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Open Access Publications from the University of California

Scholarly Works (12 results)

  • Article
  • Peer Reviewed
Tobacco-Related Disease Research Program Funded Publications (2014)
    Cover page: Evaluating the Implementation Process of a Citywide Smokefree Multiunit Housing Ordinance: Insights from Community Stakeholders
    • Article
    Tobacco Control Policy Making: United States (2010)

    Publicly available internal tobacco industry documents were analyzed to answer the following questions regarding menthol’s role in nicotine dependence: 1) What are the addiction and exposure measures and what are their relationships to menthol cigarette use? 2) Do menthol smokers show different signs or levels of nicotine dependence compared to non-menthol smokers? 3) Does menthol affect cigarette consumption (cigarettes per day) and do menthol smokers smoke more or fewer cigarettes per day compared to non-menthol smokers? 4) What is menthols’ effect on nicotine metabolism (i.e. glucuronide formation) and do menthol smokers experience different nicotine exposure and/or altered nicotine metabolism as compared to non-menthol smokers? (i.e. serum cotinine levels) 5) Does menthol have an effect on nicotine delivery? 6) Does menthol alter the addictiveness of smoking through sensory stimulation? Tobacco industry documents reveal at least two important reasons for menthol’s use in cigarettes. A final collection of 309 documents was analyzed for this report, of which 72 were deemed relevant to one or more of the research questions and cited in this paper. Our analyses of these documents indicate 1) menthol is used in cigarettes to override the harsh taste of tobacco; 2) menthol has physiological effects, and it synergistically interacts with nicotine; 3) menthol makes low tar, low nicotine tobacco products that would otherwise be tasteless and unsatisfactory acceptable to smokers. Tobacco manufacturers manipulated menthol levels to produce tobacco products that would be easier to consume, especially for new and inexperienced smokers.

      Cover page: Menthol’s Potential Effects on Nicotine Dependence: A White Paper
      • Article
      • Peer Reviewed
      UC San Francisco Previously Published Works (2011)

      Objective

      To examine what the tobacco industry knows about the potential effects menthol may have on nicotine dependence.

      Methods

      A snowball strategy was used to systematically search the Legacy Tobacco Documents Library (http://legacy.library.ucsf.edu/) between 22 February and 29 April, 2010. Of the approximately 11 million documents available in the Legacy Tobacco Documents Library, the iterative searches returned tens of thousands of results. We qualitatively analysed a final collection of 309 documents relevant the effects of menthol on nicotine dependence.

      Results

      The tobacco industry knows that menthol overrides the harsh taste of tobacco and alleviates nicotine's irritating effects, synergistically interacts with nicotine, stimulates the trigeminal nerve to elicit a 'liking' response for a tobacco product, and makes low tar, low nicotine tobacco products more acceptable to smokers than non-mentholated low delivery products.

      Conclusion

      Menthol is not only used in cigarettes as a flavour additive; tobacco companies know that menthol also has sensory effects and interacts with nicotine to produce tobacco products that are easier to smoke, thereby making it easier to expose smokers, especially those who are new and uninitiated, to the addictive power of nicotine.
        Cover page: Menthol's potential effects on nicotine dependence: a tobacco industry perspective
        • Article
        • Peer Reviewed
        UC San Francisco Previously Published Works (2011)

        Objective

        To determine what the tobacco industry knew about the potential effects of menthol on smoking topography-how a person smokes a cigarette.

        Methods

        A snowball strategy was used to systematically search the Legacy Tobacco Documents Library (http://legacy.library.ucsf.edu) between 1 June 2010 and 9 August 2010. We qualitatively analysed a final collection of 252 documents related to menthol and smoking topography.

        Results

        The tobacco industry knew that menthol has cooling, anaesthetic and analgesic properties that moderate the harshness and irritation of tobacco. Owing to its physiological effects, menthol contributes to the sensory qualities of the smoke and affects smoking topography and cigarette preference.

        Conclusion

        Our review of industry studies suggests that the amount of menthol in a cigarette is associated with how the cigarette is smoked and how satisfying it is to the smoker. If menthol in cigarettes was banned, as the US Food and Drug Administration (FDA) is currently considering, new/experimental smokers might choose not to smoke rather than experience the harshness of tobacco smoke and the irritating qualities of nicotine. Similarly, established menthol smokers might choose to quit if faced with an unpleasant smoking alternative.
          Cover page: Menthol sensory qualities and smoking topography: a review of tobacco industry documents
          • Article
          • Peer Reviewed
          UC San Francisco Previously Published Works (2013)
          Abstract Background Targeting of marginalized groups with aggressive tobacco marketing has been identified as exacerbating health disparities. However, interpretation of such targeting by groups varies, from surprise and outrage to regarding such marketing as evidence of social legitimacy. We sought to learn how an often-overlooked marginalized group, older adults, would respond to industry documents offering evidence of tobacco company target marketing. Methods We conducted 10 focus groups in California cities with older (≥50 years) smokers and former smokers. A set of previously-undisclosed tobacco industry documents related to target marketing was shown to the group in sequence. Audiotaped discussions were transcribed and data analyzed using qualitative approaches. Results Responses to evidence of tobacco industry targeting varied, with some regarding it as exploitive and others as normal business practice. However, in most groups, discussions turned to government’s failure to protect the public—even though government action /inaction was not prompted nor addressed in the discussion documents. Conclusion Given the Food and Drug Administration’s new authority to regulate tobacco products, these findings suggest that some of the tobacco industry’s “best customers” (older, established smokers and ex-smokers) may be strong supporters of government regulation of tobacco.
            Cover page: Older smokers could be the strongest supporters for U.S. government regulation of tobacco: a focus group study
            • Article
            Tobacco Control Policy Making: United States (2010)

