Adding Menthol to Tobacco Increases Addictive Properties and Targets Specific Groups
By Don Drake, Connelly Law Offices, Ltd.
According to RJ Connelly III, a professional fiduciary and certified elder law attorney, cigarette smoking is still the primary cause of preventable disease, disability, and death in the United States. In fact, it is responsible for over 480,000 deaths yearly, equivalent to about 1 in 5 deaths, as per the latest CDC figures. In 2021, almost twelve out of every one hundred adults aged 18 years or older smoked cigarettes, translating to an estimated 28.3 million adults who currently smoke cigarettes.
Unfortunately, more than sixteen million Americans are living with a smoking-related disease. Though the number of active smokers has decreased over time, the sale and use of menthol cigarettes remain robust in the tobacco market.
"As an elder law attorney, it is heartbreaking to see adults dying in the prime of life and leaving young family members behind," stated Attorney Connelly. "What's so frustrating is that it is a preventable death. Although we try to educate about the dangers of tobacco use, it falls on deaf ears when slick advertising makes it so enticing. What's even more anger-inducing is the way the advertising targets specific communities. The marketing of menthol flavored tobacco is an abject lesson in this devious practice."
The communities Attorney Connelly speaks of are more appropriately defined by race. It is essential to consider the race of menthol cigarette smokers, as they make up 37% of the cigarette market in the United States. Here is a breakdown of the percentages by race:
85% of African American tobacco users smoke menthols.
46% of Hispanic American tobacco users smoke menthols.
39% of Asian American tobacco users smoke menthols.
Before delving into the role of race and menthol cigarettes, it is vital to understand the nature and effects of menthol. Let's explore this topic first.
Menthol is a type of alcohol that can be made from mint oils or created artificially. It is a covalent organic compound that has a waxy, crystalline texture and can be either clear or white in appearance. At room temperature, it is solid and only slightly melts when heated. Menthol stimulates cold receptors and can be found naturally in peppermint and corn oil. It is commonly used to mask the harshness of cigarette smoke and create a cooling sensation, and according to users, does promote further tobacco use.
Tobacco companies have influenced the perception of menthol cigarettes by consumers. It is not just used as a flavoring agent, as cigarette companies use its ability to mask irritation and provide sensory effects to make menthol cigarettes more appealing to youth and health-conscious smokers. This is particularly true for low-tar cigarettes, which are made more palatable with menthol. As a result of targeted marketing, young people, women, and African Americans more commonly smoke menthol cigarettes.
The addition of menthol in tobacco products further complicates nicotine's addictive effects. Despite being labeled "menthol" or not, tobacco companies add menthol to over 90% of their products, proving that it is being used as more than just a flavor or brand. The reason is this -- menthol affects the sensory characteristics of cigarettes and interacts with nicotine in a way that affects smoking behavior, regardless of whether it is consciously perceived or not.
Additionally, menthol increases fine particles in cigarette smoke, which can immediately increase the risk of heart attack. Menthol flavoring also allows the lungs to expand further, causing more of the toxic and cancer-causing chemicals in cigarette smoke to be absorbed into the body, leading to increased addiction, disease, and death.
The History of Menthol and Tobacco
Lloyd "Spud" Hughes, an Ohio resident, is recognized for introducing American smokers to the "refreshing taste" of menthol cigarettes a century ago. While working as a cashier in a restaurant, Hughes proposed adding menthol flavoring to create the perception of a "cooler" smoking experience. This led to the launch of Spud brand cigarettes, which became the first widely sold menthol cigarettes in America. By 1932, Spuds had climbed to the fifth position in popularity among cigarettes nationwide.
The popularity of Spud caught the interest of Brown & Williamson tobacco company, who created their own menthol brand, Kool, in 1932. Kool was initially marketed towards high-end smokers and had a mascot of a cartoon penguin wearing a top hat and monocle. Menthol cigarettes became even more popular in 1956 with the launch of Salem by R.J. Reynolds, which was the first menthol cigarette with a filter.
