People who smoke mentholated cigarettes are no more likely to develop lung cancer or die from the disease than are smokers of non-mentholated brands, researchers at Vanderbilt-Ingram Cancer Center (VICC), Meharry Medical College and the International Epidemiology Institute (IEI) in Rockville, Md., report.
The study was published online March 23 in the Journal of the National Cancer Institute.
William Blot (Vanderbilt)
“Black men are known to have a higher incidence of lung cancer and are more likely to smoke mentholated cigarettes compared to white men,” said the lead author, William Blot, professor of Medicine at Vanderbilt and CEO of IEI. “It has been hypothesized that menthol in cigarettes influences smoking behavior, perhaps increasing dependency or adversely affecting the biology of the lung. However, our large study found no evidence to support those theories.”
The study was based on results from the Southern Community Cohort Study (SCCS), an ongoing investigation of cancer incidence and mortality disparities among racial, and urban versus rural populations in 12 southern states. Smoking prevalence among SCCS participants was exceptionally high, and both menthol and non-menthol cigarette use was common.
Among 85,806 racially diverse adults enrolled in the SCCS between March 2002 and September 2009, the investigators studied 12,373 smokers who responded to a follow-up questionnaire. Study leaders compared rates of quitting between menthol and non-menthol smokers. They also analyzed 440 lung cancer patients and 2,213 demographically-matched control subjects without lung cancer.
Among people smoking 20 or more cigarettes a day, menthol smokers were approximately 12 times more likely to develop lung cancer than never-smokers, while non-menthol smokers were about 21 times more likely to have the disease. The differences were mirrored for lung cancer death rates and were found to be statistically significant.
Undue emphasis on reduction of menthol relative to other cigarettes may distract from the ultimate health prevention message that smoking of any cigarettes is injurious to health.” – William Blot
The researchers also found that both white and black menthol smokers reported smoking fewer cigarettes per day than non-menthol smokers. When it comes to the likelihood of quitting smoking, there was no significant difference between menthol and non-menthol smokers.
The authors conclude that the findings suggest menthol cigarettes are no more, and perhaps less, harmful than non-menthol cigarettes.
“Cigarette smoking remains the leading cause of premature death in the United States, but undue emphasis on reduction of menthol relative to other cigarettes may distract from the ultimate health prevention message that smoking of any cigarettes is injurious to health,” said Blot.
Other study investigators include Melinda Aldrich, assistant professor of Medicine and Thoracic Surgery; Joseph McLaughlin, professor of Medicine; and Lisa Signorello, research associate professor of Medicine, all of VICC; Margaret Hargreaves, professor of Internal Medicine at Meharry; and Sarah Cohen, epidemiologist, IEI.
Funding for the study was provided by the National Cancer Institute.
Learn more about lung cancer research at Vanderbilt.