Sam N Cwalina1, Anuja Majmundar2, Jennifer B Unger3, Jessica L Barrington-Trimis4, Mary Ann Pentz5. 1. Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA 90089, United States. Electronic address: cwalina@usc.edu. 2. Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA 90089, United States. Electronic address: anuja.majmundar@usc.edu. 3. Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA 90089, United States. Electronic address: unger@usc.edu. 4. Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA 90089, United States. Electronic address: jtrimis@usc.edu. 5. Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA 90089, United States. Electronic address: pentz@usc.edu.
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 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.
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 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.
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