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Nicotine & Tobacco Research : Official... Oct 2022A ban on menthol cigarettes and flavored cigars may reduce smoking and tobacco-related disparities.
INTRODUCTION
A ban on menthol cigarettes and flavored cigars may reduce smoking and tobacco-related disparities.
AIMS AND METHODS
We aimed to examine the response of current smokers to a hypothetical ban on menthol cigarettes and flavored cigars. Current smokers were recruited online and reported the alternative products that they may switch to under a hypothetical ban, if they would try to obtain the banned products from illicit channels, and their support to the ban.
RESULTS
51% of current smokers would use nonflavored cigarettes and cigars as alternatives, 45% would switch to flavored heated tobacco products or e-cigarettes or quit smoking. 17% would try to obtain the banned flavored products from illicit markets. A majority of menthol only smokers opposed the ban. Daily smokers would be more likely to switch to nonflavored smoking, to try illicit market products, and were less supportive of the ban. Black smokers would be less likely to switch to nonflavored smoking and were more supportive of the ban. Smokers who used menthol cigarettes only would be more likely to switch to nonflavored smoking, less likely to try illicit market sellers, and were the least supportive of the ban.
CONCLUSIONS
In response to a ban of all added flavors for cigarettes or cigars, nearly half of the current smokers would quit smoking, largely by switching to nonsmoking products. However, smokers with more chronic use and those who used only menthol cigarettes would be more likely to switch to nonflavored smoking, diminishing the harm reduction potential. The ban may decrease the relatively higher prevalence of menthol cigarette smoking among Blacks compared with other groups.
IMPLICATIONS
A ban on the sale of menthol cigarettes and flavored cigars may decrease the prevalence of smoking because some current smokers may quit smoking and switch to nonsmoking products. However, smokers with more chronic use and those who used menthol cigarettes only were more likely to switch to nonflavored cigarettes or cigars, diminishing the harm reduction potential of the ban. Black smokers would be more likely to switch to products other than cigarettes and cigars thus decreasing their relatively higher prevalence of smoking compared with other groups.
Topics: Electronic Nicotine Delivery Systems; Flavoring Agents; Humans; Menthol; Smokers; Nicotiana; Tobacco Products
PubMed: 35353183
DOI: 10.1093/ntr/ntac078 -
PloS One 2022In June 2020, Massachusetts implemented a law prohibiting the sale of all flavored tobacco products, including menthol cigarettes. This law was associated with...
BACKGROUND
In June 2020, Massachusetts implemented a law prohibiting the sale of all flavored tobacco products, including menthol cigarettes. This law was associated with significant declines in overall cigarette and menthol cigarette sales in Massachusetts, however it is unknown whether the law has increased cross-border sales in neighboring states where menthol cigarettes are still sold.
METHODS
U.S. cigarette retail scanner data were licensed from the IRi Company. Cigarette pack sales were summed in 4-week periods during January 2020-December 2021 (n = 832). Outcomes were state-level pack sales per 1000 population, overall and by flavor status (menthol and non-flavored). A difference-in-differences analysis was used to examine adjusted sales for Massachusetts border states (New Hampshire, Connecticut, Vermont, and Rhode Island) before (January 2020-May 2020) and after (June 2020-December 2021) the Massachusetts's law, compared to 28 non-border states. Control variables included state and time fixed effects; real price per pack; tobacco control policies; COVID-19 cases and deaths, and related statewide closure; and state sociodemographic characteristics.
RESULTS
Following the law, unadjusted sales of menthol, non-flavored, and overall cigarettes trended upward in border states; however, these increases were not statistically significant or different from sales patterns in non-border states. This finding persisted after accounting for product prices, tobacco control policies, the COVID-19 pandemic, sociodemographic factors, and fixed effects.
CONCLUSION
Laws prohibiting the sale of flavored tobacco products, including menthol products, reduce access to these products, while having no significant impact on cross-border sales in neighboring states where menthol cigarettes are sold.
Topics: COVID-19; Humans; Massachusetts; Menthol; Pandemics; Tobacco Products
PubMed: 36099316
DOI: 10.1371/journal.pone.0274022 -
Addictive Behaviors Sep 2023Electronic nicotine delivery system (ENDS) device and liquid characteristics (e.g., wattage, nicotine concentration) are diverse and important in determining product...
