Menthol Increases Nicotine Addiction By Tweaking Brain
The menthol in menthol cigarettes could be making people more addicted to nicotine
Its a fresh problem. People who smoke menthol cigarettes often smoke more frequently and can be less likely to quit and it could be because fresh-tasting menthol is changing their brains to more sensitive to nicotine.
How menthol enhances nicotine addiction has been something of a mystery. Now, Brandon Henderson at the California Institute of Technology in Pasadena and his colleagues have shown that exposing mice to menthol alone causes them to develop more nicotinic receptors, the parts of the brain that are targeted by nicotine.
Menthol can be used medically to relieve minor throat irritations, and menthol-flavoured cigarettes were first introduced in the 1920s. But smokers of menthol cigarettes can be less likely to quit. In one study of giving up smoking, 50 per cent of unflavoured-cigarette smokers were able to quit, while menthol smokers showed quitting rates as low as 23 per cent, depending on ethnicity.
Over time, smokers of both menthol and unflavoured cigarettes acquire more receptors for nicotine, particularly in neurons involved in the bodys neural pathways for reward and motivation. And research last year showed that smokers of menthol cigarettes develop even more of these receptors than smokers of unflavoured cigarettes.
Ii Menthol Blunts The Aversive Sensory Experience Of Smoking Tobacco Cigarettes
Recent publicly available data from tobacco company records strongly suggested the reason for including menthol as an additive was to minimize the aversive experiences associated with tobacco smoking and, thus, decrease smokings perceived health risk . These documents revealed that smokers of mentholated cigarettes report using them because they have less harsh, less irritating, and more soothing sensory profiles. Moreover, the flavor profile of mentholated cigarettes were reported to be improved compared to non-mentholated cigarettes, likely due to the appetitive minty flavor of menthol as well as its ability to mask aversive flavors of tobacco.
Cigars And Little Cigars
Many people view cigar smoking as more sophisticated and less dangerous than cigarette smoking. Yet one large cigar can contain as much tobacco as an entire pack of cigarettes.
Most cigars are made of a single type of aged, air-cured or dried tobacco thats fermented in a multi-step process. The fermentation causes chemical and bacterial reactions that change the tobacco. This is what gives cigars a different taste and smell from cigarettes. Cigars come in many sizes:
- The smallest, known as little cigars or small cigars, are about the size of cigarettes. Other than the fact that they are brown and maybe a little longer, they look like cigarettes. They come in flavors like mint, chocolate, or fruit, and many have filters. Theyre often sold in packs of 20. Most people smoke these small cigars exactly the same way as cigarettes.
- Slightly larger cigars are called cigarillos, blunts, or cheroots. They contain more tobacco than little cigars, and are also often flavored. Studies suggest that some people smoke them more like cigarettes than cigars, inhaling and smoking every day. They look like small versions of traditional cigars, but they can be bought in small packs.
- True large cigars may contain more than half an ounce of tobacco as much as a whole pack of cigarettes. It can take from 1 to 2 hours to smoke a traditional large cigar.
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Menthol And Racial Disparities
Even though tobacco use has declined over the last few decades, there are still large disparities across groups defined by race, ethnicity, educational level and socioeconomic status. Menthol cigarettes not only contribute to these numbers but frequently are the most popular tobacco product. In fact, studies show that Black Americans, individuals who identify as LGBTQ+, and individuals with behavioral health disorders are more likely to report smoking menthol cigarettes than other population groups. This largely has to do with the tobacco industry targeting certain populations through advertising. For instance, Big Tobacco has been known to market menthols as a smoother or healthier cigarette, and they have used popular musicians or actors to push the message to their target audience.
Youth And Young Adults
Young people use menthol tobacco products, including cigarettes and e-cigarettes, at disproportionally high rates, which could facilitate nicotine addiction.
- Menthol reduces the harshness of cigarette smoke, which may appeal to young, inexperienced smokers.
- Preference for menthol among cigarette smokers remains inversely correlated with age: 49.7% of 12-17-year-old cigarette smokers used menthol compared to 29.2% of those 65 years old or older in 2018.
