Individuals who smoke mentholated cigarettes are no more likely to develop lung cancer or to die from the disease than smokers of non-mentholated cigarettes, according to a new study led by William Blot, Ph.D., professor of Medicine, Vanderbilt-Ingram Cancer Center (VICC), Nashville, Tenn., and colleagues at VICC, Meharry Medical College (MMC), Nashville, and the International Epidemiology Institute (IEI), Rockville, Md.
The new smoking study was published online March 23 in the Journal of the National Cancer Institute
"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 Blot. "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 of lung cancer risk 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 participants in the SCCS 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.
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, Ph.D., M.P.H., assistant professor of Medicine and Thoracic Surgery, Joseph McLaughlin, Ph.D., M.P.H., professor of Medicine, Lisa Signorello, Sc.D., research associate professor of Medicine (all VICC), Margaret Hargreaves, Ph.D., professor of Internal Medicine, MMC, and Sarah Cohen, Ph.D., epidemiologist, IEI.
Funding for the study was provided by the National Cancer Institute.