INTRODUCTION
Electronic nicotine delivery system (ENDS) device and liquid characteristics (e.g., wattage, nicotine concentration) are diverse and important in determining product appeal, aerosol volume/nicotine levels, and toxicity. Little is known about how device and liquid characteristics vary by flavor; we address this gap to identify potential regulatory implications.
METHODS
Data are from a longitudinal cohort study (Waves 2 and 3; December 2020-December 2021) of adult (≥21 years) U.S. ENDS users (≥5 days of use/week). Participants (n = 1809) reported on and submitted photos of their most used device and liquid. Participants were categorized into flavor groups of high prevalence in our sample and in prior literature: sweet, menthol/mint, or tobacco. Participants using liquids without nicotine or flavors other than sweet, menthol/mint, or tobacco were excluded (n = 320). Data were analyzed cross-sectionally. Chi-square and linear regression (n = 1489) were used to examine device and liquid characteristics by flavor.
RESULTS
Sweet flavors were most common (n = 1135; 76.2%), followed by menthol/mint (n = 214, 14.4%) and tobacco (n = 140, 9.4%). Sweet flavors were less common among participants using reusable devices with disposable pods/cartridges (nicotine salt) than those using other device-liquid groupings (5.2% vs 86.5-93.9%; p < 0.001). Sweet flavors were less common among those using ENDS for non-flavor reasons vs the flavor (73.5% vs 90.4%; p < 0.001). Sweet flavors correlated with lower nicotine concentrations, higher wattages, and lower ages of ENDS first use (p < 0.001).
CONCLUSIONS
Regulatory agencies must consider how regulations on device and liquid characteristics may affect ENDS users' behaviors (e.g., limiting availability of sweet flavors may encourage use of non-sweet flavors and lower wattages).
Topics: Adult; Humans; Nicotine; Smokers; Menthol; Electronic Nicotine Delivery Systems; Longitudinal Studies; Flavoring Agents; Tobacco Products
PubMed: 37119714
DOI: 10.1016/j.addbeh.2023.107727 -
Toxicological Sciences : An Official... May 2023Menthol and tobacco flavors are available for almost all tobacco products, including electronic cigarettes (e-cigs). These flavors are a mixture of chemicals with...
Menthol and tobacco flavors are available for almost all tobacco products, including electronic cigarettes (e-cigs). These flavors are a mixture of chemicals with overlapping constituents. There are no comparative toxicity studies of these flavors produced by different manufacturers. We hypothesized that acute exposure to menthol and tobacco-flavored e-cig aerosols induces inflammatory, genotoxicity, and metabolic responses in mouse lungs. We compared two brands, A and B, of e-cig flavors (PG/VG, menthol, and tobacco) with and without nicotine for their inflammatory response, genotoxic markers, and altered genes and proteins in the context of metabolism by exposing mouse strains, C57BL/6J (Th1-mediated) and BALB/cJ (Th2-mediated). Brand A nicotine-free menthol exposure caused increased neutrophils and differential T-lymphocyte influx in bronchoalveolar lavage fluid and induced significant immunosuppression, while brand A tobacco with nicotine elicited an allergic inflammatory response with increased Eotaxin, IL-6, and RANTES levels. Brand B elicited a similar inflammatory response in menthol flavor exposure. Upon e-cig exposure, genotoxicity markers significantly increased in lung tissue. These inflammatory and genotoxicity responses were associated with altered NLRP3 inflammasome and TRPA1 induction by menthol flavor. Nicotine decreased surfactant protein D and increased PAI-1 by menthol and tobacco flavors, respectively. Integration of inflammatory and metabolic pathway gene expression analysis showed immunometabolic regulation in T cells via PI3K/Akt/p70S6k-mTOR axis associated with suppressed immunity/allergic immune response. Overall, this study showed the comparative toxicity of flavored e-cig aerosols, unraveling potential signaling pathways of nicotine and flavor-mediated pulmonary toxicological responses, and emphasized the need for standardized toxicity testing for appropriate premarket authorization of e-cigarette products.
