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Objective Our objective was to better understand differences in use behavior and exposure when smoking menthol and nonmenthol cigarettes using a 2-part cross-over design. Methods Adult daily smokers were randomly assigned to alternate between 2 weeks of exclusively smoking a menthol test cigarette or a nonmenthol test cigarette. Urine and saliva were collected for biomarker measurements, carbon monoxide (CO) was measured, and participants smoked test cigarettes through a CreSS® smoking topography device during 3 clinic visits. Participants turned in their cigarette butts from the test periods for determination of mouth level nicotine and completed subjective questionnaires related to the test cigarettes. Results Regardless of cigarette preference, participants had higher salivary cotinine when smoking the nonmenthol test cigarette, but there were no significant differences detected in urine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol between the 2 test cigarettes. Mouth level nicotine, puff volume and puff duration were significantly higher when smoking the menthol brand. Both menthol and nonmenthol smokers reported significantly lower enjoyment and satisfaction scores for test cigarettes compared with their brand of choice. Conclusions Our results suggest that mentholation has an effect on measures of smoking behavior and that mouth level nicotine is a useful indicator of between-brand smoke exposure.

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Background and Objective : Community mitigation strategies could help reduce COVID-19 incidence. In a national county-level analysis, we examined the probability of being identified as a county with rapidly increasing COVID-19 incidence (rapid riser identification) during the summer of 2020 by implementation of mitigation policies prior to the summer, overall and by urbanicity. Methods : We analyzed county-level data on rapid riser identification during June 1–September 30, 2020 and statewide closures and statewide mask mandates starting March 19 (obtained from state government websites). Poisson regression models with robust standard error estimation were used to examine differences in the probability of rapid riser identification by implementation of mitigation policies ( P -value<.05); associations were adjusted for county population size. Results : Counties in states that closed for 0–59 days were more likely to become a rapid riser county than those that closed for >59 days, particularly in nonmetropolitan areas. The probability of becoming a rapid riser county was 43% lower among counties that had statewide mask mandates at reopening (adjusted prevalence ratio [aPR] = 0.57; 95% confidence intervals [CI] = 0.51–0.63); when stratified by urbanicity, associations were more pronounced in nonmetropolitan areas. Conclusions : These results underscore the potential value of community mitigation strategies in limiting the COVID-19 spread, especially in nonmetropolitan areas.