VCU news

By Blake Belden
VCU Massey Cancer Center

Tobacco use is the most preventable cause of death in the U.S., and cigarette smoking increases the risk of a wide variety of cancers. Previous research suggests that e-cigarettes may serve as a less harmful alternative to traditional cigarettes; however, less is known regarding the effect of e-cigarette uptake on tobacco use and associated health consequences among African American smokers, particularly those who smoke menthol cigarettes.

VCU Massey Cancer Center researchers Andrew Barnes, Ph.D., and Caroline Cobb, Ph.D., who are both members of the Cancer Prevention and Control research program at Massey, were recently awarded more than $1.3 million through a three-year grant from the National Institute on Drug Abuse to predict how e-cigarette flavor regulations will impact future tobacco use, exposure to carcinogens and other biomarkers of tobacco use and addiction among African American menthol smokers.

“Menthol is the only characterizing flavor allowed in cigarettes under current federal regulations, and menthol use is associated with progression to established cigarette smoking as well as more difficulty quitting,” said Barnes, an associate professor in the Department of Health Behavior and Policy at the VCU School of Medicine. “Nearly 80% of African American smokers choose menthol as their usual brand, compared to 25% percent of white smokers.”

African Americans have the highest rates of tobacco-related cancer of any racial or ethnic group in the country, and they are more likely to die from the disease, according to the nonprofit public health organization Truth Initiative.

“African American menthol smokers are disproportionately harmed by tobacco products and could experience health benefits from increased availability of well-regulated e-cigarettes to help them reduce their traditional cigarette use and ultimately quit all tobacco products,” Barnes said. “This study is aimed at finding out whether having e-cigarette flavors available, particularly menthol, increases uptake of e-cigarettes and reduces menthol cigarette use.”

Through this grant funding, Barnes and Cobb will conduct a six-week clinical trial separated into three groups of study participants based on potential Food and Drug Administration regulations on e-cigarette flavor availability, including 1) participants who have access to menthol and tobacco-flavored e-cigarettes, 2) participants who only have access to tobacco-flavored e-cigarettes and 3) participants who only have access to unflavored e-cigarettes.

Study visits will occur every few weeks with daily tobacco use monitored throughout. Other measures will include brief qualitative interviews with participants and a 30-day post-intervention follow-up.

“Results of this work will help the FDA make predictions about the impact of shifting from the current regulatory market where menthol-flavored e-cigarettes are available to a market where only tobacco and unflavored e-cigarettes are available, in order to maximize health-promoting effects and minimize unintended consequences among African American menthol smokers,” said Cobb, an associate professor in the Department of Psychology in the College of Humanities and Sciences.