May 17, 2016

Study finds menthol cigarettes do not further increase smokers’ cardiovascular disease, stroke risk

Smoking is deleterious to health, but smokers who prefer menthol cigarettes to nonmenthol can breathe a sigh of relief…for now.

Smoking is deleterious to health, but smokers who prefer menthol cigarettes to nonmenthol can breathe a sigh of relief…for now.

According to a Circulation study published last week, menthol does not appear to increase a smoker’s risk for cardiovascular disease or stroke any more than nonmenthol cigarette smoking does.

ashtray full of cigarette butts

Conducted by researchers at the International Epidemiology Institute and Vanderbilt University Medical Center, the study aimed to determine whether black smokers, who prefer menthol cigarettes over nonmenthol cigarettes by a large margin (84 percent versus 27 percent), have an increased risk for developing cardiovascular disease (CVD) and stroke than nonmenthol smokers.

Blacks experience a higher incidence of mortality from several smoking-related diseases, including cardiovascular disease and stroke, but whether menthol cigarette smoking contributes to these differentials was not clear, the authors write.

It’s a timely topic given that the U.S. Food and Drug Administration (FDA) has been deliberating the regulation of menthol cigarettes since the Tobacco Control Act, a law banning the use of all flavoring except menthol in cigarettes, was passed in 2009, says senior author William Blot, Ph.D., associate director for Population-Based Research and professor of Medicine (Epidemiology).

Researchers used the Southern Community Cohort Study (SCCS), with its large number of black and white smokers, because it affords the unique opportunity to assess the effects of menthol cigarette use on smoking-related mortality.

Previously conducted studies point to a lower lung cancer risk for menthol smokers, but for cardiovascular disease (CVD) mortality, evidence has been inconsistent.

Looking at all-cause and CVD mortality for menthol compared with nonmenthol cigarette smokers among 65,600 participants in the Southern Community Cohort Study, the researchers found that of the 27,619 current cigarette smokers, 4,224 died during follow-up, with 1,130 deaths attributed to CVD. Participants were followed for 8.1years on average.

Both all-cause and CVD mortality risks were similar in menthol compared with nonmenthol cigarette smokers among both blacks and whites.

Smoking, regardless of cigarette type, is hazardous to health, but these results do not indicate that menthol cigarettes are associated with greater CVD risks than nonmenthol cigarettes,” Blot said.

Contributing authors on the Circulation study are Heather Munro, M.Sc., and Robert Tarone, Ph.D., from the International Epidemiology Institute, and Thomas Wang, M.D., physician-in-chief of the Vanderbilt Heart and Vascular Institute and director of the Division of Cardiovascular Medicine.