = 186) into a lab-based study. Nicotine dependence was assessed using the Fagerstrom Test of Nicotine Dependence (FTND), the Nicotine Dependence Syndrome Scale (NDSS), and the brief Wisconsin Inventory for Smoking Dependence Motives (WISDM). Multiple regression analyses were used to examine differences in nicotine dependence between menthol and non-menthol smokers and the relationship between each nicotine dependence scale with self-efficacy to quit, quit attempt in the past 12 months, and number of attempts.
Menthol smokers were more likely to report difficulty refraining from smoking in places where forbidden (p = .04) and had higher scores on social/environmental goads subscale of the WISDM (p = .0005). Two-way interaction models of the FTND and menthol status showed that menthol smokers with higher levels of dependence were more likely to have tried to quit smoking in the past 12 months (p = .02), but were less likely to have had multiple quit attempts (p =.01).
Components of the FTND and WISDM distinguish levels of dependence between menthol and non-menthol smokers. Higher FTND scores were associated with having a quit attempt, but fewer quit attempts among menthol smokers.

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Short communicationShorter time to first cigarette of the day in menthol adolescent cigarette smokers

Abstract

Introduction

Section snippets

Methods

Results

Discussion

Acknowledgements

Addictive Behaviors

Environmental Research

Addictive Behaviors

Mentholated cigarette smoking inhibits nicotine metabolism

Journal of Pharmacology and Experimental Therapeutics

Are adolescent smokers dependent on nicotine? A review of the evidence

Drug and Alcohol Dependence

Menthol and related cooling compounds

The National Journal of Pharmacy and Pharmacology

Short communication
Shorter time to first cigarette of the day in menthol adolescent cigarette smokers