Women Smoking Menthol Cigarettes Have Greater Nicotine Exposure


Contact: Karen Ahijevych
Ohio State University

COLUMBUS, Ohio -- Women who smoke menthol cigarettes may be more likely to inhale deeper with each drag on their cigarette and potentially take in more nicotine than do smokers of non-menthol cigarettes, new research shows.

The study also showed that users of menthol cigarettes tend to smoke their first cigarette of the day sooner than do users of non-menthol cigarettes. The sooner a person smokes his or her first cigarette of the day, the more nicotine dependent the person is thought to be.

"These results should caution smokers who believe that menthol cigarettes are in some way healthier or less irritating than non-menthol brands. There is no safe cigarette," said Karen Ahijevych, associate professor of nursing at Ohio State University. Ahijevych, a researcher with Ohio State's Comprehensive Cancer Center, conducted the study.

"These results are particularly important for African-American women because the majority of African-Americans who smoke choose menthol cigarettes," she said. "Black women also have a higher rate of smoking-related morbidity and mortality than do white women."

Studies have shown that 65 percent or more of African American smokers use mentholated cigarettes, compared to about 25 to 30 percent of white smokers.

The study, published in the January/February issue of the journal Addictive Behaviors, involved 95 women smokers; 48 were Black and 47 were White. Of these, 27 Black women and 22 white women smoked mentholated cigarettes. The women had an average age of 35, and smoked on average 17 cigarettes per day for 15 years.

Ahijevych measured nicotine and carbon monoxide levels before and after each of the women smoked a single cigarette. Other measures included the volume of smoke inhaled (puff volume) in milliliters (mls), and each woman's blood level of cotinine (in nanograms per milliliter[ng/ml]). Cotinine is a breakdown product of nicotine, and it is frequently used as a marker for nicotine exposure. Ahijevych also recorded each woman's smoking history, including the number of cigarettes smoked per day and how soon after waking each woman smoked her first cigarette of the day.

The results showed that smokers of menthol cigarettes had a significantly larger puff volume than did smokers of non-mentholated cigarettes (45.8 mls vs 37.8 mls). Menthol has been shown in animal studies to stimulate cold receptors in the throat. "Stimulating those receptors would produce a cooling sensation, so smokers might find the smoke less irritating as they inhale. That might lead them to inhale more deeply," Ahijevych said.

"Larger puff volumes could lead to a greater tobacco-smoke and nicotine exposure," she said.

The study's finding that menthol smokers had significantly higher cotinine levels (239 ng/ml vs. 189 ng/ml) than did the users of non-menthol brands supports that supposition. In addition, the study found that while Black women in both groups smoked fewer cigarettes per day than did white women (15 vs 19), they had higher blood levels of cotinine (249 ng/ml vs 182 ng/ml). Other studies have also found higher cotinine levels in Black compared to white smokers. The reason why this occurs remains unknown.

Smokers of menthol cigarettes also had a significantly shorter time to first cigarette after waking (19 mins vs 37 mins) than did non-menthol smokers.

"That's useful to know because we believe that the shorter that time period is, the more nicotine-dependent the smoker is likely to be," said Ahijevych.

It also suggests that a link may exist between menthol and nicotine dependence, she said.

It also indicates that clinicians should not use "number of cigarettes smoked per day" as their only estimate of a patient's nicotine dependence, said Ahijevych.

"Asking smokers how soon after getting out of bed they have their first cigarette of the day also has important implications for treatment."

This research was funded by a grant from the American Lung Association.


Written by Darrell E. Ward, 614-292-8456;