Tobacco companies continued to market menthol cigarettes as being "fresher" and "healthier" even though neither the filter nor the menthol protected smokers from the harmful effects of cigarettes. Salem print ads in the early '70s promoted the brand's "natural" menthol, claiming it gave the cigarettes a taste as soft and fresh as springtime. Similarly, the makers of menthol Newport launched a long-running campaign promoting the brand as being "Alive with Pleasure."
Interestingly, approximately 30% of all cigarettes sold in the United States are flavored with menthol. Surprisingly, only two other countries, the Philippines and Cameroon, have higher rates of menthol cigarette use. Additionally, the U.S. has had a racial component to menthol cigarette consumption since the 1960s. African American smokers prefer menthol cigarettes and are four times more likely than white smokers to choose menthol brands.
Race as a Component
The origin of African Americans' preference for menthol cigarettes remains unknown. However, targeted marketing efforts have solidified this preference, leading to what Phillip Gardiner, a research scientist at the University of California's Tobacco Related Disease Research Program, refers to as the "African-Americanization" of menthol cigarette usage.
In the early 1950s, research conducted by tobacco companies revealed that African American smokers slightly preferred the menthol brand, Kools. This led companies to target the black community by marketing menthol cigarettes directly to them.
Elston Howard, a renowned African American baseball player, became a spokesperson for menthol Kools in the late 1950s. Advertisements featuring Howard, who was a star catcher for the New York Yankees, claimed that the cigarettes offered a new level of smoothness "deep in the throat." Studies have shown that this targeted advertising makes Black Americans more likely to smoke menthol cigarettes than other groups. But there may also be another reason.
According to MedPage Today, researchers have discovered a genetic variant exclusively in individuals of African descent that they say significantly increases their preference for smoking menthol cigarettes. This research is still new, and the genetic variant only affects 8% of black Americans, so targeted advertising still appears to be the most significant contributor to the issue.
Menthol and Addiction
Smoking tobacco cigarettes is the leading cause of preventable death in the US, with one in five Americans dying prematurely due to it. Despite tobacco companies' unproven health claims about mentholated products, menthol-flavored cigarettes are proven to be more addictive. In fact, smokers of these flavored cigarettes have lower success rates when trying to quit and may even be resistant to traditional treatments, both behavioral and pharmacological.
Recent research has shown that menthol may impact the addictive potential of nicotine-containing tobacco products through various biological mechanisms. Let's review these.
Menthol changes nicotinic receptors' expression, function, and stoichiometry (calculating products and reactants in a chemical reaction).
Menthol's chemosensory properties can mask the unpleasant properties of using tobacco products.
Menthol's chemosensory properties serve as a conditioned cue that can increase nicotine intake and lead to relapse.
Menthol can alter nicotine metabolism, increasing its bioavailability.
Adding menthol to nicotine can lead to increased communication between two areas of the brain. These two areas are the reward and memory pathways, which are already known to play a role in nicotine addiction and withdrawal.
Addressing the Problem
Flavored tobacco products, including menthol cigarettes, were restricted from sale in Massachusetts in November 2019, making it the first state to do so. Following suit in 2020, New Jersey, New York, and Rhode Island implemented similar regulations on flavored e-cigarettes. Additionally, California joined in on the ban by prohibiting the sales of both flavored e-cigarettes and menthol cigarettes, becoming the second state to follow Massachusetts' lead.
Initially, the Food and Drug Administration had intended to establish guidelines to prohibit menthol flavorings in cigarettes and cigars by June of 2022, with plans to implement the ban in May 2023. However, the announcement was postponed, and the final rules from the FDA are expected to be revealed sometime this month (August 2023).
A Final Word
As Attorney Connelly stated, our time on this earth is limited, and losing someone early due to tobacco use of any kind is a tragedy, mainly because it is a preventable death. Additionally, we should all acknowledge and call out tobacco companies for using any type of targeted advertising. Smoking, whether unflavored or flavored tobacco products, can harm almost every part of the body and is responsible for one in five deaths in the United States. It can also lead to other cancers and health issues.
Attorney Connelly emphasizes that no amount of tobacco use is safe, and even smoking just one cigarette daily over a lifetime can result in smoking-related cancers and premature death. Here's the bottom line, quitting smoking can help reduce the risk of health issues and premature death.