Use of menthol in cigarettes, its pharmacological and toxocological effectsby Ferris Wayne G, Garrett B, Connolly G, Henningfield J
Menthol cigarettes are the only additive-based cigarette market category, constituting more than a quarter of the overall market. Public health research has suggested patterns of use of mentholated brands as a potential explanation for the health disparities between black (largely menthol) and white (largely non-menthol) smokers, and has explored the effects of menthol on smoker behavior, consumption patterns and consequent delivery of smoke constituents. However, few published studies have directly examined the biochemical and physiological impact of menthol delivery in cigarettes. Reviewed studies describe a range of physiological and respiratory effects of menthol that may effect perception of menthol in cigarettes. These effects could have important implications for use patterns and uptake, as well as increased toxic effects. Most significant from a public health perspective is the potential for increased uptake of nicotine and smoke constituents due to reduced perception of irritation, enhanced absorption, and deeper/ longer inhalation; increased toxicity and respiratory irritation; and potential CNS effects produced by prolonged menthol uptake. However, further studies are needed in these areas. We conclude that the unique design of menthol cigarettes and their potential effects should be considered separately from non-menthol cigarettes in research, cessation treatment, and developing and enacting tobacco product regulations.