Topics: Animals; Mice; Electronic Nicotine Delivery Systems; Menthol; Phosphatidylinositol 3-Kinases; Mice, Inbred C57BL; Nicotine; Lung; Aerosols; Flavoring Agents; Tobacco Products
PubMed: 37052522
DOI: 10.1093/toxsci/kfad033 -
Tobacco Control Jan 2023'Ice' e-cigarette flavours-marketed as a combination of fruity/sweet and cooling flavours (eg, 'blueberry ice' or 'melon ice')-recently entered the US market. The...
BACKGROUND
'Ice' e-cigarette flavours-marketed as a combination of fruity/sweet and cooling flavours (eg, 'blueberry ice' or 'melon ice')-recently entered the US market. The prevalence and correlates of ice flavoured e-cigarette use in young adults are unknown.
METHODS
This cross-sectional study of a Los Angeles, California, USA, cohort analysed data from the past 30-day e-cigarette (current) users (n=344; M (SD)=21.2 (0.4) years old) who completed web-based surveys from May-August 2020. The exposure variable was self-reported e-cigarette flavour used most often in the past month (menthol/mint, fruit/sweet or ice). Outcomes included self-reported combustible tobacco use, vaping dependence symptoms, frequency of use and device type used.
RESULTS
Among current e-cigarette users, 48.8% reported using ice flavours most often, 33.7% predominately used fruit/sweet and 17.4% used menthol/mint. Using primarily ice-flavour was associated with reporting more past-30-day vaping days (vs menthol/mint: b=4.4, 95% CI (1 to 7.7); vs fruit/sweet: b=3.6, 95% CI (0.8 to 6.4)) and more episodes per vaping day versus fruit/sweet users (b=2.4, 95% CI (0.5 to 4.3)). Ice-flavour users were less likely than menthol/mint users to use JUUL/cartridge-based rechargeable (OR=0.1, 95% CI (0.03 to 0.45)) and more likely than sweet/fruit users to use disposable non-cartridge (OR=3.9, 95% CI (2.1 to 7.4)) devices than refillable/rechargeable tank/pen or other devices. Ice users had greater odds of past 30-day combustible tobacco use versus menthol/mint users (OR=2.7, 95% CI (1.3 to 5.7)) and vaping dependence symptoms than versus sweet/fruit users (OR=2.6, 95% CI (1.5 to 4.4)).
CONCLUSION
Young adult use of ice flavoured e-cigarettes may be common and positively associated with combustible tobacco use, nicotine vaping frequency and dependence and use of disposable e-cigarette devices. Further study of the prevalence, determinants and health effects of ice flavoured e-cigarette use is warranted.
Topics: Young Adult; Humans; Infant; Vaping; Electronic Nicotine Delivery Systems; Cross-Sectional Studies; Menthol; Flavoring Agents; Tobacco Products
PubMed: 34127549
DOI: 10.1136/tobaccocontrol-2020-056416 -
Regulatory Toxicology and Pharmacology... Oct 2014Menthol in cigarettes has been examined for its potential to affect smoking dependence, measured primarily as number of cigarettes smoked per day and time to first... (Review)
Review
Menthol in cigarettes has been examined for its potential to affect smoking dependence, measured primarily as number of cigarettes smoked per day and time to first cigarette after waking; the ability to quit smoking constitutes an additional measure of dependence. Successful quitting among menthol compared to non-menthol cigarette smokers is difficult to determine from the literature, due in part to the various definitions of quitting used by researchers. Nevertheless, intervention and follow-up studies of smoking cessation treatments generally indicate no differences in quitting success among menthol compared to non-menthol smokers, while cross-sectional studies suggest some differences within race/ethnicity groups. The association between menthol cigarette use and likelihood of being a former versus current smoker was examined based on data from the National Health Interview Survey and Tobacco Use Supplement to the Current Population Survey. Analyses stratified by race/ethnicity and limited to smokers who had quit at least one year prior to survey participation provided inconsistent results with regard to menthol cigarette use and quitting, both within surveys (i.e., comparing race/ethnicity groups) and between surveys (i.e., same race/ethnicity group across surveys). Evidence suggesting the existence or direction of an association between menthol in cigarettes and quitting depended on the data source.
