Adding menthol to cigarettes increases smoking frequency and nicotine addiction in young people


Currently in the public consultation phase, the U.S. Food and Drug Administration is set to finalize rules banning menthol in tobacco products, citing an effort to reduce addiction and experimentation among young people, improve the quitting current smokers and addressing health disparities. A nationally representative study of 1,092 young people in the United States, conducted between 2013 and 2019, provides evidence in support of this FDA action.

Published in the June 6, 2022, online issue of JAMA Network Open by researchers at the University of California, San Diego Herbert Wertheim School of Public Health and Human Longevity Science, the study noted that the proportion of older cigarette smokers 12 to 17 year olds who smoked menthol increased to 56% and these menthol cigarettes seem to have caused them to smoke more frequently and become more addicted to nicotine.

The “cooling” sensation of menthol masks the harshness of tobacco which can make cigarettes more palatable to young people. Additionally, this cooling sensation can allow the smoke to be inhaled more deeply and stay longer, which can lead to more nicotine absorption per puff.”

Eric Leas, Ph.D., MPH, senior author, assistant professor at UC San Diego Herbert Wertheim School of Public Health and Human Longevity Science

“It can accelerate physical dependence on nicotine, leading young people to smoke more often,” Leas said.

Using data from the nationally representative longitudinal Population Assessment of Tobacco and Health (PATH) study, undertaken by the National Institute on Drug Abuse and the FDA Center for Tobacco Products under contract to Westat, the researchers compared cigarette use menthol flavored and menthol free.

Among youth who smoked, menthol cigarette use was associated with 2.8 more days of smoking in the past 30 days, a 38% higher risk of frequent smoking, and 8% higher nicotine dependence .

Young people who switched from menthol to unflavored cigarettes smoked 3.6 days less over a 30-day period, were 47% less likely to be a frequent smoker and 3% less addicted to nicotine.

About menthol cigarettes

  • Menthol is a natural chemical found in mint oils, but it is also produced synthetically in the laboratory.
  • In addition to the “menthol” taste, menthol has pain-relieving and anesthetic properties.
  • Menthol was first added to tobacco in the 1920s and 1930s. Today, nearly 18.6 million current smokers use menthol cigarettes in this country.
  • Marketing of menthol products has been targeted at Black and LGBTQ+ people and low-income communities. About 85% of black smokers use menthol cigarettes compared to 48% of Latinos, 41% of Asians and 30% of white smokers. The FDA reported that the use of menthol cigarettes declined among white youth, but did not decline among black or Latino youth.

Towards a ban on menthol

According to the Centers for Disease Control and Prevention, smoking remains the leading cause of preventable disease, disability, and death in the United States. Tobacco use is associated with 1 in 5 deaths. Over 90% of current smokers started smoking in adolescence, and an estimated 80% of young people who started smoking with flavored tobacco products.

“Some studies predict that banning menthol could avert up to 633,000 deaths,” said lead author John P. Pierce, Ph.D., professor emeritus at the Herbert Wertheim School of Public Health and UC San Diego Moores Cancer Center.

“Our results suggest that adding menthol to cigarettes increases smoking frequency and nicotine dependence in young people. Menthol cigarettes also complicate their progress towards smoking cessation. These results strongly support the proposed ban by the FDA of menthol flavoring in cigarettes to protect our youth.

Co-authors include Tarik Benmarhnia and David Strong of UC San Diego.


University of California San Diego

Journal reference:

Leas, EC, et al. (2022) Use of menthol cigarettes, smoking frequency, and nicotine addiction among American youth. JAMA network open.


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