In many higher income countries fewer people smoke than did a decade ago. However, the proportion who smoke menthol-flavored cigarettes is on the rise in countries like the U.S. Menthol, a compound found in plants such as peppermint, is added to tobacco products to make them more appealing.
More than 9 million adults, or about 32 percent of all smokers, use menthol cigarettes, according to the Centers for Disease Control and Prevention (CDC). In Virginia, the proportion stands higher, at 38 percent.
This made the use of menthol tobacco products a suitable area of focus by Virginia Tech’s Fralin Biomedical Research Institute.
Researchers found that if menthol products were unavailable, smokers found replacement therapies such as nicotine gum and lozenges were practical alternatives, potentially improving health outcomes for people who use menthol cigarettes. The researchers analyzed preferences for menthol-flavored cigarettes and e-cigarettes and the effect of filter ventilation options on purchase decisions.
The findings come from a study that examined what products adult smokers purchased in an experimental marketplace that adjusted prices and availability of tobacco and nicotine products.
The findings are based on data from 172 people who exclusively smoke cigarettes — 76 of whom smoke menthol and 96 non-menthol cigarettes — and 91 people who use multiple tobacco products. Participants were older than 21, smoked at least 10 cigarettes daily, and had smoked a minimum of 100 cigarettes in their lifetime.
The researchers were especially keen to discern how different flavor policies interact, the role of cigarette filter ventilation, and how different types of smokers would respond to those policies.
The volunteers were asked to complete trial purchases in the Experimental Tobacco Marketplace, a tool addiction recovery research expert Warren Bickel created to study the effects of tax and regulatory policies on health behaviors.
In the marketplace, participants used an account in an online platform to purchase tobacco and nicotine products, including replacement therapies. Options were tailored to each participant’s preferred flavors and nicotine concentrations, and they were given an account balance designed to reflect their personal budget constraints.
Research participants shopped for products under different market conditions — with varying prices and restricted or unrestricted cigarette or e-cigarette flavors.
The findings were that when menthol cigarettes were not available, smokers who preferred menthol cigarettes were less willing to purchase any type of cigarettes and more willing to purchase products such as nicotine gum and other replacement therapies. In addition, cigarette smokers who prefer menthol products were less likely to substitute e-cigarettes when menthol flavored e-cigarettes were also restricted.
The study appears in the journal Drug and Alcohol Dependence. The study is titled “Restrictions of cigarette and e-cigarette flavor and filter ventilation on demand and substitution in the Experimental Tobacco Marketplace.”
