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ABSTRACT: The World Health Organization has identified several additives such as menthol in the manufacturing of cigarettes to specifically reduce smoke harshness. These additives may have important implications for reinforcing smoking behavior and motivation to quit smoking. The purpose of this paper is to synthesize research related to the role of menthol's sensory characteristics in strengthening the reinforcing effects of nicotine in cigarettes and the impact on nicotine addiction and smoking behavior.
Research reports from 2002 to 2010 on the addictive potential of menthol cigarettes were reviewed that included qualitative focus groups, self-reports and biomarkers of nicotine dependence, human laboratory, and epidemiological studies.
Positive sensory effects of menthol cigarette use were identified via reports of early smoking experiences and as a potential starter product for smoking uptake in youth. Menthol cigarettes may serve as a conditioned stimulus that reinforces the rewarding effects of smoking. Nicotine dependence measured by shorter time-to-first cigarette upon waking was increased with menthol cigarette use in most of the studies reviewed. Smoking quit rates provide additional indicators of nicotine dependence, and the majority of the studies reviewed provided evidence of lower quit rates or higher relapse rates among menthol cigarette smokers.
The effects of menthol cigarette use in increasing the reinforcing effects of nicotine on smoking behavior were evidenced in both qualitative and quantitative empirical studies. These findings have implications for enhanced prevention and cessation efforts in menthol smokers.
Nicotine & Tobacco Research 12/2010; 12 Suppl 2:S110-6. · 2.58 Impact Factor
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ABSTRACT: Perceptions of menthol cigarette use may have implications for smoking initiation and cessation. This study explores harm and health perceptions of menthol cigarette use among a national sample of U.S. adults and current smokers.
We examined data from the 2009 HealthStyles survey (n = 4,556), an annual mail survey of adults ≥18 years of age that collects information on attitudes and behaviors, including smoking. Frequencies and weighted percentages were calculated by sex, race/ethnicity, age, education level, household income, and smoking status. Unadjusted odds ratios (OR) were used to compare perceptions of menthol cigarette use between demographic groups.
Close to half of adults (45.8%) believed that menthol cigarettes are just as harmful as nonmenthol cigarettes, and 40.9% of adults did not know whether menthol cigarettes are more or less harmful than nonmenthol cigarettes. Few adults (0.6%), including smokers, perceived menthol cigarettes to be less harmful than nonmenthol cigarettes. Blacks (OR = 3.22, 95% CI = 1.80-5.76) were more likely to believe that menthol cigarettes have health benefits when compared with Whites. Almost half of current smokers believed menthol cigarettes are equally addictive as nonmenthol cigarettes and 74.9% believed menthol and nonmenthol cigarettes are equally hard to quit.
Findings suggest directions for targeted public health messages for menthol cigarette use. Future research is needed among a nationally representative sample to capture more subtle differences in perceptions among menthol and nonmenthol smokers.
Nicotine & Tobacco Research 12/2010; 12 Suppl 2:S125-35. · 2.58 Impact Factor
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ABSTRACT: Even though its health consequences are well known, tobacco use continues to kill millions of smokers worldwide every year. In the US alone, tobacco use kills > 430,000 people each year. The global mortality toll is approximately 5 million annually and this is increasing. It is the powerful grip of tobacco addiction that sustains high levels of daily smoke intake and persistent smoking, with > 90% of all cigarette smokers who quit, resuming smoking within 1 year. Tobacco addiction, which places tremendous health and economic burdens on individual societies, is also becoming a global epidemic. Although tobacco addiction is a complex phenomenon, it is treatable and several effective medications are now available. In the mid-1980s, the US FDA approved nicotine gum, the first of these effective pharmacological aids. Other effective medications have subsequently become available, including nicotine transdermal patches, nasal spray, oral vapour inhaler, sublingual nicotine tablets and bupropion. These medications and the potential for development of new medications will be reviewed.
Expert Opinion on Pharmacotherapy 02/2005; 2(10):1545-1555. · 3.20 Impact Factor
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ABSTRACT: Menthol is the only tobacco additive promoted and advertised by the tobacco industry. Although a considerable body of research has examined the effects of menthol when it is administered alone and unburned, the effects of menthol when burned in cigarette smoke are more complex because it is administered in a matrix of more than 4,000 substances. Therefore, it is difficult to isolate potential pharmacological and toxic effects of menthol when it is administered in a smoke mixture. Menthol properties include cooling and local anesthesia, as well as effects on drug absorption and metabolism, bronchodilation and respiration changes, and electrophysiology. Subjective effects of smoothness and less harshness have been identified as reasons for menthol cigarette smoking, but findings have been inconclusive regarding the effect of menthol on carbon monoxide exposure and smoking topography parameters. Gaps in the research literature and future research areas include the following: (a) What is the role of menthol in tobacco reinforcement and addiction? (b) In the absence of nicotine, is menthol reinforcing? (c) Are the pharmacological and physiological effects of menthol mediated by a menthol-specific receptor or some other central nervous system-mediated action? (d) What are the influences of menthol and menthol metabolism on the metabolic activation and detoxification of carcinogens in tobacco smoke? and (e) Do differences exist in cigarette smoking topography in relation to the interaction of ethnicity, gender, and menthol cigarette preference? Answers to these questions will help to elucidate the function of menthol in cigarettes and its impact on smoking behavior.
Nicotine & Tobacco Research 03/2004; 6 Suppl 1:S17-28. · 2.58 Impact Factor
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Nicotine & Tobacco Research 03/2003; 5(1):9-11. · 2.58 Impact Factor
