African Americans who smoke menthol cigarettes are 12 percent less likely to quit smoking than other menthol smokers, a study shows. Targeted marketing may be why.
The findings underscore the role that mentholated cigarettes play in smoking cessation efforts, particularly among African American tobacco users, says Philip Smith, an assistant professor in the kinesiology and health department at Miami University in Ohio and lead author of the paper in Nicotine & Tobacco Research.
Menthol cigarettes appeared on the market in the 1920s. The tobacco industry began targeting African Americans in the 1940s and menthol use grew along with the belief that menthols were less dangerous, says senior author Gary Giovino, a professor of community health and health behavior at the University at Buffalo.
The study—a meta-analysis of 19 studies plucked from a review of more than 400 abstracts—looks at the association between menthol use and smoking cessation.
The finding that menthol flavoring links to less success in quitting smoking among African Americans didn’t surprise researchers, Smith says. But the lack of an association with white smokers did.
“Much of the rationale for why menthol flavoring might impede cessation has to do with how menthol flavoring might make the nicotine in cigarettes more reinforcing,” Smith says.
“This would be true regardless of race or ethnicity, so we might expect to see menthol flavoring making it more difficult for everyone to quit. The fact that we didn’t find consistency across racial and ethnic groups, we think, might point to the causal role of social influences like tobacco marketing.”
Big Tobacco’s marketing efforts have included heavier advertising of menthols on billboards in predominantly African American neighborhoods, and ads in African American-centric magazines, compared to white communities and periodicals, researchers say.
In addition, the industry has provided philanthropic support to organizations such as the National Association for the Advancement of Colored People and the National Urban League, Giovino says.
Giovino authored another recent study suggesting that tobacco companies are holding onto the menthol market better than non-menthol cigarettes. “Less quitting by menthol smokers is part of the reason why,” Giovino says, adding smokers’ inaccurate perceptions of menthol cigarettes have further compounded cessation efforts.
“Some people believe they are less dangerous, even though they are, in epidemiological studies, found to be at least as dangerous as non-mentholated cigarettes,” he says. “Menthol is a topical anesthetic that numbs the respiratory tract. People inhale them more easily, which gives the perception of safety.”
The idea for the study stemmed from a conversation between Smith and coauthor Biruktawit Assefa, who worked with Smith when she was an undergraduate intern at Yale.
“We wanted to more conclusively look at whether there are racial differences in how menthol flavoring may impede smoking cessation, across studies published on the topic,” Smith says.
Essentially, it’s about social injustice, says Smith, who wants to use research “to give power back to communities from which power has been taken.”
“It all comes down to power and who has more of it and who has less of it, and why. Banning menthol from tobacco products—which the study recommends—might help shift the power.
“Such a policy might effectively take some power away from the tobacco industry and give it back to blacks and African Americans in the US.”
Source: University at Buffalo