- Longitudinal studies show that initiation with menthol cigarettes facilitates progression to established cigarette use among young smokers.
- In young people, using menthol cigarettes and cigars first is associated with continued cigarette use. Data from nationally representative samples show that the youngest cigarette smokers use menthol at the highest rates .
- In 2021, 150,000 middle and high school students used menthol cigarettes, based on the National Youth Tobacco Survey. 38.8% of middle and high school students who used cigarettes used menthol cigarettes.
- A nationally representative study found that, among youth and young adults, non-menthol cigarette prevalence declined from 2004 to 2010. By contrast, menthol cigarette prevalence remained constant among youth and increased among young adults over this period.
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Efforts To Ban Menthol Cigarettes Ban Flavored Cigars Build On Previous Flavor Ban And Mark Significant Steps To Reduce Addiction And Youth Experimentation Improve Quitting And Address Health Disparities
Today, the U.S. Food and Drug Administration announced it is committing to advancing two tobacco product standards to significantly reduce disease and death from using combusted tobacco products, the leading cause of preventable death in the U.S. The FDA is working toward issuing proposed product standards within the next year to ban menthol as a characterizing flavor in cigarettes and ban all characterizing flavors in cigars the authority to adopt product standards is one of the most powerful tobacco regulatory tools Congress gave the agency. This decision is based on clear science and evidence establishing the addictiveness and harm of these products and builds on important, previous actions that banned other flavored cigarettes in 2009.
For far too long, certain populations, including African Americans, have been targeted, and disproportionately impacted by tobacco use. Despite the tremendous progress weve made in getting people to stop smoking over the past 55 years, that progress hasnt been experienced by everyone equally, said Mitch Zeller, J.D., director of the FDAs Center for Tobacco Products. These flavor standards would reduce cigarette and cigar initiation and use, reduce health disparities, and promote health equity by addressing a significant and disparate source of harm. Taken together, these policies will help save lives and improve the public health of our country as we confront the leading cause of preventable disease and death.
Bidens Menthol Ban Is Bad Policy
The proposed ban wont improve health outcomes, but will bring more people under government coercion.
After more than a decade of reports, conferences, petitions, proposals and protests, President Joe Bidens Food & Drug Administration just announced its intention to pursue something that many tobacco-control advocates have urged for years: a ban on menthol cigarettes . Since roughly a third of all cigarettes purchased by Americas more than 35 million smokers have menthol as their characterizing flavor and most of the rest contain some of the minty substance, a total ban would rank among Americas most sweeping product bans since national alcohol prohibition began in 1920. As politics, the approach supported by some civil-rights and nearly all prominent tobacco-control groups might pay some dividends. Judged as health policy, however, its a weak gruel at best.
At the end of the day, banning menthol cigarettes wont reduce smoking in any meaningful way. But it will disproportionately affect some of Americas most vulnerable communities: namely, those who already suffer from over-policing. As the American Civil Liberties Union aptly points out , with this proposed ban, the Biden administration runs the risk of prioritizing criminalization over public health and harm reduction.
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Does Menthol Contribute To Addiction
Traditionally, research into the addictive properties of tobacco cigarettes has focused on the actions of nicotine in the brain. The role of menthol has been attracting increasing attention, and emerging research suggests that menthols role in tobacco addiction deserves even closer scrutiny. One of the more significant scientific suggestions is that menthol can alter the metabolism of nicotine in the body. This effect of menthol is shown to provide smokers an enhanced exposure to systemic nicotine and its metabolites . In accordance with this idea, menthol cigarette smokers on the whole are known to exhibit different smoking habits from other smokers. For example, they tend to smoke fewer cigarettes per day, and find it more difficult to quit . Relapse rates are also considerably higher in menthol cigarette smokers suggesting that menthol may contribute more than just flavor.
