Menthol versus regular cigarettes: Which is more harmful?

Dear Alice,

I have heard that menthol cigarettes are more harmful than regular ones. Is this true, and if so, why?

Dear Reader,

In terms of safety, there doesn’t seem to be any difference between a menthol and non-menthol cigarette. Both types of tobacco products are associated with illness and mortality. However, it may not be the menthol cigarettes themselves, but the way that they’re smoked that poses the real risk to a person’s health. Menthol, a mint-derived substance, causes skin to feel cooler by arousing nerve endings that sense cold temperatures. In cigarettes, manufacturers use menthol as a flavor additive because it can soothe and cool the irritation that’s associated with smoking. Menthol ingestion from cigarettes is carried to the liver, where it’s broken down into harmless chemicals that are then excreted from the body. With that in mind, some research suggests that those who smoke menthol cigarettes take in a higher concentration of carcinogens and experience more smoking-related illnesses than do people who smoke regular cigarettes.

This difference between the two tobacco products may be due to how a typical user tends to inhale more tobacco smoke with each drag due to the menthol’s cooling sensation. This extra intake of carcinogenic substances may be the cause of higher incidences of smoking-related sicknesses among menthol smokers. As a result, menthol cigarette smokers may become more quickly addicted and may smoke more cigarettes than those who smoke non-mentholated cigarettes. The cycle tends to repeat, with smokers continuing to smoke more cigarettes to feed the addiction. Thus, smokers of menthol cigarettes have a higher rate of smoking-related ailments than smokers of regular cigarettes. Smokers who choose menthol cigarettes may also have more difficulty quitting as well.

Of course, the experience of using menthol cigarettes varies from person-to-person. A number of factors are at play, including the amount of smoke per drag and the various types and brands of cigarettes smoked. The design of the cigarette and filter can even change how much smoke people can inhale each time (e.g., filtered versus unfiltered cigarettes, fingers covering holes in filter, etc.).

Regardless of these variables, the bottom line still stands: any type of smoking is harmful to one's health, even if someone is not inhaling, or if s/he is inhaling secondhand smoke. For even more information about tobacco products, associated health risks, and cessation resources visit Smokefree.gov.

Last updated Dec 18, 2015
Originally published Apr 22, 2005