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African Americans who use menthols less likely to quit smoking

African American smokers who used menthol cigarettes were 12% less likely to quit smoking than nonmenthol smokers, possibly due to targeted advertisements from the tobacco industry, according to a study published in Nicotine & Tobacco Research.

The results suggest that a menthol flavoring ban would provide a unique public health benefit to African American and possibly Hispanic/Latinx smokers, according to the researchers.

“Some people believe [menthol cigarettes] are less dangerous, even though they are, in epidemiological studies, found to be at least as dangerous as nonmentholated cigarettes,” Gary A. Giovino, PhD, of the departments of community health and health behavior at the School of Public Health and Health Professionals at the University of Buffalo and the State University of New York, said in a press release. “Menthol is a topical anesthetic that numbs the respiratory tract. People inhale them more easily, which gives the perception of safety.”

To evaluate associations between menthol use and smoking cessation in the United States, researchers conducted a meta-analysis of cross-sectional and prospective studies from multiple online databases. Additional analyses were performed for studies that tested for racial/ethnic differences in associations between menthol cigarette use and smoking cessation.

Researchers included 22 reports of 19 studies in analyses that accounted for 147,584 smokers. All studies included smokers from the United States, and one study included both U.S. and Canadian smokers. The overall OR of smoking cessation in menthol users was 0.95 (95% CI; 0.89-1.03).

Evaluations of studies that included racial/ethnic information found that compared with nonmenthol smokers, African American menthol smokers were 12% (OR = 0.88; 95% CI, 0.78-1) less likely to quit smoking.

Hispanic/Latinx smokers had a similar effect size (OR = 0.85; 95% CI, 0.68-1.06), but the difference in odds of smoking cessation was not statistically significant. According to the researchers, more studies that include racial/ethnic information are needed to determine the association between menthol use and smoking cessation.

There was no association with menthol use and smoking cessation in white smokers (OR = 1.04; 95% CI, 0.96-1.13) compared with nonmenthol smokers.

Researchers noted that previous studies found that the tobacco industry specifically targeted African Americans, which may be partially to blame for the lack of smoking cessation in the group. Additionally, they noted that a ban on menthol cigarettes would positively affect smoking cessation rates in African Americans and possibly in Hispanic/Latinx smokers.

“Much of the rationale for why menthol flavoring might impede cessation has to do with how menthol flavoring might make the nicotine in cigarettes more reinforcing,” Phillip H. Smith, PhD, of the department of kinesiology and health at Miami University, Ohio, and City University of New York School of Medicine, said in the press release. “This would be true regardless of race or ethnicity, so we might expect to see menthol flavoring making it more difficult for everyone to quit. The fact that we didn’t find consistency across racial and ethnic groups, we think, might point to the causal role of social influences like tobacco marketing.”– by Erin Michael

Disclosures: The authors report no relevant financial disclosures.