MONDAY, April 9 (HealthDay News) -- Menthol cigarettes may pose
an even greater risk for stroke than other types of cigarettes,
especially for women and non-black smokers, says a new, large
In the latest look at the hazards of menthols vs. regular
cigarettes, Canadian researchers found the stroke risk for those
who smoked menthols was more than twice that for regular-cigarette
smokers. And for women and non-blacks, the risk was more than three
But no elevated risk was seen between mentholated cigarette
smoking and high blood pressure, heart attack, heart failure and
the lung disease chronic obstructive pulmonary disease (COPD), the
Exactly how, or if, smoking menthol cigarettes raises risk of
stroke more than other cigarettes types is not fully
"One potential mechanism is that menthol stimulates upper-airway cold receptors, which can increase breath-holding time, which may in turn facilitate the entrance of cigarette particulate matter into the lungs," said study author Dr. Nicholas Vozoris of St. Michael's Hospital, in Toronto. "Why smoking mentholated cigarettes would not result in an increase in forms of cardiopulmonary disease, other than stroke, is not clear."
The findings appear in a research letter published April 9 in
Archives of Internal Medicine.
Blacks are more likely to smoke menthol cigarettes than white
smokers, but their stroke risk was lower in this study compared to
non-blacks. "While this group has higher risk for stroke than
Caucasians in general, this study found that the increased stroke
risk among mentholated cigarette smokers was actually driven by
non-African Americans, and not African-Americans," he said.
The findings should not be interpreted as any one type of
cigarette is safer than any other. "There is no 'good' cigarette
type," Vozoris said. "Smoking any kind of cigarette is bad for
one's health, and serves to increase one's risk for a variety of
cancers, heart diseases and lung diseases. However, this study
shows that smoking mentholated cigarettes may place one at even
higher risk for stroke than smoking regular, non-mentholated
To date, research on menthol cigarettes has been inconclusive.
Last year, a U.S. Food and Drug Administration advisory panel said
a ban on mentholated cigarettes might benefit the public health
because the minty flavor seems to help people take up smoking more
readily. However, the panel did not conclude that menthols were
more harmful than regular cigarettes in terms of risks for lung
cancer or other respiratory ailments.
Shortly after that recommendation was made, a study published in
Journal of the National Cancer Institute reported that people
who smoke menthol cigarettes might even have a somewhat lower risk
of developing and dying from lung cancer than other smokers.
For this new study, the researchers used data from the 2001-2008
U.S. National Health and Nutrition Examination Surveys on more than
5,000 smokers age 20 and older. About 26 percent said they usually
The researchers found that stroke risk associated with smoking
menthols was 2.25 times higher compared to regular smokers; 3.28
times higher for women, and 3.48 times higher for non-blacks.
However, Vozoris said the new study has several limitations. The
researchers didn't account for drug treatment that might have
affected the findings, and the smoking habits were self-reported.
Also, former smokers weren't included in the data.
Dr. Clinton Wright, an associate professor of neurology at the
University of Miami Miller School of Medicine, said that more study
is needed before any conclusions can be drawn about specific health
risks associated with specific types of cigarettes. "Very little
work has been done on mentholated cigarettes," he said.
Also, the new study "only shows an association, it does not show
any cause and effect," he added.
Still, "mentholation may have chemicals involved in the process
that may carry their own risks," he said. As to the finding that
this elevated stroke risk was driven by whites, Wright said that
the study may not have had enough blacks to pick up on a higher
risk in this group.
The U.S. Centers for Disease Control and Prevention has more on
ills of smoking.