Perceptions of the Harm of Cigarettes, Mental Health, and Quality of Life Among Transgender Adults Who Smoke Menthol Cigarettes: Results from Wave 5 of the Population Assessment for Tobacco and Health (PATH) Study

Sexual and gender minority (SGM) individuals in the United States are at greater risk for combustible tobacco use and mental health problems compared to heterosexual and cisgender individuals. National data comparing associations of menthol cigarette use and mental health among transgender and cisgender individuals in the United States are lacking. The goals of the current study were to (1) characterize transgender and cisgender individuals who smoke menthol cigarettes, and (2) investigate cross-sectional associations between gender identity, harm perceptions of cigarettes, mental health experiences, and quality of life. Data were drawn from Wave 5 of the Population Assessment of Tobacco and Health (PATH) Study (2018-2019). A total of 3989 cisgender (mean [SD] age, 40.47 [0.32] years) and transgender (mean [SD] age, 38.36 [0.09] years) participants who reported current (past 30-day) menthol cigarette use were included in the analysis. Comparing transgender to cisgender groups, significant differences were found in associations between harm perceptions of cigarettes (adjusted odds ratio [AOR] 0.07; 95% CI: 0.02-0.28) and reported depression (AOR 4.57; 95% CI: 1.36-15.33). Collectively, these findings provide evidence that transgender adults who smoke menthol cigarettes are less likely than cisgender adults who smoke menthol cigarettes to perceive smoking as harmful to health and more likely to report recent experiences of depression.