Does menthol cigarette use moderate the effect of nicotine metabolism on short-term smoking cessation?

Nancy C. Jao*, Anna K. Veluz-Wilkins, Matthew J. Smith, Allison J. Carroll, Sonja Blazekovic, Frank T. Leone, Rachel F. Tyndale, Robert A. Schnoll, Brian Hitsman

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


The nicotine metabolite ratio (NMR) has been shown to predict response to the transdermal nicotine patch, such that faster nicotine metabolism is associated with a lower abstinence rate. Menthol cigarette use, versus nonmenthol cigarette use, slows nicotine metabolism and therefore may attenuate the effect of NMR on smoking abstinence. In this study, we evaluated whether cigarette type (menthol vs. nonmenthol) modified the association between NMR and short-term abstinence. This was a secondary analysis examining treatment in the first 8 weeks of 21 mg/day nicotine patch therapy in a completed clinical trial (n = 474). Menthol cigarette use was based on self-report. NMR was defined dichotomously (0 = fast, 1 = slow) to distinguish between fast (≥0.47) versus slow NMR. Using logistic regression analysis, we tested whether cigarette type moderated the association between NMR and bioverified 7-day point prevalence abstinence at Week 8. Covariates include nicotine dependence, age, race, and gender. Three hundred two participants reported smoking menthol cigarettes, of which 234 (77%) were classified as slow NMR. Among the 172 nonmenthol smokers, 136 were classified as slow NMR (79%). Contrary to our expectations, the NMR × Cigarette Type interaction effect on abstinence was not significant (odds ratio [OR] = 0.91, p = .86). Excluding the interaction variable, fast NMR was associated with decreased likelihood of abstinence (OR = 0.55, p = .03), but menthol cigarette use was not (OR = 1.15, p = .56). Further exploration of risk factors among menthol cigarette smokers, especially among racially diverse and light smokers, could clarify the association between menthol cigarette use and poorer smoking outcomes.

Original languageEnglish (US)
Pages (from-to)216-222
Number of pages7
JournalExperimental and Clinical Psychopharmacology
Issue number3
StatePublished - Jun 2017


  • Cigarette smoking
  • Menthol
  • Nicotine metabolism
  • Smoking abstinence

ASJC Scopus subject areas

  • Pharmacology
  • Psychiatry and Mental health
  • Pharmacology (medical)


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