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TSRC, Tob. Sci. Res. Conf., 2018, 72, abstr. 076

Do levels of menthol in mainstream cigarette smoke influence dependence? Data from NHANES 2007-2014

PARMS T.(1); VAN LANDINGHAM C.(2); MARANO K.M.(1)
(1) RAI Services Company, Winston-Salem, NC, USA; (2) Ramboll, Monroe, LA, USA

A 2013 preliminary scientific evaluation by the U.S. Food and Drug Administration (FDA) concluded that menthol in cigarettes is likely associated with increased initiation and progression to regular cigarette smoking, increased dependence, and reduced success in smoking cessation, especially among African American menthol smokers. However, there has been considerable debate as to whether the available evidence, in fact, supports these preliminary conclusions. Further, published studies analyzing whether varying levels of menthol in commercial cigarettes affect these smoking behaviors is not available. This paper addresses this gap in the literature by evaluating two indicators and a validated measure of cigarette dependence (i.e., cigarettes per day, time to first cigarette, and heaviness of smoking index [HSI] scores) among current regular smokers of cigarettes containing varying levels of menthol. Data from the 2007-2014 National Health and Nutrition Examination Surveys (NHANES) were analyzed. Smokers were defined as adults, ages 20 years and older, who had smoked ≥100 cigarettes in their lifetime, currently smoke (every day or some days), and exclusively used cigarettes in the last five days. Mean menthol content in mainstream smoke for various cigarette brands and styles was obtained from Altria Client Services’ publically available response to FDA’s Docket No. FDA-2010-N-0001, 75 FR 28027, and product names were matched in NHANES. Results indicated that after adjusting for age, gender, and race, there were no statistically significant differences in dependence as measured by cigarettes per day, time to first cigarette, or HSI by level of menthol in cigarette smoke. These findings - that the amount of menthol in mainstream smoke does not influence these metrics of smoking dependence - contribute to the evidence base regarding the potential impact of menthol in cigarettes on public health, and should inform regulatory decision making.