Reactions to a Hypothetical Menthol Cigarette Ban among Sexual- and Gender-Minoritized Communities: A Concept Mapping Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participant Recruitment and Eligibility
2.2. Participant Questions Survey
2.2.1. Demographic Characteristics
2.2.2. Tobacco Use Behaviors
2.3. Concept Mapping Procedures
2.3.1. Brainstorming
2.3.2. Statement Reduction
2.3.3. Sorting
2.3.4. Rating
2.4. Representation
3. Results
3.1. Participant Characteristics
3.2. Concept Mapping Results
3.2.1. Thoughts and Reactions to the Ban
3.2.2. Positive Preparation/Action Strategies
3.2.3. Maintaining Substance Use
3.3. Cluster Rating Comparisons
3.3.1 Demographic Characteristics
3.3.2 Tobacco Use Characteristics
3.4. Pattern Match Comparisons
4. Discussion
Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristic | Mean | (SD) | |
---|---|---|---|
Percentage | (n) | ||
Age, years | 33.15 | (10.07) | |
U.S. Region | |||
Northeast | 29.2 | (21) | |
Midwest | 15.3 | (11) | |
South | 20.0 | (18) | |
West | 30.6 | (22) | |
Education A | |||
9th grade–GED | |||
9th, 10th, or 11th grade | 2.8 | (2) | |
12th grade, no diploma | 1.4 | (1) | |
High school graduate, high school diploma | 11.1 | (8) | |
GED (general education diploma) | 5.6 | (4) | |
Some college, no degree | |||
Some college credit, but less than 1 year | 15.3 | (11) | |
1 or more years of college, no degree | 29.2 | (21) | |
Associate’s degree+ | |||
Associate’s degree | 11.1 | (8) | |
Bachelor’s degree | 18.1 | (13) | |
Master’s degree | 4.2 | (3) | |
Professional degree (e.g., MD) | 1.4 | (1) | |
Income A | |||
USD 0–39,999 | |||
USD 0–USD 19,999 | 40.3 | (29) | |
USD 20,000–USD 39,999 | 27.8 | (20) | |
USD 40,000+ | |||
USD 40,000–USD 59,999 | 18.1 | (13) | |
USD 60,000–USD 79,999 | 9.7 | (7) | |
USD 80,000–USD 99,999 | 2.8 | (2) | |
USD 100,000–USD 119,999 | 1.4 | (1) | |
USD 120,000+ | 0.0 | (0) | |
Insurance Status A | |||
No insurance | 25.0 | (18) | |
Public insurance (Tricare, Medicaid, Medicare, veterans benefits) | 75.0 | (54) | |
Private insurance (plans through employers, the Marketplace, parents, and universities, federal employee plans) | 0.0 | (0) | |
Racial/Ethnic Identity A | |||
American Indian/Asian or South Asian/Hispanic/Jewish/Latino/a/e B | 5.6 | (4) | |
American Indian | 1.4 | (1) | |
Asian or South Asian | 2.8 | (2) | |
Hispanic | 2.8 | (2) | |
Latino/a/e | 1.4 | (1) | |
Black, African, or Caribbean B | 26.4 | (19) | |
African or Caribbean | 4.2 | (3) | |
Black or Brown American | 23.6 | (17) | |
European or White B | 43.1 | (31) | |
Multiethnic C | 19.4 | (17) | |
American Indian | 6.9 | (5) | |
Asian or South Asian | 2.8 | (2) | |
Black or Brown American | 5.6 | (4) | |
European or White | 18.1 | (13) | |
Hispanic | 8.3 | (6) | |
Jewish | 6.9 | (5) | |
Latino/a/e | 5.6 | (4) | |
Sex Assigned at Birth A | |||
Male B | 43.1 | 31 | |
Female B | 52.8 | 38 | |
Intersex | 4.2 | 3 | |
Gender Identity A | |||
Cisgender man D | 23.6 | (17) | |
Cisgender man | 15.3 | (11) | |
Man | 11.1 | (8) | |
Cisgender woman D | 27.8 | (20) | |
Cisgender woman | 9.8 | (7) | |
Woman | 21.0 | (15) | |
Transgender man/transmasculine D | 2.8 | (2) | |
Transgender man | 2.8 | (2) | |
Transmasculine | 0 | (0) | |
Man | 0 | (0) | |
Transgender woman/transfeminine D | 4.2 | (3) | |
Transgender woman | 4.2 | (3) | |
Transfeminine | 0 | (0) | |
Woman | 0 | (0) | |
Gender-expansive identities (non-binary, etc.) E | 22.2 | (16) | |
Agender | 0 | (0) | |
Bigender | 5.6 | (4) | |
Demigirl | 1.4 | (1) | |
Genderqueer | 1.4 | (1) | |
