Menthol: putting the pieces together.
Study Goal
The researchers aimed to assess how tobacco companies use menthol in cigarettes and its impact on smoking behavior, initiation, and cessation, particularly among specific populations.
Results Summary
The study found that menthol masks irritation, enhances sensory effects, and disproportionately targets youth, women, and African Americans. It increases smoking initiation, reduces cessation, and interacts with nicotine to facilitate addiction, while also raising fine particles in smoke linked to heart attack risk.
Population
Youths, women, and African Americans.
Effective Dosage
Not Assessed
Duration
Not Assessed
Interactions
Complex interaction with nicotine.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
menthol cigarettes | neutral | consumer perceptions | - | - | shaped consumer perceptions | #1 |
menthol | decrease | irritation and sensory effects | - | - | mask irritation and provide sensory effects | #2 |
menthol cigarettes | increase | appeal | youth and health-concerned smokers | - | make menthol cigarettes appeal to | #3 |
menthol | increase | palatability of low-tar cigarettes | - | - | makes low-tar cigarettes more palatable | #4 |
menthol cigarettes | increase | smoking prevalence | youths, women and African Americans | - | disproportionately smoke | #5 |
menthol | neutral | addictive effects of nicotine | - | - | complex interactions with addictive effects | #6 |
menthol | neutral | sensory characteristics | - | - | imparts sensory characteristics to cigarettes | #7 |
menthol | neutral | smoking behavior | - | - | complex interaction with nicotine that affects smoking behavior | #8 |
menthol | increase | fine particles in cigarette smoke | - | - | increases fine particles in cigarette smoke | #9 |
increased fine particles in cigarette smoke | increase | risk of heart attack | - | - | have immediate adverse effects on the risk of | #10 |
menthol | increase | population harm from smoking | some groups | - | increases population harm from smoking by increasing initiation and reducing cessation | #11 |
menthol | increase | smoking | - | - | facilitates and increases smoking | #12 |
smoking | increase | disease and death | - | - | causes | #13 |
OBJECTIVE: To integrate information on cigarette companies' understanding and use of menthol as summarised in published research based on previously internal tobacco industry documents with results from large population-based surveys of tobacco use and other independent sources. DATA SOURCES: Papers published in this supplement of Tobacco Control, together with papers identified using PubMed searches. RESULTS: Tobacco companies shaped consumer perceptions of menthol cigarettes. Menthol is not just a flavouring agent. Cigarette companies use menthol's ability to mask irritation and provide sensory effects to make menthol cigarettes appeal to youth and health-concerned smokers, in part because menthol makes low-tar cigarettes more palatable. Consistent with targeted marketing, youths, women and African Americans disproportionately smoke menthols. There appear to be complex interactions with addictive effects of nicotine. The ubiquitous addition of menthol by tobacco companies to over 90% of all tobacco products, whether labelled 'menthol' or not, demonstrates that menthol is not simply a flavour or brand. Menthol imparts sensory characteristics to cigarettes and has a complex interaction with nicotine that affects smoking behaviour whether it is perceived or not, or whether cigarettes containing menthol are marketed as 'menthol' or not. Adding menthol increases fine particles in cigarette smoke, which have immediate adverse effects on the risk of heart attack. CONCLUSION: Information from industry documents, confirmed by independent scientific literature, consistently demonstrates that menthol increases population harm from smoking by increasing initiation and reducing cessation in some groups. Menthol facilitates and increases smoking, which causes disease and death.