Menthol and Non-Menthol Cigarette Smoking: All-Cause, Cardiovascular Disease and Other Causes of Death Among Blacks and Whites
Background—SIn contrast to whites, African American smokers prefer menthol cigarettes over non-menthol cigarettes by a large margin and also tend to have higher mortality from several smoking-related diseases than whites, raising the possibility that menthol cigarettes contribute to racial disparities in risk. Evidence regarding differential associations between menthol vs. non-menthol cigarettes indicates lower cancer risk for menthol smokers, but for cardiovascular disease (CVD) mortality evidence has been inconsistent.
Methods and Results—Cox proportional hazards models were used to compute hazard ratios (HRs) and accompanying 95% confidence intervals (CIs) for all-cause and CVD mortality for menthol compared to non-menthol cigarette smokers among 65,600 participants in the Southern Community Cohort Study, an ongoing community-based cohort with the largest number of menthol smokers being traced. Among the 27,619 current cigarette smokers, 4224 died during follow-up with 1130 deaths attributed to CVD. Both all-cause (HR = 0.93, 95% CI = 0.86 to 1.01, p = 0.10) and CVD (HR = 0.88, 95% CI = 0.76 to 1.03, p = 0.10) mortality risks were similar in menthol compared to non-menthol cigarette smokers.
Conclusions—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 non-menthol cigarettes.
- Received November 20, 2015.
- Revision received March 16, 2016.
- Accepted March 18, 2016.