Tobacco & Nicotine Products
Differences in Subjective Experiences to First Use of Menthol and Non-Menthol Cigarettes among a National Sample of Young Adult Smokers
(UMD SPH Behavioral and Community Health Doctoral Student )
Objectives: Although cigarette smoking among young adults has significantly declined in recent years, the prevalence of menthol cigarette use has increased. Initiating smoking with menthol cigarettes has been shown to predict negative health outcomes, including regular use and nicotine dependence. Previous research on early smoking experiences has found that smokers recall both pleasant and unpleasant experiences at first cigarette use. However, we know little about how initial subjective responses were influenced by the type of cigarette (i.e. menthol or non-menthol) used at initiation. The purpose of this study was to: (1) identify differences in pleasant and unpleasant subjective responses to first use of a menthol vs. non-menthol cigarette and; (2) assess the unique contribution of menthol initiation to subjective responses after controlling for demographics and other tobacco-related risk factors. Approach: Data were analyzed from waves 5-8 of the Truth Young Adult Cohort Study, a national sample of young adults aged 18-34 assessed every six months. Participants (n=251) reported nine subjective responses to their first tobacco use as well as past 30-day use of tobacco products (including cigarettes, little cigars/cigarillos, e-cigarettes, and hookah), current substance use (alcohol and marijuana), and mental health status. Logistic regression models examined associations between menthol/non-menthol initiation and subjective experiences, retaining variables with p<.05 from bi-variate analyses as covariates. Findings: 53.1% of participants reported using a menthol cigarette at first use. 96% of menthol smokers and 88% of non-menthol smokers maintained the same cigarette type. Menthol initiators were more likely to be Black (27.3%) relative to non-menthol initiators (7.8%) where as non-menthol initiators were more likely to be White (50.3%) than menthol initiators (36%). After controlling for demographic and mental health characteristics, menthol initiators were significantly less likely than non-menthol initiators to report feeling moderate-intense nausea, difficulty inhaling, and liking the smell in response to their first cigarette. Conclusions: Our finding that menthol initiators experience less negative experiences relative to non-menthol initiators, suggests that menthol may mask the unpleasant effects of tobacco, thus facilitating continued experimentation. Future research is needed to understand the mechanisms by which menthol plays a role in the progression towards established smoking. Public Health Significance: Regulatory action restricting the marketing and promotion of menthol cigarettes has the potential to decrease the appeal of menthol cigarettes, discourage experimentation, and prevent initiation.