Menthol Cigarette Smoking and Obesity in Young Adult Daily Smokers in Hawaii

This study investigates 1) the relationship between menthol cigarette smoking and obesity and 2) the association of body mass index with the nicotine metabolite ratio among menthol and non-menthol daily smokers aged 18–35 (n = 175). A brief survey on smoking and measures of height and weight, carbon monoxide, and saliva samples were collected from participants from May to December 2013 in Honolulu, Hawaii. Multiple regression was used to estimate differences in body mass index among menthol and non-menthol smokers and the association of menthol smoking with obesity. We calculated the log of the nicotine metabolite ratio to examine differences in the nicotine metabolite ratio among normal, overweight, and obese smokers. Sixty-eight percent of smokers used menthol cigarettes. Results showed that 62% of normal, 54% of overweight, and 91% of obese smokers used menthol cigarettes (p = .000). The mean body mass index was significantly higher among menthol compared with non-menthol smokers (29.4 versus 24.5, p = .000). After controlling for gender, marital status, educational attainment, employment status, and race/ethnicity, menthol smokers were more than 3 times as likely as non-menthol smokers to be obese (p = .04). The nicotine metabolite ratio was significantly lower for overweight menthol smokers compared with non-menthol smokers (.16 versus .26, p = .02) in the unadjusted model, but was not significant after adjusting for the covariates. Consistent with prior studies, our data show that menthol smokers are more likely to be obese compared with non-menthol smokers. Future studies are needed to determine how flavored tobacco products influence obesity among smokers

ADOLESCENT NICOTINE METABOLISM: ETHNORACIAL DIFFERENCES AMONG DEPENDENT SMOKERS

Variations in nicotine metabolism are thought to contribute to differences in cigarette consumption between African Americans and Caucasian adult smokers. To investigate the potential mechanism of previously documented lower smoking rates among African- American adolescent smokers seeking cessation treatment, we measured nicotine metabolite ratios as markers of the metabolic disposition of nicotine, which is generally considered to be under the influence of cytochrome P450 (CYP) 2A6. Plasma ratios of trans-39-hydroxycotinine (3HC) to cotinine (COT) were examined in 92 cessation treatment- seeking adolescents (mean age 15.2 years, standard deviation [SD] 1.3, 69% female, 31% African American, mean Fagerstro ¨m Test for Nicotine Dependence [FTND] 6.5, SD 1.6, mean years smoked 2.6, SD 1.6). Groups were similar in age, gender distribution, and mean FTND score. Analysis with independent t tests revealed significantly lower number of cigarettes per day (CPD) (15.1, SD 7.6 vs 19.6, SD 8.0, P5.013) and nicotine metabolite ratios (0.27, SD 0.15 vs 0.35, SD 0.16, P5.026) in African-American compared to Caucasian adolescent smokers. Consistent with metabolic variation, mean COT/CPD ratio was significantly higher in African-American compared to Caucasian adolescents. Results remained statistically significant when comparing menthol smokers by ethnicity. These findings are consistent with those found among adult smokers and provide a putative mechanism for reported ethnoracial differences in adolescent cigarette consumption. Our results underscore the need for measures independent of consumption for determining degree of nicotine dependence and treatment selection across ethnicities, even among youths

Differences in Risk-Taking Propensity Across Inner-City Adolescent Ever- and Never-Smokers

Because adolescent smoking is a significant public health concern, potential value lies in understanding and identifying the psychological factors that distinguish ever- and never-smokers. To that end, we examined the relationship between risk-taking propensity as measured by the Balloon Analogue Risk Task and ever-smoking (i.e., even one puff) versus never-smoking in a sample of 125 predominantly African American high-school adolescents (M = 15.1, SD = 1.5). Results indicated that ever-smokers and never-smokers differed on risk-taking propensity; further risk-taking propensity was related to smoking status above and beyond both demographic variables and a measure of self-reported impulsive sensation seeking. We discuss these results in relation to the potential utility of a multimethod assessment approach (i.e., self-report measures and behavioral tasks) to identify adolescents\u27 risk-taking susceptibilities and engagement in smoking and other risk-taking behaviors

Nicotine replacement therapy use among adolescent smokers seeking cessation treatment.

