EFFECT OF MENTHOL CIGARETTES ON BIOCHEMICAL MARKERS OF SMOKE EXPOSUREAMONG BLACK-AND-WHITE SMOKERS

Study objectives: Black smokers have been reported to have higher seru m cotinine levels than do white smokers, and have higher rates of most smoking-related diseases, despite smoking fewer cigarettes per day. A nother striking racial difference is the preference for mentholated ci garettes among black smokers. The contribution of menthol to variabili ty in biochemical markers of cigarette smoke exposure (end-expiratory carbon monoxide and serum cotinine) was evaluated in a biracial sample . Design: Descriptive cross-sectional. Setting: A university smoking r esearch laboratory. Participants: Sixty-five black and 96 white adult established smokers who were paid for their participation. Measurement s: Information was obtained through direct observation, self-report (i nterview and self-administered questionnaires), measurement of butts c ollected for a week, and laboratory analyses of the biochemical marker s of exposure. Results: Compared with the white smokers, the black smo kers had significantly higher cotinine and carbon monoxide levels per cigarette smoked and per millimeter of smoked tobacco rod (both p<0.00 1). After adjusting for race, cigarettes per day, and mean amount of e ach cigarette smoked, menthol was associated with higher cotinine leve ls (p=0.03) and carbon monoxide concentrations (p=0.02). Conclusions: The use of methanol may be associated with increased health risks of s moking. Menthol use should be considered when biochemical markers of s moke exposure are used as quantitative measures of smoking intensity o r as indicators of compliance with smoking reduction programs. In addi tion, the effect of menthol on total ''dose'' should be considered in any efforts to regulate the amount of nicotine in cigarettes.