How Menthol Cigarettes Increase Blood Nicotine Levels and Mask Warning Signs of Illness
By Bob Sherman
What exactly is the purpose of menthol in menthol cigarettes and how does it affect you?
Menthol is often found in cough medicines and other preparations for minor throat irritation and respiratory dysfunction. Most medicines have a label warning you not to use the products continuously because they may mask warning signs of a serious illness.
Early warning signs of several illnesses include chronic cough, heavy mucus, bronchitis, wheezing, and shortness of breath caused by smoking can be masked or reduced in severity by using mentholated cigarettes. Sensory nerves able to detect cold that exist in the upper respiratory tract are energized by menthol and produce sensations of coolness, comfort and increased airflow--even though airflow had not increased.
Some menthol cigarettes contain around 3 mg of menthol of which 20% is absorbed by the smoker. This is enough to activate the sensory nerve that detect cold. Thus, smokers using mentholated cigarettes may be unaware of early stages of serious illness.
Menthol acts as a local anesthetic and helps produce a cooling sensation to the tongue. This helps reduce the burning sensation produced by cigarette smoke.
Menthol provides a perceived cooling of the upper airway may depress respiratory activity. Studies have shown that healthy people can hold their breath longer when sucking on a lozenge containing menthol.
Menthol can also cause smokers to hold their breath after inhaling and can result in prolonged exposure to nicotine and the 4,000 other substances in tobacco smoke. Not only that, but when holding your breath the air in your lungs is under greater pressure, causing a more rapid transfer into the bloodstream.
Menthol cigarettes typically have higher levels of tar and nicotine than non-mentholated cigarettes. Smokers of menthol cigarettes typically increase the amount of smoke inhaled and hold it longer in their lungs.
Once in the blood, nicotine is broken down to continine. Menthol inhibits this metabolism so the level of nicotine in the blood decreases more slowly. This would allow mentholated cigarette smokers to maintain higher levels of nicotine and yet smoke fewer cigarettes.
No conclusive results describing the direct effects of menthol on smokers have been established. For example, some studies show carbon monoxide concentrations in the blood of mentholated cigarette smokers to be somewhat elevated over that of non-mentholated cigarette smokers. Other studies are inconclusive or show just the opposite effect.
A study of menthol and nonmenthol cigarettes showed that both cigarette types similarity affected heart rate, blood pressure (both systolic and diastolic), and changes in expired carbon monoxide. In addition, the number of puffs and the time to smoke a cigarette were similar. Neither did menthol affect smoker evaluations of cigarette strength when cigarettes of different nicotine composition were smoked.
One study found that adolescent mentholated cigarette smokers report a shorter time to their first cigarette in the morning than nonmentholated smokers. This indicates that mentholated cigarettes may be producing a stronger craving for nicotine than nonmentholated cigarettes. This may mean that menthol helps produce stronger addiction to nicotine.
No conclusive evidence exists to indicate that mentholated cigarettes cause an increase in lung cancer or other smoking related diseases.
African Americans and Menthol Cigarettes
Most African-Americans smoke mentholated cigarettes. Around 75% of African-American smokers smoke mentholated cigarettes while only 10-15% of Caucasian smoke mentholated cigarettes.
A higher percentage of African-American smoke than Caucasian. Although African-Americans generally smoke fewer cigarettes than Caucasian, African-American smokers have a 50% higher risk of developing lung cancer and experience three times the rate of upper respiratory and digestive tract cancers. Deaths from all lung disease is 20.4% higher for African-Americans than for Caucasian.
African-Americans seek medical help at later stages of pulmonary diseases such as lung cancer. Thus, African-Americans are more likely to have advanced cancers.
Of those smokers who do get lung cancer, 54% of Caucasian will die of lung cancer while 81% of African-Americans will die of lung cancer.
Menthol Cigarettes Summary
While much is yet to be learned, mentholated cigarettes appear to mask early signs of severe illness, increase addiction and reduce nicotine metabolism. For these reasons, mentholated cigarettes cannot be recommended as more healthful than regular cigarettes.
References
- Wallace B Pickworth, Eric T Moolchan, Ivan Berlin & Ram Murty, Sensory and physiologic effects of menthol and nonmenthol cigarettes with differing nicotine delivery, Pharmocology, Biochemistry and behavior, v 71, 2002, 55-61.
- C L Gaworski, M M Dozier, J M Gerhart, N Rajendran, L H Brennecke, C Aranyi & J D Heck, 13-Week Inhalation Toxicitty Study of Menthol Cigarette Smoke, Food and Chemical Toxicology, v 35, 1997, 683-692.
- Terri L Richardson, African-American Smokers and Cancers of the Lung and of the Upper Respiratory and Digestive Tracts: Is Menthol Part of the Puzzle?, West Journal of Medicine, v 166, March 1997, 198-194.
- Samuel Garten & Victor Falkner, Continual smoking of mentholated cigarettes may mask the early warning symptoms of respiratory disease, Preventive Medicine, v 39, 2003, 291-296.
- Daniel R Brooks, Julie R Palmer, Brian L Strom & Lynn Rosenberg, Menthol Cigarettes and Risk of Lung Cancer, American Journal of Epidemiology, 158(7) October 1, 2003, 609-616.
- Samuel Garten & Victor Falkner, Role of mentholated cigarettes in increased nicotine dependence and greater risk of tobacco-attributable disease, Preventive Medicine, v 38, 2004, 793-798.
- Neal L Benowitz, Brenda Herrera & Payton Jacob III, Mentholated Cigarette Smoking Inhibits Nicotine Metabolism, The Journal of Pharmacology and Experimental Therapeutics, 310(3), 1208-1215.
- Charles C Collins & Eric T Moolchan, Shorter time to first cigarette of the day in menthol adolescent cigarette smokers, Addictive Behaviors, v 31, 1460-1464.
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