Quitting menthol cigarettes may be harder for some smokers

Menthol cigarettes may be harder to quit, particularly for some teens and African-Americans, who have the highest menthol cigarette use, according to a study by a team of researchers.

Recent studies have consistently found that racial/ethnic minority smokers of menthol cigarettes have a lower quit rate than comparable smokers of regular cigarettes, particularly among younger smokers.

One possible reason suggested in the report is that the menthol effect is influenced by economic factors - less affluent smokers are more affected by price increases, forcing them to consume fewer cigarettes per day.

"This pattern of results is consistent with an effect that relies on menthol to facilitate increased nicotine intake from fewer cigarettes where economic pressures restrict the number of cigarettes smokers can afford to purchase," said Jonathan Foulds, Ph.D., professor, Public Health Sciences, Penn State College of Medicine, and an author of the report.

Menthol is a compound extracted from mint oils or produced synthetically that activates cold-sensitive neurons in the nervous system. Menthol cigarettes make up about 25 percent of the market but are preferred by certain subgroups of smokers, including about half of teenage smokers and 80 percent of African-American smokers.

Research has shown that menthol cigarettes may provide higher levels of carbon monoxide, nicotine and cotinine per cigarette smoked than regular cigarettes.

"Menthol stimulates cold receptors, so it produces a cooling sensation," Foulds said. "This effect may help smokers inhale more nicotine per cigarette and so become more addicted. In effect it helps the poison go down easier.

"The smoker who has reduced their cigarette consumption typically compensates by increasing inhalation per cigarette. Menthol in cigarettes makes the smoke less harsh, enabling these smokers to obtain a larger and more reinforcing nicotine hit."

The researchers, who published their results in a special issue of the journal Nicotine and Tobacco Research, reviewed the evidence from 10 published studies that compared smoking cessation rates or proportions between mentholated and regular cigarette smokers.

Not all of the studies included in the report found an effect of menthol on quitting, and no studies to date have been specifically designed to look at menthol and cessation, but the effects of menthol on quitting were larger in more recent studies, in younger smokers and largely restricted to African-American and Latino smokers.

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Other members of the research team are Monica Webb Hooper, Ph.D., Department of Psychology and Biobehavioral Oncology, University of Miami; Mark J. Pletcher, M.D., M.P.H., Department of Epidemiology and Biostatistics, University of California at San Francisco; and Kolawole S. Okuyemi, M.D., M.P.H., Program in Health Disparities Research, University of Minnesota Medical School.