Menthol and Nonmenthol Cigarette Smoking

Menthol is a chemical compound with mild local anesthetic qualities and a mint scent that is added to some cigarettes. Smokers have reported that they experienced easier and deeper inhalation and less irritation in the throat while smoking menthol cigarettes. It has been suggested that mentholation may affect cigarette smoking behaviors such as initiation, inhalation, dependency, and cessation. Menthol cigarette smoking is much more prevalent among black smokers than white smokers, and in recent years (2004–2010), menthol cigarette use has remained stable in adults while nonmenthol cigarette use has declined. Blacks experience a higher incidence of and mortality from several smoking-related diseases, including cardiovascular disease (CVD) and stroke, but whether menthol cigarette smoking contributes to these differentials is not clear, with inconsistent evidence from the few studies that have examined risks of these illnesses in menthol versus nonmenthol smokers. The issue is topical because the US Food and Drug Administration has been deliberating the regulation of menthol cigarettes since the Tobacco Control Act, a law banning the use of all flavoring except menthol in cigarettes, was passed in 2009. The Southern Community Cohort Study (SCCS), with its large number of black smokers, affords the unique opportunity to assess the effects of menthol cigarette use on smoking-related mortality.