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A cross-sectional study on tobacco use and dependence among women: Does menthol matter?

Judith Rosenbloom12, Vaughan W Rees3, Kathleen Reid14, Jeannie Wong15 and Taru Kinnunen1*

Author Affiliations

1 Tobacco Dependence Treatment & Research, Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Harvard Medical School, 188 Longwood Avenue, Boston, MA, 02115, USA

2 Total Health Care, 1501 Division Street, Baltimore, MD, 21217, USA

3 Center for Global Tobacco Control, Department of Society, Human Development and Health, Harvard School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA

4 Department of Psychiatry, Boston Medical Center, 771 Albany Street, Dowling 7103, Boston, MA, 02118, USA

5 Oliver Wyman, Health & Life Sciences, 1166 Avenue of the Americas, New York, NY, 10036, USA

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Tobacco Induced Diseases 2012, 10:19  doi:10.1186/1617-9625-10-19

Published: 27 November 2012



The question of whether mentholation of cigarettes enhances tobacco dependence has generated conflicting findings. Potential mediating factors in a putative relationship between menthol use and tobacco dependence may include race and gender. While an association between menthol use and dependence is mixed, research on the role of race solely among women smokers is scarce. This study examined whether women menthol smokers have higher tobacco use and dependence than non-menthol smokers. Further, the study investigated differences between White and African American smokers.


A cross-sectional study was conducted among 928 women seeking tobacco dependence treatment in Boston, Massachusetts. Measures obtained included preferred brand and menthol content, dependence markers (cigarettes per day (CPD); time to first cigarette in the morning; number of and longest previous quit attempts) and smoking history (age of initiation; years smoking; menthol or non-menthol cigarette preference). Analysis of variance (ANOVA) was used to detect interactions between menthol preference by race for continuous variables, and Pearson’s chi-squared test was used for analyses with dichotomous variables.


A greater proportion of menthol smokers smoked their first cigarette within five minutes of waking (p < 0.01) and were less likely to have a previous quit attempt longer than 90 days (p < 0.01). ANOVAs revealed no main effects for menthol preferences. However, African American smokers smoked fewer CPD (p<.001), started smoking later in life (p= .04), and had been smoking the same brand for longer (p= .04).


Women menthol smokers showed signs of greater tobacco dependence than non-menthol smokers. African Americans smoked fewer CPD but nevertheless had evidence of greater dependence.

Cigarette smoking; Menthol cigarettes; Tobacco use; Tobacco dependence; Race/Ethnicity; Female Sex/Gender