Association of Menthol in Cigarettes with Dependence and Cigarette Smoking Cessation: Analysis of The Population Assessment of Tobacco and Health Study Waves 4 and 5

BACKGROUND. Much speculation remains as to whether menthol increases the inherent dependence potential of cigarettes and interferes with the ability to quit smoking. This research evaluates differences in cigarette dependence and smoking cessation between adults who smoke (AS) menthol and non-menthol cigarettes, particularly non-Hispanic Black AS. METHODS. Data were drawn from the Population Assessment of Tobacco and Health (PATH) Study Waves 4-5 among AS 18+ (n = 7,007 [1,127 non-Hispanic Black AS]). Baseline characteristics, dependence outcomes (e.g., heaviness of smoking index, tobacco dependence index), and cessation rates were compared between AS by menthol use and race/ethnicity. Cessation rates by menthol preference and respondent characteristics were further assessed using backward stepwise logistic regressions. RESULTS. AS who prefer menthol cigarettes (MAS) had lower cigarette dependence and smoked fewer cigarettes per day than non-menthol preferring AS (NMAS); this was also true among non-Hispanic White AS. No difference in cessation rates were observed between MAS and NMAS. AS had lower odds of cessation if they were older, non-White, reported smoking every day, and had moderate/high dependence. AS with college or higher education or planning to quit had higher odds of cessation. Among all non-Hispanic Black AS, there was lower odds of cessation among everyday smokers reporting moderate cigarette addiction, and a higher odds of cessation among higher-income and current users of smoke-free products. Menthol use was not a significant correlate of cessation. CONCLUSIONS. Menthol smoking was not associated with higher dependence or smoking cessation. Further, results suggest that household income and cigarette smoking frequency are potential barriers to cessation among non-Hispanic Black AS.