Abstract Rationale Varenicline is a first-line pharmacotherapy for smoking cessation. African American smokers disproportionately use mentholated cigarettes, which may influence addiction severity and treatment response. This study evaluates cessation outcomes in an Advanced Practice Respiratory Therapist (APRT)-led Tobacco Treatment Clinic (TTC), with a focus on differences in varenicline efficacy by cigarette type. Methods A retrospective chart review was conducted on 350 patients treated for tobacco use disorder in an APRT TTC. Most patients received combination therapy with varenicline and nicotine replacement therapy (NRT) in the form of lozenges, gum, or nasal spray. Self-reported quit rates and clinical outcomes were analyzed, with attention to cigarette type (menthol vs. non-menthol) and demographic characteristics. Results Of the 350 patients, 145 reported smoking mentholated cigarettes. This subgroup—predominantly African American—demonstrated significantly lower sustained abstinence rates despite adherence to pharmacologic and counseling protocols. In contrast, non-menthol smokers showed higher quit success with varenicline. These findings align with prior research suggesting that menthol may alter nicotine metabolism and increase behavioral dependence, potentially reducing the effectiveness of cessation pharmacotherapy. Conclusion African American smokers who used menthol cigarettes experienced reduced cessation success with varenicline in an APRT-led TTC. These findings underscore the importance of personalized cessation strategies for high-risk populations. Potential interventions include transitioning patients to non-menthol cigarettes or incorporating menthol lozenges alongside varenicline to mitigate withdrawal symptoms. Further research is warranted to elucidate the biological and behavioral mechanisms underlying these disparities and to optimize treatment protocols for menthol smokers. This abstract is funded by: n/a
Conklin et al. (Fri,) studied this question.