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Menthol Cigarettes

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What is menthol?

Menthol is a substance naturally found in mint plants such as peppermint and spearmint. It gives a cooling sensation and is frequently used to relieve minor pain and irritation and to prevent infection [1].

Which tobacco products contain menthol?

Menthol is found in cigarettes, cigars, little cigars, smokeless tobacco products, and tobacco rolling paper.

How much menthol is found in cigarettes?

About 90% of cigarettes marketed in the United States contain menthol, even if they are not advertised as menthol cigarettes. Only cigarettes containing a certain amount of menthol (0.1% to 0.45% of the tobacco filler weight) are marketed and advertised as menthol cigarettes [2].

What are some common menthol cigarette brands?

Some common cigarette brands that are only made in menthol flavor include Kool, Newport, and Salem [3]. Other brands of menthol and non-menthol cigarettes include Doral, Virginia Slims, Marlboro, and Camel [3, 4].

Of all menthol and non-menthol cigarettes, Marlboro is the brand used most often by 42.2% of smokers [5]. Newport is second (11.3%), followed by Camel (7.5%), Basic (4.2%), Doral (3.1%), Kool (2.9%), Parliament (2.0%), Salem (1.9%), and USA Gold (1.9%) [5].

How long has menthol been a cigarette additive?

Menthol was first added to cigarettes during the 1920s. Spud was the first cigarette brand to add menthol [6].

What is the difference between menthol and non-menthol cigarettes?

Aside from the amount of menthol added, we need more research to understand the main differences between these cigarette types and how they are harmful to your health.

Is it safer to smoke a menthol cigarette than a non-menthol cigarette?

No. All cigarettes are harmful, including menthol cigarettes. Many smokers think menthol cigarettes are less harmful, but there is no evidence that menthol cigarettes are safer than other cigarettes. Like other cigarettes, menthol cigarettes harm nearly every organ in the body and cause many diseases, including cancer, cardiovascular diseases, and respiratory diseases. Menthol cigarettes, like other cigarettes, also negatively impact male and female fertility and are harmful to pregnant women and their unborn babies [7].

Do menthol cigarettes contain fiberglass?

There is no evidence to suggest that fiberglass (used to make car parts) is in menthol cigarettes. However, there are more than 7,000 known chemical compounds, as well as toxic and carcinogenic agents, in tobacco and cigarette smoke [8]. Some of these include ammonia (used in fertilizer and household cleaning products), formaldehyde (used to preserve dead bodies), and methanol (used in antifreeze). All of these chemicals have been shown to cause cancer and other deadly diseases [9].

Are menthol cigarettes more addictive than non-menthol cigarettes?

Some research shows that menthol cigarettes may be more addictive than non-menthol cigarettes [10-12]. More research is needed to understand how addiction differs between menthol and non-menthol cigarette use.

Who smokes menthol cigarettes?

An estimated 43.8 million people, or 19.0% of all adults (aged 18 years or older), in the United States smoke cigarettes [13]. Approximately one out of every four cigarettes sold in the United States has the descriptor “menthol” on the cigarette pack. Menthol cigarettes are disproportionately smoked by certain groups, such as adolescents, African Americans, adult females, and families with lower income. The following trends in the use of menthol cigarettes can be seen among youth and adult smokers [25]:

Youth

  • From 2004 to 2008, almost half of adolescent smokers aged 12 to 17 years reported smoking menthol cigarettes (approximately 1 million adolescents).
  • Adolescent smokers are more likely to smoke menthol cigarettes than older smokers (44.8% among adolescents, 36.5% among young adults aged 18 to 25 years, and 30.1% among older adults).
  • Very high proportions of black/African American adolescents smoke menthol cigarettes. In 2008, about 7 out of 10 (71.9%) adolescent African American smokers reported smoking menthol cigarettes. However, this is significantly lower than the 82.7% (about 8 out of 10) of African American adult smokers who reported smoking menthol cigarettes in 2008.
  • While the prevalence of smoking among adolescents declined from 1997 to 2007 (36.4% to 20%), the percentage of adolescent smokers smoking menthol cigarettes increased from 2004 to 2008 (43.4% to 48.3%).

