Why are mentholated cigarettes more addictive?

My colleagues and I just published a research study which examined the quit rates of patients attending our specialist Tobacco Dependence Clinic, and focused on the differences between those who smoked mentholated cigarettes and those who smoked non-menthol cigarettes.
Consistent with numerous other studies, we found that far more African American (81%) and Latino (66%) smokers smoked menthols, as compared with non-Latino Whites (32%). But the more interesting finding was that while African American and Latino smokers of non-menthol cigarettes had similar quit rates to whites, the quit rates of those smoking menthols was significantly lower. For example, African Americans who smoked menthols had half the odds of quitting of African Americans who smoked regular non-menthol cigarettes.
This “menthol effect” on quitting occurred despite the fact that menthol smokers typically smoked fewer cigarettes per day. So why do many smokers, and particularly African Americans and Latinos find menthol cigarettes to be particularly hard to quit?
In an earlier study we found that menthol cigarette smokers have higher nicotine, cotinine and carbon-monoxide levels than non-menthol smokers. This suggests that they tend to inhale more smoke from each cigarette. Menthol stimulates cold receptors and may therefore cool the harshness of cigarette smoke and make it easier to inhale larger amounts. It seems that the “menthol effect” is more pronounced in situations where the smoker may need to try to inhale more nicotine from fewer cigarettes. Thus in New Jersey, where we have amongst the highest cigarette taxes in the country, many people on low incomes can no longer afford to smoke a pack or two per day, but they have become addicted to that amount of nicotine. When a smoker reduces their cigarette consumption it is typical that they “compensate” by inhaling more from each one. This can be easily achieved, without any conscious effort, by taking larger puffs. But there comes a point where the larger puffs are difficult to sustain because of the smoke harshness causing an unpleasant effect on the throat. But for menthol cigarettes the larger puff means a larger cooling effect from the menthol. So the menthol enables the smoker to inhale more nicotine per cigarette, and perhaps obtain a stronger “hit” and become more addicted.
So it is possible that even if you are a relatively light smoker of menthol cigarettes, you may be more nicotine dependent than the simple daily cigarette consumption would imply. A summary of the new study may be found at: http://www.ncbi.nlm.nih.gov/pubmed/19222622?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum


For more information about our Tobacco Dependence Clinic, check out: http://www.healthline.com/blogs/smoking_cessation/2008/02/what-does-tobacco-treatment-clinic-do.html

Labels: addiction, cessation, cigarette smoking, jonathan foulds, menthol

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