Menthol Cigarettes Seem Tougher to Quit

This may help explain higher smoking-related illness among blacks, researchers say

MONDAY, Sept. 25, 2006 (HealthDay News) -- Although the dangers of menthol and regular cigarettes appear to be the same, people who smoke menthol brands may have a harder time quitting, a new study found.

The risk seems of particular concern to black Americans. For historical and cultural reasons, including targeted advertising by the tobacco industry, black smokers are much more likely to smoke menthol cigarettes than white smokers, approximately 70 percent to 30 percent, respectively, the researchers said.

"We were interested to see if menthol cigarettes were more harmful than non-menthol cigarettes," said lead researcher Dr. Mark J. Pletcher, an assistant adjunct professor of epidemiology at the University of California, San Francisco. "If it were true, it might help explain some of the difference in disease rates between African-Americans and whites."

Black Americans tend to smoke less than whites, but have disproportionately high rates of cancer, cardiovascular disease and other smoking-related illnesses, according to background information from the study.

"However, we found that menthol cigarettes don't appear to be any more harmful than non-menthol cigarettes," Pletcher said. "However, there is some evidence that they may be harder to quit."

In the study, published in the Sept. 25 issue of Archives of Internal Medicine, the researchers collected data on 1,535 smokers who were part of the Coronary Artery Risk Development in Young Adults Study. Pletcher's team looked at the association between being able to quit smoking and smoking menthol cigarettes. They also measured for 10 years the build-up of calcium in the arteries that can lead to coronary-artery disease and changes in lung function.

Pletcher's group found that the 63 percent of the study participants preferred menthol cigarettes, and 36 percent preferred non-menthol cigarettes. Eighty-nine percent of blacks smoked menthol cigarettes, compared with 29 percent of whites.

People who smoked menthols were more often young, female and unemployed. They also tended to be less educated, overweight, and to drink less alcohol and smoke fewer cigarettes a day, the researchers said.

The researchers found that people who smoked menthol cigarettes in 1985 were more likely to still be smoking in 2000. For example, 69 percent of menthol smokers were still smokers, compared with 54 percent of non-menthol smokers.

Most of this difference is explained by the fact that black smokers were more likely to smoke menthols and less likely to quit smoking. "Menthol smokers were less likely to quit and more likely to relapse," Pletcher said.

Pletcher said it's not clear why menthol cigarettes seem harder to quit. One reason, he said, is that they may taste better. This may suggest that menthol smokers may need more support when they try to quit.

Dr. Norman H. Edelman, a scientific consultant for the American Lung Association, said he doesn't think the study proves that menthol cigarettes are either more or less dangerous than regular cigarettes.

"The statistics in the study seem weak," he said. "The authors themselves realize that a definitive conclusion of 'no difference' [between the types of cigarettes] would have required a larger sample size," he added.

"So, instead of saying that the poorer health outcomes of African-American smokers is not related to their greater use of menthol cigarettes, we must say it 'does not seem to be related, based upon available information,' " Edelman said.

In a related matter, a federal judge on Monday granted class-action status to a racketeering lawsuit filed by smokers of "light" cigarettes against Philip Morris USA and several other large makers of the cigarettes. The ruling will allow the smokers to pursue their claims against the tobacco industry as a group, MarketWatch reported.

The smokers filed their case in 2004 and are seeking as much as $200 billion in damages. They contend the tobacco industry defrauded them by making them think "light" or "low-tar" cigarettes were safer than regular cigarettes, when they are not, MarketWatch said.

A spokeswoman for Philip Morris USA declined to comment.

More information

The American Lung Association can tell you more about stopping smoking.

SOURCES: Mark J. Pletcher, M.D., M.P.H., assistant adjunct professor of epidemiology, University of California, San Francisco; Norman H. Edelman, M.D., scientific consultant, American Lung Association, New York City; Sept. 25, 2006, Archives of Internal Medicine
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