Menthol and nonmenthol cigarettes appear to be equally harmful to the arteries and to lung function, but smokers of menthols may be less likely to attempt or succeed at quitting, according to a report in the September 25 issue of Archives of Internal Medicine.

The researchers found that those who smoked menthol cigarettes in 1985 were more likely to still be smoking at follow-up examinations—in 2000, for example, 69% were still smokers versus 54% of nonmenthol smokers. Once the researchers factored in other social and demographic variables, however, most of this difference was explained by the fact that African Americans were both more likely to smoke menthols and less likely to quit smoking. “Among smokers who tried to quit, menthol seemed unrelated to quitting, but menthol was associated with a lower likelihood of trying to quit in the first place,” the authors write. Analyzing the data over time, they found that menthol smokers were almost twice as likely to relapse after quitting and also were less likely to stop for a sustained period of time. Both coronary calcification and a decline in lung function over 10 years were associated with the number of cigarettes smoked, but whether the cigarettes were menthol or not did not appear to make a difference.

“Mentholation of cigarettes does not seem to explain disparities in ischemic heart disease and obstructive pulmonary disease between African Americans and European Americans in the United States but may partially explain lower rates of smoking cessation among African American smokers,” the authors conclude. “It is possible, therefore, that switching from menthol cigarettes to nonmenthol cigarettes might facilitate subsequent smoking cessation, especially in African Americans, and thereby reduce tobacco-related health disparities.”