Menthol and Cigarettes

What’s the bottom line?

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Tobacco companies add menthol to make cigarettes seem less harsh and more appealing to new smokers and young people.

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Menthol cigarettes are not less harmful. They are just as dangerous as non-menthol cigarettes.

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Different groups of people—like some racial/ethnic minorities, LGBT people, people with mental health conditions, etc.—are more likely to smoke menthol cigarettes than the rest of the population. This is particularly true for African Americans.

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Some studies show that people who smoke menthol cigarettes have a harder time quitting smoking than those who smoke non-menthol cigarettes.

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We can help reduce menthol cigarette smoking and help people who smoke menthol cigarettes to quit with policies that limit where menthol cigarettes are sold and marketed, and by reaching out to groups that are more likely to smoke menthol cigarettes.

What is Menthol?

Menthol is a chemical compound found naturally in peppermint and other similar plants. Menthol can also be produced in a lab. Even though many brands of cigarettes are marketed as “menthol cigarettes,” almost all cigarettes sold in the U.S. contain at least some natural or lab-created menthol.1 Usually, there is more menthol in cigarettes marketed as “menthol” than in other cigarettes. According to federal law, tobacco manufacturers cannot market cigarettes with characterizing flavors (i.e. that have a distinct taste), except for cigarettes that taste like menthol or tobacco.2

Menthol in cigarettes creates a cooling sensation in the throat and airways when the user inhales, making cigarette smoke feel less harsh on the user.1,3 Tobacco companies market menthol cigarettes as “smoother” than other cigarettes.3 However, menthol cigarettes are not less harmful than other cigarettes and they are likely a greater risk to public health than non-menthol cigarettes.3

Why is Menthol in Cigarettes Dangerous?

Smoking any kind of cigarette, including menthol cigarettes, is harmful and increases risk for serious illness and death. Studies have shown that menthol in cigarettes likely leads people—especially young people—to experiment with smoking. It also could increase a young person’s risk of becoming dependent on nicotine.1 Compared to adults who smoke non-menthol cigarettes, adults who smoke menthol cigarettes make more attempts to quit smoking and have a harder time quitting.1,4

Marketing messages imply that menthol cigarettes are a “healthier” alternative. This is not true; menthol cigarettes are just as dangerous as any other type of cigarette.

Different Groups Are at Higher Risk

Menthol cigarettes contribute to tobacco-related health disparities in the U.S.3,5 This is because some groups of people are more likely to start smoking menthol cigarettes and keep smoking because of menthol cigarettes, which puts them at higher risk of getting tobacco-related diseases. Even though fewer people are smoking any kind of cigarette now than in the past, the percentage of people who smoke menthol cigarettes is going down more slowly than the percentage of people who smoke non-menthol cigarettes.1,4

Young people and African Americans are more likely to smoke menthol cigarettes than other groups.1,3

  • More than half (54%) of youth ages 12-17 years who smoke use menthol cigarettes.6
    • That percentage is higher than the percentage of adults 18 and older who smoke menthol cigarettes.6
    • A nationwide study showed that among smokers who started smoking as young adults (over age 18), a majority first started smoking using menthol cigarettes.7,8
  • The majority of African Americans who smoke use menthol cigarettes.3
    • Seven out of 10 African American youth ages 12-17 who smoke use menthol cigarettes.6
    • A higher percentage of black adults who smoke started by using menthol cigarettes (93%) than white adults who smoke (44%).8
    • Non-Hispanic black adults have the highest percentage of menthol cigarette use compared to other racial and ethnic groups.6 In 2014-2015, 76.8% of non-Hispanic black adults who smoked usually used menthol cigarettes, compared to 34.7% of Hispanic adults and 24.6% of white adults.9

These groups likely have higher percentages of menthol cigarette smoking in part because the tobacco industry has aggressively marketed menthol products to young people and African Americans, especially in urban communities.3 From their research, tobacco manufacturers knew that young people preferred smaller amounts of menthol in their menthol cigarettes, while older people who smoke preferred more menthol. The tobacco companies purposely lowered the menthol in some of their brands to make young people who smoke and those just starting to smoke want to use them.1

