Mentholated cigarettes and non-lung smoking related cancers in California, USA

Division of Research, Kaiser Permanente Medical Care Program, Oakland, CA 94611, USA.
Journal of Epidemiology & Community Health (Impact Factor: 3.5). 04/1998; 52(3):202. DOI: 10.1136/jech.52.3.202
Source: PubMed

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    • "In addition, menthol cigarettes are preferred by African Americans , and while African Americans smoke fewer cigarettes per day and tend to begin smoking later in life than do whites, African American males are at greater risk for smoking-related lung cancer, and their total smokingrelated mortality from diseases associated with tobacco use is higher [6] [7]. Nonetheless, epidemiologic studies attempting to link menthol cigarette use to increased risk of tobacco-related disease have been inconclusive, largely because (1) such studies lack the power to measure a small difference in harm in the presence of the overwhelming harm associated with smoking any tobacco product, and (2) it is difficult to identify " menthol cigarette users " without error, particularly since most of the reported studies were not originally designed to address menthol in cigarettes [8] [9] [10] [11] [12] [13] [14] [15] [16]. "
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    ABSTRACT: In the U.S. menthol remains the sole permitted characterizing cigarette flavor additive in part because efforts to link menthol cigarette use to increased tobacco-related disease risk have been inconclusive. To perform definitive studies, cigarettes that differ only in menthol content are required, yet these are not commercially available. We prepared research cigarettes differing only in menthol content by deposition of L-menthol vapor directly onto commercial nonmenthol cigarettes, and developed a method to measure a cigarette's menthol and nicotine content. With our custom-mentholation technique we achieved the desired moderately high menthol content (as compared to commercial brands) of 6.7 ± 1.0 mg/g (n = 25) without perturbing the cigarettes’ nicotine content (17.7 ± 0.9 mg/g [n = 25]). We also characterized other pertinent attributes of our custom-mentholated cigarettes, including percent transmission of menthol and nicotine to mainstream smoke and the rate of loss of menthol over time during storage at room temperature. We are currently using this simple mentholation technique to investigate the differences in human exposure to selected chemicals in cigarette smoke due only to the presence of the added menthol. Our cigarettes will also aid in the elucidation of the effects of menthol on the toxicity of tobacco smoke.
    Full-text · Article · Dec 2014 · Toxicology Reports
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    • "We identified 14 studies published between 1989 and 2012 for the meta-analysis (Figure 1), including 2 studies of all cause mortality [34,35], 3 of cardiovascular disease [14,34,36,37], 9 of lung cancer [29,31,32,34,35,38–41] and 3 of non-lung cancers [27,28,30]. Figure 2 summarizes the study characteristics and relative risk estimates for studies comparing risk for all-cause mortality, cardiovascular disease and cancer among menthol cigarette smokers compared to smokers of nonmenthol cigarettes. "
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    ABSTRACT: The U.S. Food and Drug Administration has the authority to regulate tobacco product constituents, including menthol, if the scientific evidence indicates harm. Few studies, however, have evaluated the health effects of menthol cigarette use. To investigate associations of cigarette smoking and menthol cigarette use with all-cause, cancer and cardiovascular risk in U.S. adults. We studied 10,289 adults ≥ 20 years of age who participated in the National Health and Nutrition Examination Survey from 1999-2004 and were followed through December 2006. We also identified studies comparing risk of all-cause mortality, cardiovascular disease and cancer for menthol and nonmenthol cigarette smokers and estimates were pooled using random-effects models. Fifty-five percent of participants were never smokers compared to 23%, 17% and 5% of former, current nonmenthol and current menthol cigarette smokers, respectively. The adjusted hazard ratios (95% CI) for former, current nonmenthol and current menthol cigarette smokers compared to never smokers were 1.24 (0.96, 1.62), 2.40 (1.56, 3.71) and 2.07 (1.20, 3.58), respectively, for all-cause mortality; 0.92 (0.62, 1.37), 2.10 (1.02, 4.31) and 3.48 (1.52, 7.99) for cardiovascular mortality; and 1.91 (1.21, 3.00), 3.82 (2.19, 6.68) and 2.03 (1.00, 4.13) for cancer mortality. Using data from 3 studies of all-cause mortality, 5 of cardiovascular disease and 13 of cancer, the pooled relative risks (95% CI) comparing menthol cigarette smokers to nonmenthol cigarette smokers was 0.94 (0.85, 1.05) for all-cause mortality, 1.28 (0.91, 1.80) for cardiovascular disease and 0.84 (0.76, 0.92) for any cancer. In a representative sample of U.S. adults, menthol cigarette smoking was associated with increased all-cause, cardiovascular and cancer mortality with no differences compared to nonmenthol cigarettes. In the systematic review, menthol cigarette use was associated with inverse risk of cancer compared to nonmenthol cigarette use with some evidence of an increased risk for cardiovascular disease.
    Full-text · Article · Oct 2013 · PLoS ONE
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    ABSTRACT: Approximately one-fourth of all cigarettes sold in the United States are mentholated. An understanding of the consequences, patterns, and correlates of menthol cigarette use can guide the development and implementation of strategies to reduce smoking prevalence and smoking-attributable morbidity and mortality. This paper summarizes the literature on the health effects of mentholated cigarettes and describes various patterns of use as indicated by consumption and survey data from the United States and other nations. The epidemiological literature on menthol cigarettes and cancer risk is inconclusive regarding whether these cigarettes confer a risk for cancer above that of nonmentholated varieties. Available data indicate that mentholated cigarettes are at least as dangerous as their nonmentholated counterparts. In addition, because mentholation improves the taste of cigarettes for a substantial segment of the smoking population and appears to mask disease symptoms, this additive may facilitate initiation or inhibit quitting. Menthol market share is high in the Philippines (60%), Cameroon (35%-40%), Hong Kong (26%), the United States (26%), and Singapore (22%). Newport has become the leading menthol brand in the United States. Surveys from four nations indicate that menthol use among adult smokers is more common among females than males. Among U.S. smokers, 68.9% of Blacks, 29.2% of Hispanics, and 22.4% of Whites reported smoking a mentholated variety. Research is needed to better explain factors that may influence menthol preference, such as marketing, risk perceptions, brand formulation, and taste preferences. Such research would guide the development of potentially more effective programs and policies.
    Full-text · Article · Mar 2004 · Nicotine & Tobacco Research
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