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

INTRODUCTION: The purpose of this study was to characterize smoking cessation at pregnancy and postpartum return to use as a function of pre-pregnancy 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 three longitudinal time-points indicating pre-pregnancy, pregnancy, and postpartum in 179 participants who reported exclusive cigarette smoking at pre-pregnancy and were currently pregnant during the middle interval. Outcomes included (1) quit attempts and successful quitting within 12 months of pregnancy change in past 30-day smoking frequency at pregnancy, and 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 pre-pregnancy, almost 80% attempted to quit/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 pre-pregnancy 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 pre-pregnancy 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.