Topics: Ethnicity; Humans; Likelihood Functions; Menthol; Research Design; Smoking; Smoking Cessation; Tobacco Products
PubMed: 25017361
DOI: 10.1016/j.yrtph.2014.07.009 -
Trends in Biochemical Sciences Sep 2020Transient receptor potential (TRP) melastatin member 8 (TRPM8), which is a calcium-permeable ion channel, functions as the primary molecular sensor of cold and menthol... (Review)
Review
Transient receptor potential (TRP) melastatin member 8 (TRPM8), which is a calcium-permeable ion channel, functions as the primary molecular sensor of cold and menthol in humans. Recent cryoelectron microscopy (cryo-EM) studies of TRPM8 have shown distinct structural features in its architecture and domain assembly compared with the capsaicin receptor TRP vanilloid member 1 (TRPV1). Moreover, ligand-bound TRPM8 structures have uncovered unforeseen binding sites for both cooling agonists and membrane lipid phosphatidylinositol 4,5-bisphosphate [PI(4,5)P]. These complex structures unveil the molecular basis of cooling agonist sensing by TRPM8 and the allosteric role of PI(4,5)P in agonist binding for TRPM8 activation. Here, we review the recent advances in TRPM8 structural biology and investigate the molecular principles governing the distinguishing role of TRPM8 as the evolutionarily conserved menthol receptor.
Topics: Cryoelectron Microscopy; Humans; Ligands; Menthol; Phosphatidylinositols; TRPM Cation Channels
PubMed: 32532587
DOI: 10.1016/j.tibs.2020.05.008 -
BMJ Open Nov 2022The Food and Drug Administration (FDA) announced its intention to reduce the nicotine content in cigarettes as a strategy to promote cessation and reduce smoking-related... (Clinical Trial)
Clinical Trial
INTRODUCTION
The Food and Drug Administration (FDA) announced its intention to reduce the nicotine content in cigarettes as a strategy to promote cessation and reduce smoking-related harm. A low nicotine product standard will apply to all cigarettes on the market, including menthol cigarettes. In December 2021, the FDA approved a modified risk tobacco product application for menthol and non-menthol flavoured very low nicotine cigarettes (VLNC) from the 22nd Century Group. Notably, experimentation with menthol cigarettes is linked to smoking progression, as well as greater nicotine dependence relative to non-menthol cigarette use. If menthol VLNCs are perceived as more appealing than non-menthol VLNCs, this would indicate that some aspect of menthol may maintain smoking even in the absence of nicotine and FDA's regulatory authority to ban or restrict the sale of menthol cigarettes should apply to reduced nicotine content of cigarettes. In April 2022, the FDA announced proposed rulemaking to prohibit menthol cigarettes, however it is unclear if a menthol prohibition would apply to VLNCs.
METHODS AND ANALYSIS
This study will recruit 172 young adult menthol smokers (with a specific subsample of n=40 sexual and gender minority young adults) and measure appeal for smoking experimental menthol and non-menthol VLNCs, and the impact of proposed product standards on tobacco product purchasing behaviour using an Experimental Tobacco Marketplace. Appeal across product standards will be assessed in a controlled laboratory and using ecological momentary assessment.
ETHICS AND DISSEMINATION
The protocol was approved by the University of Oklahoma Health Sciences Center Institutional Review Board (#11865). Findings will examine the effects of a reduced nicotine standard and a menthol ban on young adult smoking and will be disseminated through peer-reviewed journal articles and presentations at scientific conferences.
TRIAL REGISTRATION NUMBER
NCT04340947.
Topics: Humans; Young Adult; Menthol; Nicotine; Smokers; Tobacco Products; Tobacco Use Disorder
PubMed: 36410805
DOI: 10.1136/bmjopen-2022-067694 -
Translational Behavioral Medicine Aug 2023Banning flavors in e-cigarettes and other tobacco products may decrease their use. To examine how current users of flavored e-cigarettes might react to a ban on flavored...