Genderflux | 1.4 | (1) | |
Genderfluid | 1.4 | (1) | |
Man | 2.8 | (2) | |
Nonbinary | 12.5 | (9) | |
Pangender | 1.4 | (1) | |
Queer | 4.2 | (3) | |
Questioning | 1.4 | (1) | |
Transfeminine | 1.4 | (1) | |
Transmasculine | 1.4 | (1) | |
Transgender man | 2.8 | (2) | |
Two-spirit | 4.2 | (3) | |
Woman | 4.2 | (3) | |
Queer/questioning F | 19.4 | (14) | |
Cisgender man | 1.4 | (1) | |
Cisgender woman | 1.4 | (1) | |
Queer | 18.2 | (13) | |
Questioning | 2.8 | (2) | |
Man | 5.6 | (4) | |
Transgender man | 1.4 | (1) | |
Transgender woman | 1.4 | (1) | |
Transmasculine | 1.4 | (1) | |
Woman | 5.6 | (4) | |
Sexual Orientation A | |||
Straight/heterosexual B | 4.2 | (3) | |
Same-gender attraction B | 22.2 | (16) | |
Gay | 15.3 | (11) | |
Lesbian | 6.9 | (5) | |
Same-gender loving | 1.4 | (1) | |
Attraction to 2+ genders G | 61.1 | (44) | |
Asexual | 1.4 | (1) | |
Bisexual | 45.8 | (33) | |
Demisexual | 2.8 | (2) | |
Gay | 6.9 | (5) | |
Homoflexible | 2.8 | (2) | |
Lesbian | 6.9 | (5) | |
Pansexual/polysexual/omnisexual | 20.8 | (15) | |
Queer | 15.3 | (11) | |
Questioning | 5.6 | (4) | |
Same-gender loving | 8.3 | (6) | |
Straight | 6.9 | (5) | |
Queer/questioning H | 8.3 | (6) | |
Gay | 2.8 | (2) | |
Queer | 6.9 | (5) | |
Questioning | 1.4 | (1) | |
Asexual/demisexual B | 4.2 | (3) | |
Asexual | 2.8 | (2) | |
Demisexual | 1.4 | (1) |
Group | Cluster | Statement | Mean Rating | |
---|---|---|---|---|
Group 1: Thoughts and Reactions to the Ban | ||||
Thoughtful Consideration of the Ban | 3.13 | |||
1 | I would be interested to learn more about menthol cigarettes and how they are more harmful than regular cigarettes. | 3.05 | ||
4 | I would be interested to know how everyone feels about the ban. | 3.62 | ||
5 | I would be interested to know if the majority of smokers would be for or against the ban. | 3.43 | ||
12 | I am not sure of a specific action I would take. | 3.25 | ||
43 | I would do some research on why and how the ban happened. | 3.82 | ||
70 | The ban wouldn’t have an effect on me. | 1.62 | ||
Negative Reactions to the Ban | 2.67 | |||
2 | I would lose my mind. | 2.26 | ||
7 | I would be angry. | 3.32 | ||
37 | I would be stressed. | 3.67 | ||
54 | I would cry. | 2.12 | ||
69 | I would panic. | 2.37 | ||
63 | I would gain weight. | 2.88 | ||
50 | I would protest. | 2.23 | ||
53 | I would begin a petition to have menthol added back into cigarettes. | 2.52 | ||
Positive Aspects of the Ban | 2.35 | |||
28 | I would save money. | 3.82 | ||
29 | I would get less of my friends accidentally hooked on smoking because they bum a menthol off me and love it. | 1.77 | ||
30 | I would feel reassured that people’s health is of concern and changes are being made. | 2.84 | ||
66 | I would be a better thinker. | 2.67 | ||
77 | I would be in support of the ban. | 1.26 | ||
79 | I would be happy. | 1.74 | ||
Group 2: Positive Preparation/Action Strategies | ||||
Strategies to Reduce Cravings | 3.48 | |||
39 | I would use tobacco replacement products (e.g., nicotine patches, gum). | 2.95 | ||
51 | I would look for other options to satisfy my smoking urge. | 3.93 | ||
55 | I would try using sunflower seeds, hard candy, or chewing gum. | 3.05 | ||
67 | I would look for a stronger method of calming my nerves. | 3.61 | ||
68 | I would look for a stronger method of calming my cravings. | 3.53 | ||
46 | I would eat more. | 3.80 | ||
Intent to Quit and Cessation Strategies | 3.18 | |||
6 | I would seek out alternative ways to control my stress. | 4.03 | ||
15 | I would try to stop smoking entirely. | 3.07 | ||
