Menthol cigarettes contributed to 378,000 premature deaths in the United States between 1980 to 2018, according to a new study.
The research also shows that about 10 million smokers were attributable to menthol cigarettes, which researchers estimate accounted for about 3 million life years lost.
“Our results indicate that mentholated tobacco products have had a significant impact on public health and could continue to pose a substantial health risk,” says David Mendez, an associate professor in the health management and policy department at the University of Michigan School of Public Health.
“We hope these data will help the Food and Drug Administration evaluate the potential regulatory actions for mentholated tobacco products.”
The study, published in Tobacco Control, indicates that the most important drivers of the relative impact of menthol cigarettes include the effects that menthol has in smoking initiation and cessation, says first author Thuy Le of the health management and policy department.
“Previous studies have shown that menthol experimentation is positively associated with progression to established smoking,” Le says. “In addition, menthol smokers are less likely to quit smoking than nonmenthol smokers. These observations were incorporated in the model and are the key factors in determining the outcomes of our study.”
For the study, researchers calibrated a well-established model that Mendez and colleague Ken Warner, dean emeritus of the School of Public Health, developed. Le and Mendez used the model in conjunction with National Health Interview Survey data and other public data sources to reproduce the overall US adult smoking prevalence between 1980 and 2018 and associated mortality.
They then used the model again with adjusted parameters to reflect a scenario which assumed menthol cigarettes were not present in the market over the same period. Finally, they compared both scenarios to quantify the public health harm attributable to menthol over the 1980-2018 period.
Mendez says the researchers hope the FDA will look at this and other data as it evaluates potential regulatory actions for mentholated tobacco products.
Menthol cigarettes were created in 1925 and became widespread in the 1950s and ’60s. In 2009, the Family Smoking Prevention and Tobacco Control Act gave the FDA authority to regulate the manufacture, distribution, and marketing of tobacco products. The FDA banned flavors such as candy, spice, and fruit, but did not ban menthol.
In 2011, the Tobacco Products Scientific Advisory Committee submitted a report to the FDA concluding that the removal of menthol cigarettes from the market would benefit public health. To date, the FDA has not taken any regulatory action on mentholated cigarettes.
According to the Population Assessment of Tobacco and Health Study, 81% of youth and 86% of young adults who ever used tobacco—even once or twice in their lifetimes—reported that the first tobacco product they used was flavored. The FDA says 86% of African-American smokers, 46% of Hispanic smokers, 39% of Asian smokers, and 29% of white smokers use menthol cigarettes.
Both Le and Mendez are researchers at University of Michigan’s Center for the Assessment of Tobacco Regulation, supported with funding from the NIH and FDA.
Source: University of Michigan