A tale of two stimulants: Mentholated cigarettes may play a role in cocaine, but not methamphetamine, dependence.

Research suggests that mentholated cigarettes may play a role in cocaine dependence. The purpose of this study was to expand upon the research on mentholated cigarettes and cocaine dependence and to evaluate the role of mentholated cigarettes in methamphetamine dependence. Data for the analysis came from National Drug Abuse Treatment Clinical Trials Network protocol CTN-0046, a multisite, randomized trial evaluating the impact of smoking cessation treatment in stimulant-dependent outpatients. Participants’ reasons for concurrent use of cigarettes and illicit stimulants were assessed via self-report. Stimulant-abstinence was measured by self-report and urine drug screens. Smoking cessation was assessed via self-report and carbon monoxide levels. Of the 301 cocaine-dependent participants, 201 (67%) were menthol and 100 (33%) were non-menthol cigarette smokers. Cocaine-dependent participants who smoked menthol, compared to non-menthol, cigarettes were significantly more likely to report that cigarettes prolong their cocaine high and were less likely to be stimulant abstinent during active treatment, at 3 month follow-up, and at 6 month follow-up. No parallel differences were found between menthol and non-menthol methamphetamine-dependent smokers. The prevalence of Caucasian menthol smokers was significantly greater in the cocaine-dependent participants (37.2%) than in the methamphetamine-dependent participants. Smoking cessation was not significantly associated with cigarette type for either cocaine- or methamphetamine-dependent participants.

Conclusions: The present results suggest that mentholated cigarettes play a role in cocaine, but not methamphetamine, dependence. Cocaine clinical trialists should assess whether participants smoke mentholated cigarettes, since these results suggest that this easily-assessed variable is associated with cocaine use outcomes. Additionally, the results suggest that concurrent use of mentholated cigarettes with cocaine is associated with more severe cocaine dependence. This potential negative impact on public health should be considered when weighing the potential costs and benefits of banning metholated cigarettes.

Related protocols: CTN-0046