One of the most striking differences in the smoking patterns between African Americans and whites is the preference for menthol cigarettes. Whereas approximately 80% of African-American smokers usually smoke menthol cigarettes, the proportion among whites is only about 20%. African Americans also smoke fewer cigarettes per day and begin smoking later in life compared to whites. Furthermore, African Americans are more likely to attempt to quit smoking than whites in any given year. However, the success rate is 34% lower for African Americans than it is for whites. Despite smoking fewer cigarettes per day, African Americans experience disproportionately higher rates of smoking-related health consequences. Because of their high preference for menthol cigarettes, it has been suggested that smoking menthol cigarettes may contribute to the excess smoking-related morbidity experienced by African Americans. Menthol cigarettes are also generally higher in nicotine and tar content.
Menthol is a naturally occurring flavoring element and one of thousands of chemicals that may be added to cigarettes during the manufacturing process. An earlier report suggested that menthol combustion produces carcinogenic compounds, such as benzopy-renes, which may contribute directly to higher lung cancer rates. However, this compound has been shown to be present in virtually all cigarettes. Research on the association between menthol cigarette use and lung cancer has produced mixed results. A case-control study did not find increased lung cancer rates among menthol smokers compared to nonmenthol smokers. In contrast, a prospective study found increased risk of lung cancer among male menthol smokers but not in females. While it remains unclear whether menthol directly increases the risk of lung cancer, it is possible that the relationship between menthol and tobacco-related morbidity is an indirect one. For example, due to its local anesthetic and cooling effects, menthol may affect smoking topography in a number of ways, including puff volume and depth of smoke inhalation. These factors are likely to increase exposure to tobacco smoke toxins and, consequently, disease risk. Another hypothesis is that menthol makes smoking more enjoyable. Menthol cigarette smokers may therefore be less able to quit smoking and continue smoking for longer periods of time. This is consistent with findings from a recent study that suggested that menthol smokers are more likely to smoke within 30 minutes of awakening and are less likely to quit smoking compared to nonmenthol smokers. canadian pharmacy
To better understand the smoking patterns of menthol cigarette smokers and their smoking cessation experiences, we conducted a secondary analysis of data from a cross-sectional study conducted to examine the smoking patterns of inner-city African Americans. We were interested in associations between smoking of menthol cigarettes and a number of intermediate measures of smoking cessation such as number and duration of previous quit attempts. We hypothesized that menthol smokers will report less success in previous attempts to quit smoking compared to nonmenthol cigarettes smokers.