HQ Team
February 15, 2025: A study by the American Cancer Society (ACS) found mortality risks for smoking menthol cigarettes were higher than non-menthol cigarettes for death, especially heart diseases. Higher risks were evident in individuals who had quit smoking and at high smoking intensities.
The large nationwide study found that Black participants smoking menthol brands were at higher risk of some heart diseases with an 88% elevated mortality risk compared to non-menthol cigarettes. The report also showed quitting smoking substantially reduced health risks from both cigarette types.
“Menthol in cigarettes is an established public health threat due to its effect on increasing smoking uptake and reducing smoking cessation,” said Dr. Priti Bandi, scientific director, risk factors and screening research at the American Cancer Society and lead author of the study. He cautioned that the share of menthol cigarettes in the market is high and stricter regulations need to be put into place to curb its sales.
Mortality risks
The study participants were a million people from the Cancer Prevention Study II, and they were observed for mortality outcomes over six years. All-cause and cause-specific mortality risk was assessed according to baseline smoking status (current, former, never) and menthol flavor status (menthol, non-menthol) of the cigarette brand smoked for the longest period.
The study found that in the 73,486 participants using menthol brands and 281,680 participants reporting non-menthol brands, there were 4,071 and 20,738 deaths, respectively.
Also, people smoking menthol or non-menthol cigarette brands showed double the mortality risks compared to never smoking. Quitting definitely reduced the mortality risk. But a history of menthol versus non-menthol smoking was associated with an increased mortality risk of 12% from all causes, 16% from all cardiovascular diseases, 13% from ischemic or coronary artery disease, and 43% from other heart diseases. Among individuals currently smoking, there was no difference in mortality risks for menthol vs. non-menthol cigarettes, except for among those smoking 40 or more cigarettes per day, and in Black individuals for some heart diseases.
Menthol cigarette addiction
According to a report in 2022, about 18.5 million people in the United States are regular menthol smokers. That’s 37% of the cigarette market. An out f these 85% are Black smokers, 46% are Hispanic smokers, and 39% are Asian American smokers. What is more concerning is due to its addictive and flavored nature, the number of teens and young using menthol cigarettes is high.
Research by Tobacco Products Scientific Advisory Committee has shown that menthol cigarettes are highly addictive and difficult to quit.
The Food and Drug Administration (FDA) proposed rules in 2022 to prohibit these products and flavored cigars. These proposed rules were in response to public health concerns about the dangers of menthol cigarettes and their huge popularity among young people and Black, Hispanic and Asian American smokers. But there has been no further activity on this proposal. So much so that the American Medical Association has joined hands with other organization to take the legal route in forcing the health authorities to adopt the proposed rules.
Experts advocate comprehensive policies that promote quitting and support through state and federal programs. ACS continues its efforts to fund tobacco prevention and cessation programs and push for proven tobacco control policies, including comprehensive smoke-free laws and tax increases on all tobacco products.
The findings are published in the journal Tobacco Control.
