Menthol Cigarette Smoking and Oesophageal Cancer

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Abstract
Hebert J R (Division of Epidemiology, American Health Foundation, 320 E 43rd St, New York, NY 10017, USA) and Kabat G C. Menthol cigarette smoking and oesophageal cancer. International Journal of Epidemiology 1989, 18: 37–44. Oesophageal cancer incidence and mortality among American blacks is over three times the rate for whites. Between 1950 and 1977 the age-adjusted oesophageal cancer mortality rate approximately doubled in non-whites while remaining virtually unchanged in whites. Between World War II and the 1970s menthol cigarette sales dramatically increased, roughly parallelling the increase in oesophageal cancer among blacks. The present study uses existing data from a large hospital-based case-control study to test whether menthol cigarette smoking is related to oesophageal cancer. Oesophageal cancer cases were current smokers. Controls were matched to the cases on age (±5 years) and sex, had conditions thought not to be related to tobacco use, and were also current smokers. Tabular analyses showed no change in risk for males ever-smoking menthol versus those never smoking menthol cigarettes. For women, however, there was an increased risk. Results of logistic regression analyses performed to account for potential confounding factors showed a marginally significant (P = 0.08) decrease in risk among male short term (<10 years) menthol smokers versus male never-menthol smokers (OR = 0.50, 95% CI: 0.23–1.07) but no increased risk for menthol smoking of longer duration. Duration of menthol smoking fitted as a continuous variable showed no increased risk(P = 0.9) after accounting for non-menthol cigarette smoking duration (about 2% per year increase, P = 0.02). For females, the logistic analysis produced a marginally significant (P = 0.07) increased risk for longer menthol use (OR = 2.30, 95% CI: 0.93–5.72). Integer years of menthol smoking showed about a 5% increase in risk per year (P = 0.09) while non-menthol duration showed only a 2% increase (P = 0.15). Future studies that can more definitively test the hypothesis are recommended.

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