Menthol is known to directly activate the cold sensitive transient receptor potential melastatin ion channel in cells, which contributes to the cool nasal and oral sensation provided by menthol. Additionally, menthol has been shown to depress respiration and enhance nicotines presence in the lungs . How the mechanisms of menthols actions impact nicotine addiction, on the other hand, is not clear.
Who Uses Menthol Products
Vulnerable populations who lack resources and opportunities that most Americans have are targeted.
Studies show that menthol tobacco products are used more by youth, women, the LGBTQ+ community, those with a mental illness, and racial/ethnic minorities.
The tobacco industry markets menthol in vulnerable communities by sponsoring community and music events, advertising in community shops and stores, and using displays and images that youth respond to.
Research regarding menthol tobacco use among people affected socially and economically disparate groups reveal menthol is preferred by:
- 54% of youth ages 12-17 years
- 70% African American youth ages 12-17 years
- 76.8% of non-Hispanic black adults
- There is a need for more research on menthol use among those people with mental illnesses. Still, studies reveal a connection between high menthol tobacco use and severe mental hardships, and those who smoke menthol cigarettes have worse mental health than those who do not use menthol products.
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Tobacco’s First Flavor Is Its Most Addictive
Menthol cigarettes might be considered the original, flavored tobacco product. Tobacco companies have been marketing the minty flavors cooling sensation to first-time tobacco users since the ingredient was introduced to tobacco products in the 1920s. Menthol can cool and soothe the harshness of tobacco, which may explain why menthol cigarette use is higher among young people than older adults. Sadly, kids who experiment with menthol tobacco products may be more likely to develop a lifelong addiction. Thats because the Food and Drug Administration has determined that menthol actually makes tobacco products more addictive and harder to quit.
Despite its dangerously addictive effects, menthol has been left out of new federal laws that restrict flavored tobacco products. While the FDA has limited the use of trendy flavor names like Fresh Mint and Ice for some types of flavored e-cigarettes, adding menthol to the tobacco products youths like most is still legal.
Is Menthol Bad For You Possible Benefits Vs Dangers
Menthol can naturally be found in peppermint oil and spearmint oil. Its the component that gives both of these herbs their cooling effects.
Youve probably experienced this sensation before if youve tasted menthol cough drops or used a refreshing mouthwash.
It can also be synthetic and found in products that are clearly health hazardous like menthol cigarettes. These cigarettes were originally marketed as a safer and cleaner tobacco product that could even help clear up coughs .
According to FDA Commissioner Scott Gottlieb, menthol cigarettes, menthol vape juice and other flavored tobacco products are contributing to the disturbing trend of youth nicotine use today. More than ever, it seems like the proposed ban on menthol cigarettes is warranted, especially since some experts estimate that during the next 40 years, it could prevent 300,000 to 600,000 deaths.
So is menthol bad for you? Lets take a closer look at a substance that appears in things you may be using on a daily basis .
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History Society And Culture
Nicotine was originally isolated from the tobacco plant in 1828 by chemists Wilhelm Heinrich Posselt and Karl Ludwig Reimann from Germany, who believed it was a poison. Its chemical empirical formula was described by Melsens in 1843, its structure was discovered by Adolf Pinner and Richard Wolffenstein in 1893, and it was first synthesized by Amé Pictet and A. Rotschy in 1904.
Nicotine is named after the tobacco plant Nicotiana tabacum, which in turn is named after the French ambassador in Portugal, Jean Nicot de Villemain, who sent tobacco and seeds to Paris in 1560, presented to the French King, and who promoted their medicinal use. Smoking was believed to protect against illness, particularly the plague.
Tobacco was introduced to Europe in 1559, and by the late 17th century, it was used not only for smoking but also as an insecticide. After World War II, over 2,500 tons of nicotine insecticide were used worldwide, but by the 1980s the use of nicotine insecticide had declined below 200 tons. This was due to the availability of other insecticides that are cheaper and less harmful to mammals.
The nicotine content of popular American-brand cigarettes has increased over time, and one study found that there was an average increase of 1.78% per year between the years of 1998 and 2005.