Tobacco companies also target menthol cigarette marketing to people who are new to smoking, mostly young people, using themes and images that appeal to these groups, like popularity, being accepted by people in their age group, and positive self-image. There also is heavy marketing by tobacco companies in African American neighborhoods, magazines that are popular with African Americans, and at music and lifestyle events aimed at African Americans.1,5

Other High-Risk Groups

Menthol cigarette smoking also affects other groups of people. For instance, women who smoke are more likely to use menthol cigarettes than men who smoke.3,6 A 2009-2010 study showed LGBT people who smoke are more likely to smoke menthol cigarettes than heterosexual people who smoke, and that the difference was even greater in terms of LGBT women versus heterosexual women.10 People with low levels of income or education are more likely to smoke menthol cigarettes than other cigarettes.3 Adults who smoke and have mental health conditions also are more likely to use menthol cigarettes than those who do not have mental health conditions.11

Menthol Smoking Continues to be a Problem

While fewer people now smoke cigarettes than in years past, the percentage of people who smoke menthol cigarettes is going down more slowly than for non-menthol cigarettes.1,4 From 2008-2010 to 2012-2014, the percentage of adult smokers who currently smoke menthol cigarettes increased.6 Furthermore, from 2011-2015, menthol cigarette sales increased while overall cigarette sales decreased.12 As of 2017, sales of menthol cigarettes made up 35% of all cigarette sales in the U.S.—the highest proportion since major tobacco companies were required to report those data.13

References

  1. Tobacco Products Scientific Advisory Committee. Menthol Cigarettes and Public Health: Review of the Scientific Evidence and Recommendations pdf icon[PDF–15.3 MB]external icon. Rockville, MD: US Department of Health and Human Services, Food and Drug Administration; 2011.
  2. 21 U.S.C. § 387g.
  3. Food and Drug Administration. Preliminary Scientific Evaluation of the Possible Public Health Effects of Menthol Versus Nonmenthol Cigarettes pdf icon[PDF–1.6 MB]external icon. 2013.
  4. Villanti AC, Collins LK, Niaura RS, Gagosian SY, Abrams DB. Menthol cigarettes and the public health standard: a systematic reviewexternal icon. BMC Public Health 2017;17:983.
  5. Gardiner P, Clark PI. Menthol cigarettes: moving toward a broader definition of harmexternal icon. Nicotine Tob Res. 2010;12(Suppl 2):S85–S93.
  6. Villanti AC, Mowery PD, Delnevo CD, Niaura RS, Abrams DB, Giovino GA. Changes in the prevalence and correlates of menthol cigarette use in the USA, 2004-2014external icon. Tob Control. 2016;25:ii14-ii20. Doi:10.1136/tobaccocontrol-2016-053329.
  7. U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. 2014.
  8. D’Silva J, Cohn AM, Johnson AL, Villanti AC. Differences in subjective experiences to first use of menthol and nonmenthol cigarettes in a national sample of young adult cigarette smokersexternal icon, Nicotine Tob Res. 20(9): 1062-1068, 2018.
  9. National Institutes of Health. The 2014-2015 Tobacco Use Supplement to the Current Population Surveyexternal icon. 2017.
  10. Fallin A, Goodin AJ, King BA. Menthol cigarette smoking among lesbian, gay, bisexual, and transgender adultsexternal icon. Am J Prev Med. 2015;48(1):93-97.
  11. Young-Wolff KC, Hickman NJ III, Kim R, Gali K, Prochaska JJ. Correlates and prevalence of menthol cigarette use among adults with serious mental illnessexternal icon. Nicotine Tob Res. 2015;17(3):285–291.
  12. Kuiper NM, Gammon D, Loomis B, et al., Trends in sales of flavored and menthol tobacco products in the United States during 2011-2015external icon, Nicotine Tob Res. 2018;20(6):698-706.
  13. U.S. Federal Trade Commission (FTC), Cigarette Report for 2017 pdf icon[PDF–361 KB]external icon, 2019.