Rationale for cigarette smoking and for mentholation preference in cocaine- and nicotine-dependent outpatients

We asked 43 cocaine- and nicotine-dependent outpatients at a substance abuse clinic their reasons for combining cocaine and cigarette use, and for preferring either mentholated or nonmentholated cigarettes. Responses to open-ended questions asked during a semistructured interview were categorized by an analysis of expressed motives for cigarette smoking. Responses that did not fit the categorization were analyzed separately in a qualitative design. Sedating, stimulating, or addictive effects were frequently stated as reasons for the combined use of cigarettes with cocaine. Sedating or calming effects of cigarette smoking included reduction of cocaine-induced paranoia. Cocaine-substituting and cocaine-enhancing effects of cigarette smoking were categorized as stimulating effects. Addictive effects included craving for cigarette smoking on its own or triggered by cocaine use. Sensorimotor or stimulating effects were frequently stated as reasons for a preference for mentholated or nonmentholated cigarettes. Sensorimotor effects of menthol included taste, anesthetic, cooling, and decongestant properties. Some responses provided by our patient sample suggest a need for research on the effect of cigarette smoking on absorption of smoked cocaine.