Some patients find it harder to quit tobacco than others. Smoking menthol cigarettes might be part of the reason. Menthol is a flavor additive commonly used in tobacco and some research shows menthol cigarettes may be more addictive[1]. It provides the user with a minty taste and aroma, and may have painkilling properties. Used in cigarettes, menthol can soothe the dry throat feeling many smokers have, leading some to say, “It makes the poison go down smoother.”

The smoother the effect, the more it makes tobacco smoke easier to inhale, which also increases the nicotine that users take in. It also activates the taste buds. In these ways, the sensory effects of menthol act as conditioned stimulus that reinforce the effects of nicotine, thereby making menthol users more addicted to nicotine[2]. It’s no wonder cessation among menthol users is less successful than non-menthol smokers[3].

These sensory effects also make menthol cigarettes more attractive to youth. More than 40 percent of youth smokers report smoking menthol cigarettes and research supports that menthol cigarettes are a starter cigarette for youth.[4][5]

African Americans, Asians, and Hispanics use menthol cigarettes at the highest rates[6]. Why is this? These communities, particularly African Americans, are targeted by tobacco companies, to the tune of nearly nine out of 10 African American smokers reporting menthol cigarette use.[7]

Providers who are doing the incredibly important work of talking to their patients about tobacco use need every tool they can get to help their patients be successful at quitting. Providers can help their patients understand the connection between menthol cigarettes and nicotine addiction, as well as adjust their quit plans with the underlying reality that menthol cigarettes are harder to quit.  

Menthol cigarettes are unique in that other flavored cigarettes are banned under the Federal Drug Administration’s (FDA) Family Smoking and Tobacco Control Act which was signed into law in 2009. Menthol was the only flavor exemption and although other countries (Brazil, Ethiopia, European Union, and some Canadian provinces) have banned menthol cigarettes it remains a contentious issue between the FDA and big tobacco companies in the United States.  

If you would like more information about the Tobacco, Vaping Device, and Marijuana Prevention Program at Spokane Regional Health District, contact Paige McGowan at pmcgowan@srhd.org or (509) 324-1504.

[1] Smokefree.gov. Menthol Cigarettes. Bethesda (MD): U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute.

[2] Ahijevch & Garrett, 2010

[3] Levy, et al., 2011

[4] www.fda.gov

[5] Hersey, et al., 2006

[6] NSDUH, 2004-2008

[7] Giovino GA, Villanti AC, Mowery PD et al. Differential Trends in Cigarette Smoking in the USA: Is Menthol Slowing Progress? Tobacco Control, doi:10.1136/tobaccocontrol-2013-051159, August 30, 2013