Menthol Cigarettes No More Likely To Kill, Study Finds

Despite claims that menthol in cigarettes makes them more addictive and more likely to lead to lung cancer, a new study funded by the National Cancer Institute finds no evidence to support that view.

William Blot, Ph.D., professor of Medicine, Vanderbilt-Ingram Cancer Center (VICC), Nashville, Tenn., led the study.

"Black men are known to have a higher incidence of lung cancer and are more likely to smoke mentholated cigarettes compared to white men," said Blot. "It has been hypothesized that menthol in cigarettes influences smoking behavior, perhaps increasing dependency or adversely affecting the biology of the lung. However, our large study found no evidence to support those theories."

Southern smokers surveyed

The study of lung cancer risk was based on results from the Southern Community Cohort Study (SCCS), an ongoing investigation of cancer incidence and mortality disparities among racial, and urban versus rural populations in 12 southern states. Smoking prevalence among participants in the SCCS was exceptionally high, and both menthol and non-menthol cigarette use was common.

Anti-smoking advocates have long targeted menthol in cigarettes as a reason smokers have a harder time kicking the habit. A December 2010 study suggested menthol cigarettes may provide higher levels of carbon monoxide, nicotine and cotinine per cigarette smoked than regular cigarettes, so smokers who favor menthol can still get their fix, even with fewer cigarettes.

"Menthol stimulates cold receptors, so it produces a cooling sensation. This effect may help smokers inhale more nicotine per cigarette and so become more addicted," said Jonathan Foulds, Ph.D., professor, Public Health Sciences, Penn State College of Medicine, and an author of the report.

Possible menthol ban

Last October the Food and Drug Administration's scientific advisory committee took up the matter of whether tobacco companies use menthol as a way to keep smokers hooked. The committee was directed to write a report on the subject and could recommend regulating, or even banning the substance.

At the time, the head of the National Black Chamber of Commerce defended menthol and branded the move to ban it as directed at African-Americans.

"It is no secret that menthol cigarettes provide a distinctive taste that is preferred by many African Americans," NBCC President Harry Alford said. "In making a recommendation, it is my fervent hope that the committee not make a decision based on mixed information, decades-old marketing information, inconclusive studies or preconceived notions."

Support for menthol defenders

The latest study is likely to provide ammunition for Alford and others who defend menthol. Among people smoking 20 or more cigarettes a day, menthol smokers were approximately 12 times more likely to develop lung cancer than never-smokers, while non-menthol smokers were about 21 times more likely to have the disease. The differences were mirrored for lung cancer death rates and were found to be statistically significant.

The researchers also found that both white and black menthol smokers reported smoking fewer cigarettes per day than non-menthol smokers. When it comes to the likelihood of quitting smoking, there was no significant difference between menthol and non-menthol smokers.

The authors conclude that the findings suggest menthol cigarettes are no more, and perhaps less, harmful than non-menthol cigarettes. But smoking any kind of cigarette, they quickly point out, is unhealthy.

"Cigarette smoking remains the leading cause of premature death in the United States, but undue emphasis on reduction of menthol relative to other cigarettes may distract from the ultimate health prevention message that smoking of any cigarettes is injurious to health," said Blot.