Banning flavors in e-cigarettes and other tobacco products may decrease their use. To examine how current users of flavored e-cigarettes might react to a ban on flavored e-cigarettes when: (i) menthol flavor is banned together with other flavors, or (ii) this ban on e-cigarettes is combined with a ban on menthol cigarettes and flavored cigars. A national cross-sectional survey of 2,347 current users of flavored e-cigarettes was conducted in May 2022. For each hypothetical ban scenario, respondents reported if they would quit all tobacco product use, continue to use e-cigarettes with no flavor or flavors that were not banned, or switch to alternative tobacco products. Multinomial logistic regressions were used to estimate the associations between responses and ban scenarios, adjusting for tobacco use and demographic variables. If e-cigarettes with any flavors except menthol and tobacco were banned, the majority of current e-cigarette users would keep using e-cigarettes with no flavor or tobacco and menthol flavor. When menthol flavor was added to a ban, a greater proportion of respondents would quit all tobacco use; however, more would also switch to cigarettes or cigars. When menthol cigarettes and flavored cigars were added to a ban, those who used menthol flavor only would be less likely to switch to cigarettes and cigars. Among current e-cigarette users, the harm reduction (i.e., from quitting all use) from a ban on flavored e-cigarettes, particularly if menthol is also banned, may be outweighed by the harm increases (i.e., switching to cigarettes or cigars, or other products that are more harmful than using e-cigarettes). A concurrent ban on menthol cigarettes and flavored cigars would secure more certain net reductions to public health harms from e-cigarette use and smoking.
Topics: Humans; Electronic Nicotine Delivery Systems; Menthol; Cross-Sectional Studies; Flavoring Agents; Tobacco Products; Nicotiana
PubMed: 36694931
DOI: 10.1093/tbm/ibac109 -
Journal of Medical Internet Research Nov 2022The US Food and Drug Administration (FDA) recently restricted characterizing flavors in tobacco products. As a result, ice hybrid-flavored e-cigarettes, which combine a...
BACKGROUND
The US Food and Drug Administration (FDA) recently restricted characterizing flavors in tobacco products. As a result, ice hybrid-flavored e-cigarettes, which combine a cooling flavor with fruit or other flavors (eg, banana ice), emerged on the market. Like menthol, ice-flavored e-cigarettes produce a cooling sensory experience. It is unclear if ice hybrid-flavored e-cigarettes should be considered characterizing flavors or menthol, limiting regulatory action. Monitoring the public's conversations about ice-flavored e-cigarettes on Twitter may help inform the tobacco control community about these products and contribute to the US FDA policy targets in the future.
OBJECTIVE
This study documented the themes pertaining to vaping and ice flavor-related conversations on Twitter. Our goal was to identify key conversation trends and ascertain users' recent experiences with ice-flavored e-cigarette products.
METHODS
Posts containing vaping-related (eg, "vape," "ecig," "e-juice," or "e-cigarette") and ice-related (ie, "Ice," "Cool," "Frost," and "Arctic") terms were collected from Twitter's streaming application programming interface from January 1 to July 21, 2021. After removing retweets, a random sample of posts (N=2001) was selected, with 590 posts included in the content analysis. Themes were developed through an inductive approach. Theme co-occurrence was also examined.
RESULTS
Many of the 590 posts were marked as (or consisted of) marketing material (n=306, 51.9%), contained positive personal testimonials (n=180, 30.5%), and mentioned disposable pods (n=117, 19.8%). Other themes had relatively low prevalence in the sample: neutral personal testimonials (n=45, 7.6%), cannabidiol products (n=41, 7%), negative personal testimonials (n=41, 7%), "official" flavor description (n=37, 6.3%), ice-flavored JUUL (n=19, 3.2%), information seeking (n=14, 2.4%), and comparison to combustible tobacco (n=10, 1.7%). The most common co-occurring themes in a single tweet were related to marketing and disposable pods (n=73, 12.4%).
CONCLUSIONS
Our findings offer insight into the public's experience with and understanding of ice-flavored e-cigarette products. Ice-flavored e-cigarette products are actively marketed on Twitter, and the messages about them are positive. Public health education campaigns on the harms of flavored e-cigarettes may help to reduce positive social norms about ice-flavored products. Future studies should evaluate the relationship between exposure to personal testimonials of ice-flavored vaping products and curiosity, harm perceptions, and experimentation with these products among priority populations.
Topics: United States; Humans; Electronic Nicotine Delivery Systems; Menthol; Ice; Social Media; Vaping; Nicotiana
PubMed: 36449326
DOI: 10.2196/41785