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Menthol cigarettes are a combination of tobacco and menthol that makes the mouth and nose feel cool without a drop in temperature.Especially popular in the warmer US climates, menthol cigarettes are disproportionately popular with African-Americans.

The History of Menthol Cigarettes

Tobacco companies first started adding menthol to cigarettes in the 1920's. In 1924 the Axton-Fisher Tobacco Company came out with Spud Menthol Cooled Cigarettes, or "Spuds," and three years later Brown & Williamson came out with the much more popular brand, Kool.

Over the years other brands of American menthol cigarettes came out, including American Spirits Menthol, Camel Menthol, Marlboro Menthol, Misty, and the bestselling brand of menthol smokes in the USA, Newport. British brands of menthol cigarettes include JPS, Lambert & Butler, Richmond, and Sterling.

About 1 in 3 cigarettes smoked in the USA is a flavored with menthol. Over 80 per cent of African-American smokers exclusively smoke menthol-flavored cigarettes. Menthol-flavored cigarettes are specifically exempted from the government regulations applied to other tobacco additives that became law in 2009 when President Obama, a smoker, signed the Family Smoking Prevention and Tobacco Control Act.

Are Menthol Cigarettes Safer than Regular Cigarettes?

Tens of millions of smokers around the world will tell you that they prefer the taste and feel of menthol cigarettes. But are they better or worse for the smoker's health? As is so often the case in medical research, there is good news, and there is bad news.

Researchers long worried that the menthol in menthol cigarettes would increase the rate at which chemicals added to tobacco pass through the lining of the mouth and throat and into the bloodstream. Menthol makes these membranes much more permeable to all kinds of water-soluble chemicals.

Taking a drag on a menthol cigarette feels good, so smokers of menthol brands hold tobacco smoke in longer. And menthol, when burned, creates the known carcinogen benzo[a]pyrene.

The good news is that despite all these additional risk factors, menthol cigarettes do not appear to be more harmful to health than regular smokes. Smoking menthol cigarettes does not result in more cancer, heart disease, or emphysema.

The Coronary Artery Risk Development in Young Adults (CARDIA) project, reported in the Annals of Internal Medicine, followed smokers of menthol cigarettes and regular cigarettes for 15 years. Both African-Americans and Americans of European descent were included in the study.

The CARDIA study found that smokers of menthol cigarettes were no more likely to develop emphysema or chronic obstructive pulmonary disease (COPD) over the 15 years of the study than smokers of ordinary cigarettes. They were no more likely to have coronary artery disease, and they were no more likely to have cancer. The results of the study were skewed by the fact that the study participants, recruited in 1985, were then 18 to 30 years old, too young to have suffered major, lasting damage to health from their smoking habit. However, even in this study, 14 per cent of smokers already had coronary artery damage by age 33 to 45.

Menthol Cigarettes Especially Addictive

The worse news is that while 46 per cent of smokers of regular cigarettes were able to quit smoking over the 15 years of the study, only 31 per cent of menthol smokers were able to quit. This was not because menthol somehow made quitting harder. Instead, the study found that menthol cigarette smokers simply did not try to quit, especially if they were African-American.

The reason most menthol smokers do not try to quit may have to do with the fact that menthol cigarettes are highly addictive. The menthol in the cigarette keeps the body from activating nicotine. The menthol smokers has to smoke more cigarettes, and hold the smoke in the lungs longer, to get the same amount of active nicotine into his or her bloodstream.

Menthol smokers tend to have their first cigarette of the day earlier in the morning, to take more puffs from each cigarette, and to burn the cigarette down to the butt. It's simply hard to quit if you smoke menthols.

Are Menthol Cigarettes "Cleaner"?

Some brands of menthol cigarettes like the Salem Pianissimo are marketed at people who tend to think of smoking as a "dirty habit." The Salem Pianissimo, the "softer cigarette," has been especially popular in Japan. The maker of the Salem Pianissimo, R. J. Reynolds, also markets "clean" cigarettes in the US and Europe under brand names such as Eclipse, Salem Preferred, and Vantage. Designed for women smokers, these brands claim to cover up smells and to have just 1 mg of tar in each cigarette, due to their "clean" formulation.

The claim that these cigarettes are exceptionally low-tar, however, is just plain false. When R. J. Reynolds began to capture a large part of the Japanese cigarette market by advertising its menthol cigarettes as having just 1 mg of tar, competitor Phillips-Morris had the cigarettes tested. The "low-tar" cigarettes actually had the same amount of tar as other brands, about 2 mg of tar in each. When confronted with these findings, R. J. Reynolds launched a new ad campaign, "Realized 1 mg tar with refreshing high menthol."

If You Want to Quit, Switch... or Quit

The moral of the stories about menthol cigarettes seems to be that if you are concerned that smoking is bad for your health and you want to quit, it may be better first to switch to a non-menthol brand. The net effect of switching to cigarettes without menthol be roughly equivalent to wearing a nicotine patch, because the absence of menthol will make the nicotine you get from your cigarettes much more available to your central nervous system.

You will feel the need to light up later in the day, and you won't need to suck every last bit of smoke out of each every cigarette. Quitting menthols for non-menthol brands is not a guarantee of success for smoking cessation, but it is a great way to start.

  • Assunta M, Chapman S. A "clean cigarette" for a clean nation: a case study of Salem Pianissimo in Japan. Tob Control. 2004 Dec.13 Suppl 2:ii58-62.
  • Heck JD. Smokers of menthol and nonmenthol cigarettes exhibit similar levels of biomarkers of smoke exposure. Cancer Epidemiol Biomarkers Prev. 2009 Feb
  • 18(2):622-9. Epub 2009 Feb 3. Erratum in: Cancer Epidemiol Biomarkers Prev. 2009 Jul.18(7):2155.
  • Pletcher MJ, Hulley BJ, Houston T, Kiefe CI, Benowitz N, Sidney S. Menthol cigarettes, smoking cessation, atherosclerosis, and pulmonary function: the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Arch Intern Med. 2006 Sep 25. 166(17): 1915-22.
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