Impact of prepregnancy menthol cigarette use on smoking cessation across pregnancy and postpartum: a longitudinal analysis of the Population Assessment of Tobacco and Health (PATH) Study

Abstract Introduction The purpose of this study was to characterize smoking cessation at pregnancy and postpartum return to use as a function of prepregnancy menthol vs non-menthol cigarette use. Methods Data were drawn from waves 1–5 (2013-2019) of the Population Assessment of Tobacco and Health (PATH) Study, using 3 longitudinal time-points indicating prepregnancy, pregnancy, and postpartum in 179 participants who reported exclusive cigarette smoking at prepregnancy and were currently pregnant during the middle interval. Outcomes included (1) quit attempts and successful quitting within 12 months of pregnancy, (2) change in past 30-day smoking frequency at pregnancy, and (3) postpartum return to use. Generalized estimating equations were conducted adjusting for sociodemographic and smoking characteristics. Results Approximately 47% of pregnant persons who smoked reported use of menthol cigarettes at prepregnancy, almost 80% attempted to quit or cut down during pregnancy, and 43.6% successfully quit. Approximately 56% of those who reported being quit at pregnancy returned to use in postpartum. Menthol use was associated with smoking on 1.13 fewer days among those who continued to smoke at pregnancy. Although prepregnancy menthol cigarette use was associated with greater nicotine dependence (fewer minutes to first cigarette; P < .05), menthol cigarette use was not significantly associated with quit attempts, successful cessation or changes in smoking frequency at pregnancy, or postpartum return to use (Ps > .05). Conclusions Our study did not find an impact of prepregnancy menthol cigarette use on quit attempts, cessation, or postpartum return to use. Findings suggest cessation efforts should focus on behavioral and contextual factors beyond cigarette mentholation alone. Implications Use of menthol vs non-menthol cigarettes in prepregnancy did not impact quit attempts, successful quitting, frequency of cigarette use at pregnancy assessment, or postpartum return to use among pregnant respondents who exclusively smoked cigarettes. Results indicate cessation outcomes during or after pregnancy may be influenced by behavioral and contextual factors beyond menthol cigarette use.