Lung Cancer Mortality Risk for U.S. Menthol Cigarette Smokers

The U.S. Food and Drug Administration is currently assessing the public health impact of menthol cigarettes. Results from a recent U.S. cohort study, composed largely of Blacks and limited to 12 Southern states, found that menthol cigarette smokers had lower risks of lung cancer incidence and mortality than nonmenthol smokers. We conducted a survival analysis of current smokers from the 1987 National Health Interview Survey Cancer Control Supplement (n = 4,832), followed for mortality through linkage with the National Death Index. We estimated mortality hazard ratios (HRs) for menthol smokers compared with nonmenthol smokers, adjusting for a full set of demographic and smoking characteristics. The overall HR for lung cancer mortality for menthol smokers was 0.69 (95% CI = 0.45-1.06). The HR for lung cancer mortality for menthol smokers at ages 50 and over was 0.59 (95% CI = 0.37-0.95). All-cause mortality net of lung cancer mortality did not differ for menthol and nonmenthol smokers. We found evidence of lower lung cancer mortality risk among menthol smokers compared with nonmenthol smokers at ages 50 and over in the U.S. population. It is not known, however, if these differences are due to the impact of menthol on cigarette smoking or long-term differences in cigarette design between menthol and nonmenthol cigarettes.