Why We Must Continue to Investigate Menthol’s Role in the African American Smoking Paradox

Alexander, Linda; Trinidad, Dennis R.; Sakuma, Kazuhiko; Pokhrel, Pallav; Herzog, Thaddeus A.; Clanton, Mark S.; Moolchan, Eric T.; Fagan, Pebbles

doi:10.1093/ntr/ntv209

Cited by 78 publications

(58 citation statements)

References 112 publications

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“…It might follow that non-blunt co-users would smoke more cigarettes than blunt co-users, however, findings here do not support that notion. It is important to note that all of the participants in this sample reported 20 or more days of past month tobacco use, and 87.2% reported smoking menthol cigarettes in the past month, consistent with other African-American smoking samples (Alexander, Trinidad, Sakuma et al, 2016). Additional research with a wide range of light and heavy menthol and non-menthol cigarette smokers is needed.…”

Section: Discussionsupporting

confidence: 84%

What did you expect?: The interaction between cigarette and blunt vs. non-blunt marijuana use among African American young adults

Montgomery

Ramo

2017

Journal of Substance Use

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Background Marijuana and tobacco co-use is highly prevalent among African American young adults. In an effort to inform prevention and treatment interventions, the current study examined the expectancies around the co-use of marijuana and cigarettes among African American young adults. Methods An anonymous online survey recruited African American adults (N = 111) age 18 to 29 who reported past-month marijuana and cigarette co-use. Participants completed the 14-item Nicotine and Marijuana Interaction Expectancy (NAMIE) Questionnaire, with three scales: (1) marijuana use increases tobacco use and urges, (2) tobacco use increases marijuana use and urges and (3) smoking to cope with marijuana urges. Participants also answered questions about marijuana and tobacco initiation and use. Analyses were conducted separately for blunt co-users (i.e., blunt and cigarette use) and non-blunt co-users (i.e., non-blunt marijuana and cigarette use). Results A majority of co-users (66%) used blunts as a form of co-use. Non-blunt co-users had higher expectancy scores on NAMIE scales 2 and 3 than blunt co-users. However, only blunt co-users showed a positive association between severity of marijuana use and NAMIE scales 2 (p <.01) and 3 (p <.01). Conclusions Findings provide further evidence for the use of the NAMIE and suggest a need to assess and address expectations regarding marijuana and tobacco co-use in prevention and treatment interventions, especially among young African American adults who co-use blunts and cigarettes.

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Section: Discussionsupporting

confidence: 84%

What did you expect?: The interaction between cigarette and blunt vs. non-blunt marijuana use among African American young adults

Montgomery

Ramo

2017

Journal of Substance Use

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“…53 It is possible that the biological effects of menthol cigarettes counteract these psychosocial phenomena. 67,68 For example, lower SES smokers might use mentholated cigarettes "to facilitate increased nicotine intake from fewer cigarettes where economic pressure restricts the number of cigarettes smokers can afford to purchase." 69 It is also possible that efforts to quit are undermined by erroneous beliefs that menthol cigarettes are less dangerous than nonmentholated brands.…”

Section: Discussionmentioning

confidence: 99%

Differences in Quit Attempts and Cigarette Smoking Abstinence Between Whites and African Americans in the United States: Literature Review and Results From the International Tobacco Control US Survey

Kulak¹,

Cornelius²,

Fong³

et al. 2016

NICTOB

110

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Results: Of 17 total analyses of quit attempts, nine (including the ITC US Survey) observed that African American smokers were more likely than whites to attempt to quit during a given year; seven found no differences. Whites were more likely than African Americans to be abstinent in five of six retrospective cohort analyses and in two of five considered community-and population-based cohort studies. Four of these 11 analyses, including one from the ITC US Survey, found no differences. Conclusions: Of 11 population-or community-based analyses, all seven that found significant differences indicated that whites were more likely to quit than African Americans. These findings, combined with the similar results from population-based birth cohort analyses, support the conclusion that white smokers are more likely to quit than African American smokers. Efforts to encourage and support quitting among all tobacco users remain a priority. Implications: This article provides a review of the literature on smoking cessation among African American and white smokers, and adds new analyses that compare quit attempts and abstinence between US African Americans and whites. Results demonstrate a clear distinction between the findings of cross-sectional and retrospective cohort studies with those of cohort studies. Reasons for these differences merit further study.

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“…Referred to as the “smoker’s paradox,” African Americans smoke fewer cigarettes per day and are less likely to smoke daily, yet they have higher rates of lung, esophageal, and oral cancers than non-Hispanic whites who smoke. 64 …”

Section: Cancer Diagnosismentioning

confidence: 99%

“…22 The disproportionate burden in lung cancer risk among African Americans cannot be explained by a greater number of cigarettes smoked. 64 However, a distinguishing smoking behavior among African Americans who smoke, which may aid in explaining disparate disease outcomes, is that African Americans are more likely to smoke menthol cigarettes than whites. 3 As part of the 2009 Family Smoking Prevention and Tobacco Control Act, the Tobacco Products Scientific Advisory Committee of the US Food and Drug Administration was tasked with submitting a report on the impact of menthol.…”

Section: Disparities In Lung Cancermentioning

confidence: 99%

“…65 However, more research is needed to further examine the potential role that menthol plays in the unequal disease burden experienced by African Americans. 3 Specifically, as noted by Alexander et al, 64 research is needed on examining additional pathways such as the role of taste sensitivity and the effects of menthol on cellular mechanisms and subsequent disease processes.…”

Section: Disparities In Lung Cancermentioning

confidence: 99%

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Tobacco-Related Health Disparities across the Cancer Care Continuum

et al. 2016

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Background Use of tobacco is the leading preventable cause of death in the United States. Racial/ethnic minorities and individuals of low socioeconomic status disproportionately experience tobacco-related disease and illness. Unique challenges and circumstances exist at each point in the cancer care continuum that may contribute to the greater cancer burden experienced by these groups. Methods We reviewed tobacco-related disparities from cancer prevention to cancer survivorship. We also describe research that seeks to reduce tobacco-related disparities. Results Racial/ethnic minorities and low-income individuals experience unique social and environmental contextual challenges such as greater environmental cues to smoke and greater levels of perceived stress and social discrimination. Clinical practice guidelines support the effectiveness of pharmacotherapy and behavioral counseling for racial and ethnic minorities, yet smoking cessation rates are lower in this group when compared with non-Hispanic whites. Superior efficacy for culturally adapted interventions has not yet been established. Conclusions To reduce health disparities in this population, a comprehensive strategy is needed with efforts directed at each point along the cancer care continuum. Strategies are needed to reduce the impact of contextual factors such as targeted tobacco marketing and social discrimination on smoking initiation and maintenance. Future efforts should focus on increasing the use of evidence-based cessation treatment methods and studying its effectiveness in these populations. Attention must also be focused on improving treatment outcomes by reducing smoking in diverse racial and ethnic patient populations.

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Why We Must Continue to Investigate Menthol’s Role in the African American Smoking Paradox

Cited by 78 publications

References 112 publications

What did you expect?: The interaction between cigarette and blunt vs. non-blunt marijuana use among African American young adults

What did you expect?: The interaction between cigarette and blunt vs. non-blunt marijuana use among African American young adults

Differences in Quit Attempts and Cigarette Smoking Abstinence Between Whites and African Americans in the United States: Literature Review and Results From the International Tobacco Control US Survey

Tobacco-Related Health Disparities across the Cancer Care Continuum

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