Menthol cigarettes harder to quit?

Menthol cigarettes don’t seem to be a greater health hazard than regular versions, but they may be tougher to quit, a study suggests.

In the U.S., black smokers are much more likely than whites to favor cigarettes with added menthol, a cool mint-flavored compound. Researchers have speculated that if menthol cigarettes are more harmful to the heart and lungs than regular cigarettes are, that might help explain the disproportionately high rates of smoking-related disease among African Americans.

The new study, published in the Archives of Internal Medicine, found no such evidence. It did, however, find indications that menthol cigarettes are harder to quit.

Of the more than 1,500 smokers researchers followed, those who used menthol cigarettes were 89 percent more likely to go back to smoking after a quit attempt.

Dr. Mark J. Pletcher of the University of California, San Francisco led the study.

The findings are based on data from 1,535 smokers who participated in a study of heart disease risk factors among young adults. They were followed from 1985 through 2000, during which time their lung function was repeatedly measured. In 2000, they had CT scans of their arteries to look for signs of heart disease.

Of African American smokers, 89 percent said they preferred menthols in 1985, while only 29 percent of white smokers said the same.

By the end of the study period, there was no evidence that lung function or heart health was worse among menthol smokers. However, they were more likely to still be smoking or to have failed a quit attempt.

Menthol cigarettes may not explain the disparities in heart and lung disease between black and white Americans, Pletcher’s team concludes, but they might contribute to the lower quit rates among African Americans.

Menthol inhibits the clearance of nicotine, leading to higher nicotine levels in the body per cigarette smoked, the researchers note. So it’s plausible that they could be more difficult to give up.

It’s also possible, the researchers write, that switching from menthol to regular cigarettes could serve as a bridge to quitting. However, they stress, kicking the tobacco habit altogether should be the prime goal.

SOURCE: Archives of Internal Medicine, September 25, 2006.

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