Longitudinal association of exclusive and dual use of menthol cigarettes and flavored cigars with cigarette and cigar smoking cessation among U.S. adults – population assessment of tobacco and health study waves 1–5 (2013–2019)

Abstract

Objective

To examine the relationship between menthol cigarette and flavored cigar use, alone or in combination, and short-term smoking cessation among U.S. adults.

Methods

We used restricted Waves 1–5 Population Assessment of Tobacco and Health Study data to estimate the risk of 30-day smoking cessation associated with menthol cigarette and flavored cigar use, alone or combined, and compared to unflavored tobacco product use. We fit multivariable discrete-time survival models to a nationally representative sample of U.S. adults with current established cigarette or cigar use, adjusting for age, sex, race, ethnicity, income, cigarette pack-years, tobacco dependency, cigarette and cigar smoking intensity, and blunt use.

Results

The majority of sample respondents (n = 8840) were male (53.5 %), non-Hispanic White (69.4 %), had a high school/General Educational Development (GED) education or less (53.9 %), and had an annual income of less than $50,000 (74.9 %). Most respondents used unflavored tobacco products (59.9 %), 33.8 % exclusively used menthol cigarettes, 2.4 % used both menthol cigarettes and flavored cigars, 1.8 % used both non-menthol cigarettes and flavored cigars, 1.3 % exclusively used flavored cigars, and 0.9 % used both menthol cigarettes and unflavored cigars. In fully adjusted models, we found no associations between menthol cigarette and flavored cigar use alone or in combination and 30-day cigarette and cigar smoking cessation relative to unflavored tobacco product use. These results were robust to sensitivity tests varying survey weights, sample inclusion criteria, and exposure definitions.

Conclusion

We found that menthol cigarette and flavored cigar use, alone or in combination, was not associated with short-term cigarette and cigar smoking cessation.