OBJECTIVE: To examine the correlates of prior nicotine replacement therapy (NRT) in an urban sample of adolescent smokers seeking smoking cessation treatment. DESIGN: Adolescents were recruited via radio, TV and print advertisements for participation in treatment studies. Participants completed a structured interview usinga prescreeningquestionnaire. SETTING: Data were collected via a telephone interview by trained research personnel. PARTICIPANTS: A sample (N=1879) cessation treatment-seeking volunteer boys (38.2%) and girls (61.8%) aged 12 to 17 years, from a diverse ethnic background residing in the Baltimore, Maryland metropolitan area. INTERVENTIONS: No interventions were used in this observational study. MAIN OUTCOME MEASURES: Use of NRT in adolescents stratified by age, Fagerstrom Test of Nicotine Dependence (FTND), and race/ethnicity. RESULTS: The sample had a mean FTND score of 5.7 (SD = 2.2). About 41% smoked 11 to 20 cigarettes per day. Adolescent smokers who had used NRT were statistically but only marginally older than those who had not (15.9 vs 15.7 years; t-test= -2.60, P=0.01). FTND score, a measure of nicotine dependence, was higher among those who had used NRT (6.0 vs 5.6; t-test= -3.37, P= .001). African American adolescents were less likely to have used NRT than their European American counterparts (33.0% vs 61.2%; chi2=16.09, P<.003). After stepwise logistic regression analyses, age, FTND and race/ethnicity remained predictors of NRT use. CONCLUSION: Our results show differences in NRT use patterns based on age, FTND, and race/ethnicity. European American youths are more likely than their 'other' counterparts to use NRT, after adjusting for age and smoking severity, whereas, African American youth are less likely than their 'other' counterparts to use NRT. These findings suggest racial/ethnic disparities in accessing smoking cessation modalities among adolescents. Further research is needed to fully elucidate factors contributing to these differences in order to facilitate increased smoking cessation rates among all adolescents

REASONS FOR WANTING TO QUIT: ETHNIC DIFFERENCES AMONG CESSATION-SEEKING ADOLESCENT SMOKERS

Objective: Enhancing adolescent cessation requires an understanding of approaches that will motivate youths to quit smoking. Methods: We compared reasons for wanting to quit expressed by European Americans to those of African American youths. Adolescent cessation-seeking smokers completed telephone interviews regarding their smoking behavior and reasons for wanting to quit in an open-ended format. Responses were then classified into nine categories. Results: Participants included 1,268 Baltimore- area adolescents (mean age 15.6 6 1.7 years, 60% female, 58% European American, mean Fagerstro¨m Test for Nicotine Dependence 5.8 6 2.2). While both groups broadly cited health as the predominant reason for wanting to quit, chi-square analyses of further stratification of health into general, future, and current health concerns showed that European Americans were more likely to endorse current health reasons (P,.001), while African Americans were more likely to state general health reasons (P5.004). European Americans were more likely to state cost (P5.002) or to not give a reason for wanting to quit (P5.008), while African Americans more frequently reported a lack of positive (pharmacologic or social) reinforcement (P,.001). Conclusions: The development of culturally tailored messages may help enhance smoking cessation efforts among adolescents

Developing smoking cessation programs for chronically ill teens: Lessons learned from research with healthy adolescent smokers

Objective: Medically fragile teens who smoke need access to smoking cessation programs, because they are at even higher risk than their healthy peers for smoking-related complications. Methods: To date, no studies on the outcome of smoking cessation programs for medically ill teens have been conducted. To suggest directions for future research, we turn to the literature on smoking cessation in the general population of teens and occasionally to the literature on adult smokers. Results: Four areas are explored: (a) the prevalence of unaided cessation in healthy teens; (b) the outcomes of various treatments for smoking cessation in healthy adolescents; (c) special issues that should be considered when designing programs for medically ill teens; and (d) lessons learned from previous research. Conclusions: Medically ill teens face a number of medical, emotional, social, and developmental challenges that can affect the quitting process. Research is sorely needed to address the unique needs of this population. © The Author 2007. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved

Link between facultative melanin and tobacco use among African Americans.

Nicotine's affinity for melanin-containing tissues may result from its precursor function in melanin synthesis or the irreversible binding of melanin and nicotine. The objective of this study was to investigate a hypothesized association of tobacco use, dependence, and nicotine exposure with melanin pigmentation among African American smokers. A criterion-based sample was employed to collect data from a study of 147 adult African American current smokers. Carbon monoxide, saliva cotinine samples, and skin reflectance measures were obtained from each participant. Questionnaire data on demographic, sociological and behavioral questions related to smoking and skin color were gathered. The three dependent measures were the average number of cigarettes per day (CPD), Fagerström Test of Nicotine Dependence (FTND) score, and cotinine concentration. Analysis of variance, Pearson Correlations, and Multiple Linear Regression were conducted to analyze findings. The mean constitutive melanin reading was 56.3 and 66.5 for facultative melanin. Respondents on average smoked 19 CPD, had a mean FTND of 5.6, and a cotinine concentration of 435 ng/ml. Facultative melanin level was correlated with CPD and cotinine concentration in the bivariate analysis. The multiple linear regression results revealed that facultative melanin was significantly and positively related to CPD, the FTND, and cotinine. The results of this analysis support the hypothesis of a positive association between melanin levels and tobacco use, dependence, and exposure among African American smokers. This analysis may have important implications for research and interventions on tobacco dependence and disease outcomes. Further research on melanin and nicotine among African Americans as well as other population groups is warranted