Using Menthol To Target Minority Communities
Menthol has a long history of being marketed to African American communities. Its still a common practice in low income and racial or ethnic minority neighborhoods, exposing kids of color and their families to two to three times the usual number of cigarette ads, especially for menthol products.
Tobaccos deliberate marketing efforts are working. Nationally, 70.5 percent of African American middle and high school students who report smoking use menthol cigarettes, compared to 51.4 percent of white students. The consequences? Lifelong addiction and the serious, often deadly, health effects of tobacco use are spreading from one generation to the next in Wisconsins communities of color.
Other vulnerable communities are being damaged too. Due to industry targeting, and the toxic stress that members of minority populations can experience, tobacco use disproportionately impacts racial and ethnic minorities, women, people who earn less, or experience homelessness, and those living with mental or behavioral health challenges. Research shows LGBTQ+ youth smoke at higher rates than the national average.
Hit play to learn more about the tricky tobacco industry tactics that have made menthol products an urgent social justice issue for vulnerable populations, including youth, African-Americans, LGBTQ+ people, people living in poverty, and others in Wisconsin.
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Menthol Smokers Are More Likely To Quit Smoking After European Menthol Ban
The EU ban on menthol cigarettes and roll-your-own tobacco introduced in May 2020 led menthol smokers to be more likely to try to quit smoking and to be successful in quitting compared to non-menthol smokers. These are the findings of a national evaluation study conducted among Dutch smokers, which was published today. At the same time, a third of Dutch menthol smokers say they still smoke menthol cigarettes despite the ban. According to the researchers, this is largely the responsibility of the tobacco industry, which has brought a wide range of accessories onto the market to enable smokers to add menthol flavouring to tobacco products themselves. The scientists are therefore calling for an additional ban on these accessories.
Iii Menthol As A Sensory Cue
A separate question that arose was whether the environmental stimuli could drive nicotine self-administration. This question was answered by a series of studies by Caggiula and colleagues examining the impact of environmental cues on acquisition and relapse of nicotine self-administration in rats . In one study, rats were trained to self-administer nicotine either in the presence or absence of contingently paired cues. Rats that received paired cues with nicotine had a much more robust self-administration than rats that had no cue pairing with nicotine . In another study, rats were trained to lever press for nicotine while receiving a paired cue. Afterward, rats underwent extinction in which the lever press had no consequence neither nicotine delivery nor cue presentation occurred upon lever pressing. Then, either the cue, nicotine, or both cue and nicotine were reintroduced to produce reinstatement of self-administration. Interestingly, the addition of the cues alone, and not nicotine alone, produced robust reinstatement of self-administration. The most robust self-administration was produced when both cues and nicotine were reintroduced. Thus, although nicotine itself may serve as a primary reinforcer, cues that have their reinforcing properties enhanced by nicotine may serve to promote smoking behavior and ultimately provoke relapse in abstinent individuals.
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A Focus On Prevention
One of the key tenets of successful tobacco prevention efforts is policy change. The U.S. Food and Drug Administration has proposed new regulations to prohibit menthol in traditional tobacco cigarettes and ban all flavors in little cigars.
“Little cigars is a product category that’s popular in the African American community,” Holm says. “With this new policy, the FDA is aiming to get flavors out of the most dangerous forms of tobacco.”
In addition to policy change, it’s important to understand the dangers inherent in tobacco products and how difficult it is to overcome an addiction. Already hooked? There are many tools and resources to help you quit. You might try a mini-quit where you don’t smoke for a brief period, or gradual weaning, where you reduce the number of cigarettes you smoke each week. You can also try one of the FDA-approved medications that are designed to help people quit smoking while breaking nicotine addiction.
To get help for a tobacco and nicotine addiction, contact the Henry Ford Tobacco Treatment Service. Services include coaching by phone, Freedom from Smoking® classes to help you quit, programs for teens and an ongoing support group.
To find a doctor at Henry Ford, visit henryford.com or call .
Amanda Holm, MPH, is the project manager for the Tobacco Treatment Service in the Henry Ford Center for Health Promotion and Disease Prevention.