Adults

  • About 3 out of 10 adult cigarette smokers reported smoking a menthol brand.
  • Young adult smokers aged 18 to 25 years are more likely to smoke menthol cigarettes (36.5%) than adults 26 years and older (30.1%). However, the proportion of menthol cigarette smokers in both groups increased from 2004 to 2008.
  • Almost half of adult menthol cigarette smokers are from minority racial/ethnic groups, such as African Americans, Puerto Ricans, Hawaiians, and Other Pacific Islanders.
  • Female adult smokers are more likely to smoke menthol cigarettes than male adult smokers. However, there is no significant gender difference among adolescent menthol smokers.
  • Adult smokers with family incomes of less than $50,000 were more likely to smoke menthol cigarettes than adult smokers with higher family incomes.

Why do people smoke menthol cigarettes?

In the past, the tobacco industry has marketed menthol cigarettes as being a "healthier" and "safer" cigarette, emphasizing its cool and refreshing taste [16]. The tobacco industry has targeted "beginner" smokers and current smokers with health concerns [16]. Many people choose menthol cigarettes because of beliefs about menthol cigarettes being safer than non-menthol cigarettes. However, no evidence exists indicating that menthol cigarettes are safer. All cigarette smoking is linked to many cancers and other diseases.

How has the tobacco industry marketed and encouraged people to smoke menthol cigarettes?

In the past, the tobacco industry has actively marketed menthol cigarettes to consumers under a concept of "coolness," with messages of fresh/refreshing taste and sensation, youthfulness, fun, and healthful effects [17]. Advertisements often showed nature, coldness, springtime, water, and other refreshing qualities [17].

Does the tobacco industry market menthol cigarettes to anyone in particular?

Yes. Studies and evidence from tobacco industry documents showed that, in the past, the tobacco industry has a history of marketing menthol cigarettes to women, youth, and minority racial/ethnic groups, including African Americans/blacks, Latinos/Hispanics, and Asian Americans [16, 18, 19].

Research suggests that African American/blacks may be the most directly targeted group of menthol smokers [18, 19].

How much of the tobacco industry sales come from menthol cigarettes?

Historically, about 27% of the tobacco industry's total sales have come from menthol cigarettes [20]. In 2006, however, menthol accounted for only 20% of the total sales, representing a notable decline for the first time in over 40 years [21].

Is menthol in other products?

Yes. Menthol is added to many other products, including:

  • Lozenges
  • Syrups
  • Creams/ointments
  • Nasal sprays
  • Powders
  • Candy

Menthol is generally used in small amounts to temporarily relieve throat irritations and coughs from colds or inhaled irritants [22]. But keep in mind that none of these products are ignited or smoked when used.

Does the FDA regulate menthol in other products?

Yes. The Food and Drug Administration (FDA) regulates the menthol concentration in other products, including lozenges, shampoos, and ointments [23, 24].

The FDA also mandates that warning labels be placed on cold medications, including those that contain menthol, indicating that continued use may hide the early warning symptoms of more serious conditions [22]. However, it is important to note that there is a difference between using products containing menthol that are approved as safe and effective by the FDA and products containing menthol that are ignited or smoked.

Does the FDA regulate menthol in cigarettes?

No, the FDA does not regulate menthol in cigarettes at this time. On June 22, 2009, President Obama signed the Family Smoking Prevention and Tobacco Control Act, which gave the FDA the authority to regulate tobacco products. Section 907 banned the use of specific flavors in cigarettes, such as herbs, spices, strawberry, and grape, but it did not ban menthol [25]. However, in 2011, the Tobacco Products Scientific Advisory Committee issued a report on the impact of menthol in cigarettes on public health, and the FDA is considering the possibility of regulating menthol.

Where can I find more information on menthol cigarettes?

Please email the NCI Smokefree Team if you have additional questions: ncismokefreeteam@mail.nih.gov.