27 | I would quit smoking tobacco. | 2.56 | ||
34 | I would prepare myself in advance to quit smoking. | 3.08 | ||
42 | I would take a break from smoking for a week or two and then reassess my habit. | 3.02 | ||
44 | I would clean. | 3.26 | ||
56 | I would find a hobby to keep my mind off smoking (e.g., cook, shop, do hair). | 3.70 | ||
72 | I would do meditation and/or yoga. | 2.77 | ||
75 | I would try to reduce my nicotine dependence before the ban. | 3.41 | ||
81 | I would try to quit cold turkey. | 2.57 | ||
82 | I would stop smoking if I could not find a pleasant alternative. | 3.63 | ||
80 | I would buy fewer cigarettes. | 3.11 | ||
3 | I would learn to live without smoking. | 3.09 | ||
Support-Seeking and Engagement in Positive Behaviors | 2.97 | |||
14 | I would exercise more (e.g., walk, jog, run, swim, ride a bike). | 3.39 | ||
16 | I would stop smoking with friends who are trying to reach the same goal. | 3.28 | ||
19 | I would start exercising (e.g., walk, jog, run, swim, ride a bike). | 3.25 | ||
25 | I may ask family for help to stop smoking. | 2.60 | ||
31 | I would seek consultation from a therapist. | 2.67 | ||
33 | I would ask my friends what they were planning to do. | 3.46 | ||
36 | I would study. | 2.43 | ||
59 | I would be more involved in my health. | 3.46 | ||
60 | I would do things to involve myself in the community. | 2.83 | ||
61 | I would do things to better the lives of others. | 3.00 | ||
65 | I would ask family what would they do or try. | 2.44 | ||
45 | I would discuss increasing the dosage/amount of my psychiatric treatment with my psychiatrist. | 2.20 | ||
23 | I would use social media to look for solutions. | 3.13 | ||
47 | I would go to the Internet. | 4.00 | ||
11 | I would be less likely to smoke because I can’t smoke non-menthols as much. | 2.40 | ||
41 | I would get help to stop smoking altogether. | 3.00 | ||
Group 3: Maintaining Substance Use | ||||
Strategies to Maintain Menthol-Flavored Product Use | 2.75 | |||
18 | I would buy them overseas from a different country. | 2.60 | ||
26 | I would buy menthol cigarettes from other states. | 3.18 | ||
40 | I would start stocking up on little disposable menthol electronic cigarettes/vapes. | 3.36 | ||
48 | I would start making my own menthol cigarettes. | 2.18 | ||
52 | I would buy menthol cigarettes on the street through illegal means. | 2.80 | ||
57 | I would buy as many cartons of menthol cigarettes as I could afford before the ban started. | 3.67 | ||
58 | I would sell some menthol cigarettes for profit. | 2.20 | ||
71 | I would save menthol cigarettes for special occasions. | 3.08 | ||
73 | I fear I would vape more nicotine than I currently smoke. | 3.16 | ||
76 | I would research how to make custom smoke blends with herbs. | 1.98 | ||
78 | I would spend my spare time learning how to cultivate my own tobacco cigarettes. | 2.07 | ||
Substance Use Alternatives to Menthol Cigarettes | 2.32 | |||
8 | I would smoke cloves. | 1.35 | ||
10 | I would vape other mint products. | 3.31 | ||
13 | I would start using non-menthol cigarettes. | 3.05 | ||
17 | I would use dip. | 0.90 | ||
20 | I would start using cigars. | 1.25 | ||
21 | I would start using electronic cigars. | 2.25 | ||
22 | I would use snus or pouches. | 1.40 | ||
24 | I would increase my cigar use. | 1.28 | ||
32 | I would use menthol electronic cigarette/vaping products. | 3.41 | ||
35 | I would start using marijuana. | 2.92 | ||
38 | I would try menthol-flavored nicotine replacement products. | 3.38 | ||
49 | I would smoke more marijuana. | 2.80 | ||
