A comprehensive nationwide study has uncovered disturbing evidence that menthol cigarettes may be more deadly than their non-menthol counterparts, with Black smokers facing particularly elevated risks of heart disease.
The research, published today in Tobacco Control, analyzed data from nearly one million participants over six years, revealing that former menthol cigarette smokers faced a 12% higher risk of death from all causes compared to those who had smoked non-menthol brands.
The findings come at a crucial time as policymakers worldwide grapple with regulations on flavored tobacco products. The study, led by the American Cancer Society (ACS), provides some of the strongest evidence yet linking menthol cigarettes to increased mortality risks.
“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 of risk factors and screening research at the American Cancer Society and the study’s lead author.
The investigation tracked 73,486 menthol cigarette smokers and 281,680 non-menthol smokers from 1982-1983, documenting 4,071 and 20,738 deaths respectively. While both types of cigarettes approximately doubled mortality risk compared to never smoking, the study revealed particularly troubling statistics for certain groups.
Among Black participants who currently smoke menthol brands, researchers observed an 88% higher mortality risk for certain heart conditions compared to those smoking non-menthol cigarettes. The study also found that individuals who had quit smoking but previously used menthol cigarettes faced increased mortality risks across several categories:
- 16% higher risk of death from all cardiovascular diseases
- 13% higher risk of death from ischemic or coronary artery disease
- 43% higher risk of death from other heart diseases
These disparities became even more pronounced among heavy smokers consuming 40 or more cigarettes daily. The findings underscore the complex relationship between menthol flavoring and tobacco’s health impacts, particularly in vulnerable populations.
Lisa A. Lacasse, president of the American Cancer Society Cancer Action Network (ACS CAN), emphasized the policy implications of these findings. “Today’s study proves once again why policymakers need to enact comprehensive policies that help individuals who currently use quit and prevent youth and young adults from becoming addicted to tobacco products,” she said.
The research emerges from the Cancer Prevention Study II, one of the largest and most comprehensive investigations of smoking-related health outcomes. While previous studies have documented menthol cigarettes’ role in increasing smoking initiation and reducing cessation success, this new data provides concrete evidence of their elevated mortality risks.
Despite the stark findings, the researchers emphasized that quitting smoking remains the most crucial factor in reducing health risks. “Continuing to smoke, whether menthol or non-menthol cigarettes, is the most harmful,” Bandi noted. “These findings reiterate that quitting all cigarette types is the only safe option to reduce your risk of disease and dying prematurely.”
The study’s implications extend beyond the United States. Bandi highlighted the global significance of the findings, noting that “in the U.S. and globally in many low- and middle-income countries, the share of menthol cigarettes in the market is substantial.”
Public health advocates are calling for enhanced cessation support, including improved access to quitlines, healthcare provider assistance, and state and federal programs. ACS CAN has announced plans to pursue increased funding for tobacco prevention and cessation programs, while also advocating for comprehensive smoke-free laws and higher tobacco taxation.
The research team included multiple ACS scientists, including Christina Newton, Zheng Xue, Dr. Samuel Asare, Dr. Minal Patel, Dr. Farhad Islami, Dr. Nigar Nargis, Dr. Alpa Patel, Dr. Ahmedin Jemal, Dr. J. Lee Westmaas, and senior author Ryan Diver.
For those seeking support in quitting smoking, the American Cancer Society maintains a 24/7 helpline at 1-800-227-2345.