            Publicly available internal tobacco industry documents were analyzed to answer the following questions regarding the sensory qualities of menthol and its possible effects on topography: 1) What properties does menthol contribute to the smoking experience? 2) Does menthol contribute to the sensory qualities of the smoke and affect smoking topography? 3) Do changes in smoking topography lead to greater exposure to toxic substances, increased nicotine dependence, or greater chance of tobacco-related disease? 4) What are the various ways menthol is measured and how are menthol yields determined? 5) Does the menthol content and/or yield have an effect on how the cigarette is smoked or cigarette preference? 6) What is the relationship between menthol and intensity in use of cigarettes (i.e., does menthol lead to a higher delivery of smoke per cigarette)? A final collection of 252 documents was analyzed for this report, of which 67 were deemed relevant to one or more of the research questions and cited in this paper. Our analyses of the documents indicate the following: 1) Menthol has cooling and anesthetic properties that moderate the harshness and irritation of tobacco; 2) Menthol contributes to the sensory qualities of the smoke and affects smoking behavior and cigarette preference depending on the level of menthol and nicotine in the cigarette; 3) It is unclear whether menthol’s effect on smoking behavior leads to greater exposure to toxic substances; 4) Menthol is measured in milligrams or micrograms that are distilled from a cigarette before and after smoking; 5) It is unclear whether the menthol content and/or yield have an effect on how a cigarette is smoked because most testing that we were able to locate in the documents was done on new mentholated products by in-house smoker panels; and 6) It is unclear what the tobacco industry knew about the relationship between menthol and intensity in use of cigarettes. The documents provide evidence that cigarette manufacturers not only use menthol as a flavorant, but also as an ingredient that has physiological effects, and synergistically interacts with nicotine.

              Cover page: Menthol Sensory Qualities and Possible Effects on Topography: A White Paper
              • Article
              • Peer Reviewed
              Tobacco-Related Disease Research Program Funded Publications (2015)
                • Article
                • Peer Reviewed
                UC San Francisco Previously Published Works (2013)

                Objectives

                Calls for public health practices, including research, to better integrate social theories of power, agency, and social change suggest that increased reflexivity about both the process and outcomes of community engagement is warranted. Yet few community-based participatory research (CBPR) projects specifically report nonresearch outcomes of such projects. The authors analyzed "secondary outcomes" of Protecting the 'Hood Against Tobacco (PHAT), a CBPR project conducted in San Francisco, California.

                Methods

                Interpretive analysis of quasi-ethnographic project documentation, including meeting minutes, field notes, retrospective observations, and interviews.

                Results

                PHAT participation created "ripple effects," encouraging healthier behaviors and public health promotion among community research partners, prompting academics to confront power asymmetries and recognize community knowledge, and widening social networks.

                Conclusions

                CBPR benefits both communities and researchers beyond the findings of the research itself. More systematically capturing these effects, perhaps through wider use of ethnographic approaches, could help enhance understanding of CBPR's true contributions.
                  Cover page: Being Part of Something
                  • Article
                  • Peer Reviewed
                  UC San Francisco Previously Published Works (2022)

                  Purpose

                  Describe racial/ethnic patterns of flavored tobacco use to illuminate equity implications of flavored tobacco policies.

                  Methods

                  Using data on US young adults (ages 18-34; n = 8,114) in the Population Assessment of Tobacco and Health Study Wave 5 (2018-2019) and survey-weighted logistic regression, we estimated any flavors (regular brand) and mint/menthol (vs. other flavors) use by race/ethnicity among cigarette, e-cigarette, cigar, blunt, hookah, smokeless tobacco, and any tobacco product users.

                  Results

                  Any flavored tobacco use was common and was significantly higher for Black (75.1%; OR: 1.4; 95% CI: 1.2, 1.7) and Hispanic/Latinx (77.2%; OR: 1.4; 95% CI: 1.1, 1.7) users than White users (73.5%). The most pronounced difference across products was in menthol cigarette use between Black and White smokers (OR: 4.5; 95% CI: 3.5, 5.9). Among flavored product users, mint/menthol use was significantly higher for Latinx blunt and hookah users.

                  Discussion

                  Racial/ethnic disparities in flavored tobacco use include and extend beyond menthol cigarettes. Comprehensive flavored tobacco restrictions that include mint/menthol and non-cigarette products will likely have more equitable impact.
                    Cover page: Flavored Tobacco Product Use Among Young Adults by Race and Ethnicity: Evidence From the Population Assessment of Tobacco and Health Study
                    • Article
                    • Peer Reviewed
                    UC San Francisco Previously Published Works (2024)
                    Reducing racial and socioeconomic inequities in smoking has been declared a priority for tobacco control in the USA for several decades. Yet despite the rhetoric, these inequities persist and some have actually worsened over time. Although tobacco companies have targeted racially and ethnically diverse and lower-income tobacco users, which substantially contributes to these disparities, less attention has been given to the role of individuals and organisations within the tobacco control movement who have allowed progress in eliminating disparities to stagnate. We examine the failure of tobacco control professionals to ensure the widespread adoption of equity-focused tobacco control strategies. Review of major US tobacco control reports found that the focus on equity often stops after describing inequities in tobacco use. We suggest ways to advance equity in tobacco control in the USA. These recommendations fall across five categories: surveillance, interventions, funding, accountability and addressing root causes. Policy interventions that will have a pro-equity impact on smoking and related disease should be prioritised. Funding should be designated to tobacco control activities focused on eliminating racial and socioeconomic inequities in smoking, and tobacco control programmes should be held accountable for meeting equity-related goals.
                      Cover page: Recommendations to advance equity in tobacco control
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