62 | I would try CBD-containing products. | 2.93 | ||
64 | I would vape electronic cigarettes without menthol flavoring. | 2.46 | ||
74 | I would purchase herbal smoke blends in bulk. | 1.80 | ||
9 | I would drink. | 2.67 |
Time to First Menthol Cigarette | Current Interest in Quitting Smoking | Currently Trying to Quit Smoking | Other Menthol Products, Current Use | Other Tobacco Product Use, Past 30 Days | |||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
0–30 min (n = 34) (M) | 31+ min (n = 25) (M) | Welch’s T-Test Results | Yes (n = 25) (M) | No/Not Sure (n = 33) (M) | Welch’s T-Test Results | Yes (n = 15) (M) | No/Not Sure (n = 44) (M) | Welch’s T-Test Results | Yes (n = 34) (M) | No (n = 25) (M) | Welch’s T-Test Results | Yes (n = 41) (M) | No (n = 18) (M) | Welch’s T-Test Results | |||||
Group 1: Thoughts and Reactions to the Ban | |||||||||||||||||||
Thoughtful Consideration of the Ban | 3.117 | 3.215 | 0.213 (ns) | 2.933 | 3.350 | 0.915 (ns) | 3.144 | 3.164 | 0.047 (ns) | 2.966 | 3.420 | 0.925 (ns) | 3.204 | 3.056 | 0.324 (ns) | ||||
Negative Reactions to the Ban | 3.205 | 1.909 | 4.362 *** | 2.254 | 2.923 | 2.409 * | 2.103 | 2.842 | 2.666 * | 2.460 | 2.933 | 1.575 (ns) | 2.613 | 2.754 | 0.497 (ns) | ||||
Positive Aspects of the Ban | 2.510 | 2.100 | 0.974 (ns) | 2.554 | 2.209 | 0.697 (ns) | 2.511 | 2.273 | 0.492 (ns) | 2.724 | 1.796 | 1.871 (ns) | 2.500 | 1.953 | 0.420 (ns) | ||||
Group 2: Positive Preparation/Action Strategies | |||||||||||||||||||
Strategies to Reduce Cravings | 3.592 | 3.313 | 1.186 (ns) | 3.269 | 3.643 | 1.558 (ns) | 3.389 | 3.502 | 0.523 (ns) | 3.525 | 3.402 | 0.472 (ns) | 3.656 | 3.056 | 2.176 (ns) | ||||
Intent to Quit and Cessation Strategies | 3.019 | 3.423 | 2.293 * | 3.498 | 2.950 | 3.092 ** | 3.430 | 3.107 | 1.968 (ns) | 3.608 | 2.614 | 5.754 *** | 3.500 | 2.487 | 5.789 *** | ||||
Support-Seeking and Engagement in Positive Behaviors | 3.061 | 2.844 | 1.123 (ns) | 2.980 | 2.973 | 0.033 (ns) | 3.105 | 2.923 | 0.829 (ns) | 3.205 | 2.645 | 2.821 ** | 3.130 | 2.600 | 2.761 ** | ||||
Group 3: Maintaining Substance Use | |||||||||||||||||||
Strategies to Maintain Menthol-Flavored Product Use | 2.992 | 2.321 | 2.379 * | 2.033 | 3.230 | 4.689 *** | 1.994 | 2.952 | 3.870 *** | 2.542 | 2.941 | 1.475 (ns) | 2.732 | 2.660 | 0.270 (ns) | ||||
Substance Use Alternatives to Menthol Cigarettes | 2.469 | 2.073 | 1.212 (ns) | 1.967 | 2.579 | 1.986 (ns) | 1.925 | 2.430 | 1.708 (ns) | 2.406 | 2.155 | 0.805 (ns) | 2.464 | 1.926 | 1.782 (ns) |
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Sawyer, A.N.; Combs, M.; Clark, V.; Soule, E.K.; Lee, J.G.L.; Breland, A.B. Reactions to a Hypothetical Menthol Cigarette Ban among Sexual- and Gender-Minoritized Communities: A Concept Mapping Study. Int. J. Environ. Res. Public Health 2023, 20, 3891. https://doi.org/10.3390/ijerph20053891
Sawyer AN, Combs M, Clark V, Soule EK, Lee JGL, Breland AB. Reactions to a Hypothetical Menthol Cigarette Ban among Sexual- and Gender-Minoritized Communities: A Concept Mapping Study. International Journal of Environmental Research and Public Health. 2023; 20(5):3891. https://doi.org/10.3390/ijerph20053891
Chicago/Turabian StyleSawyer, Ashlee N., Madison Combs, Viktor Clark, Eric K. Soule, Joseph G. L. Lee, and Alison B. Breland. 2023. "Reactions to a Hypothetical Menthol Cigarette Ban among Sexual- and Gender-Minoritized Communities: A Concept Mapping Study" International Journal of Environmental Research and Public Health 20, no. 5: 3891. https://doi.org/10.3390/ijerph20053891