Sources

  1. McCurdy, C.R. and S.S. Scully, Analgesic substances derived from natural products (natureceuticals). Life Sci, 2005. 78(5): p. 476-484.
  2. Perfetti, T.A., Menthol and the Design of Mentholated Cigarettes Course. Module 1. Menthol and Mint Flavor Additives - General History and Applications. 1985.
  3. Celebucki, C.C., et al., Characterization of measured menthol in 48 U.S. cigarette sub-brands. Nicotine Tob Res, 2005. 7(4): p. 523-531.
  4. The Landis Group, Qualitative report for Phillip Morris on menthol cigarettes. 1992: West Palm Beach, FL.
  5. Office of Applied Studies, The NSDUH Report: Cigarette Brand Preferences in 2005. 2007.
  6. Reid, J.R., A history of mentholated cigarettes: This Spud's for you. Recent Advances in Tobacco Sciences 1993. 19: p. 71-84.
  7. United States Department of Health and Human Services, The health consequences of smoking: A report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2004.
  8. U.S. Department of Health and Human Services. How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2010.
  9. Hoffmann, D., I. Hoffmann, and K. El-Bayoumy, The less harmful cigarette: a controversial issue. A tribute to Ernst L. Wynder. Chem Res Toxicol, 2001. 14(7): p. 767-790.
  10. Ahijevych, K. and L.A. Parsley, Smoke constituent exposure and stage of change in black and white women cigarette smokers. Addict Behav, 1999. 24(1): p. 115-120.
  11. Garten, S. and R.V. Falkner, Role of mentholated cigarettes in increased nicotine dependence and greater risk of tobacco-attributable disease. Prev Med, 2004. 38(6): p. 793-798.
  12. Collins, C.C. and E.T. Moolchan, Shorter time to first cigarette of the day in menthol adolescent cigarette smokers. Addict Behav, 2006. 31(8): p. 1460-1464.
  13. Centers for Disease Control and Prevention. Current Cigarette Smoking Among Adults—United States, 2011. Morbidity and Mortality Weekly Report 2012;61(44):889–94.U.S. Department of Commerce Census Bureau, Smoking Status and Menthol Cigarette Use Among Current Adult Smokers Ages 18+, Tobacco Use Supplement to the Current Population Survey (TUS-CPS) 2006/07. 2008, National Cancer Institute and Centers for Disease Control and Prevention Co-sponsored Tobacco Use Supplement to the Current Population Survey (2006-07): http://riskfactor.cancer.gov/studies/tus-cps/.
  14. U.S. Department of Commerce Census Bureau, Menthol Cigarette Use by Sociodemographics Among Current Adult Smokers Ages 18+, Tobacco Use Supplement to the Current Population Survey (TUS-CPS) 2006/07. 2008, National Cancer Institute and Centers for Disease Control and Prevention Co-sponsored Tobacco Use Supplement to the Current Population Survey (2006-07): http://riskfactor.cancer.gov/studies/tus-cps/.
  15. Kreslake, J.M., G.F. Wayne, and G.N. Connolly, The menthol smoker: tobacco industry research on consumer sensory perception of menthol cigarettes. Nicotine Tob Res, 2007. 10(4): p. 705-715.
  16. Sutton, C.D. and R.G. Robinson, The marketing of menthol cigarettes in the United States: populations, messages, and channels. Nicotine Tob Res, 2004. 6 Suppl 1: p. S83-S91.
  17. United States Department of Health and Human Services, Tobacco use among U.S. racial/ethnic minority groups—African Americans, American Indians and Alaska Natives, Asian Americans and Pacific Islanders, and Hispanics: A report of the surgeon general. Atlanta, GA: U.S. Department of Health and Human Services; 1998.
  18. Gardiner, P.S., The African Americanization of menthol cigarette use in the United States. Nicotine Tob Res, 2004. 6 Suppl 1: p. S55-S65.
  19. Federal Trade Commission, Cigarette Report for 2004 and 2005. 2007.
  20. Federal Trade Commission, Cigarette Report for 2006. 2009.
  21. Garten, S. and R.V. Falkner, Continual smoking of mentholated cigarettes may mask the early warning symptoms of respiratory disease. Prev Med, 2003. 37(4): p. 291-296.
  22. Food and Drug Administration, Dandruff, seborrheic dermatitis, and psoriasis drug products containing coal tar and menthol for over-the-counter human use; proposed amendment to the monograph. 2005.
  23. Dotzel, M., Cold, Cough, Allergy, Bronchodilator, and Antiasthmatic Drug Products for Over-The-Counter Human Use; Final Monograph for Combination Drug Products. In: Food and Drug Administration, ed. 21 CFR Part 341. United States Department of Health and Human Services; 2002.
  24. 111th Cong., Family Smoking Prevention and Tobacco Control Act. Washington, D.C.; 2009.
  25. Caraballo, R. and Asman, K, Epidemiology of Menthol Cigarette Use in the United States. Tobacco Induced Diseases 2011 9(Suppl 1):S1.
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