Menthol is a controversial cigarette additive because its physiologic or pharmacologic effects may possibly increase the risk for
cancer and its targeted market is the Black community. In a community-based cross-sectional study on 525 Black and White volunteers, we compared levels of urinary and plasma
cotinine, plasma
thiocyanate, urinary 4-(N-nitrosomethylamino)-1-(3-pyridyl)-1-butanol (NNAL), and its detoxified form (
NNAL-Gluc) between
menthol and nonmenthol smokers. In regression models that adjusted for daily cigarette intake, no significant differences were observed in the concentration of these
biomarkers by
menthol status in both races. There was no significant association between high Fagerstrom
nicotine dependence scores and the use of
menthol cigarettes (odds ratio, 1.1; 95% confidence interval, 0.6-2.0), but an increased risk was observed with smoking a cigarette soon (<or=30 minutes) after waking (odds ratio, 2.1; 95% confidence interval, 1.0-3.8). The ratio of
NNAL-Gluc to NNAL, a possible
indicator of
lung cancer risk, was significantly lower in
menthol versus nonmenthol smokers. The
NNAL-Gluc/NNAL ratio was 34% lower in Whites (P < 0.01) and 22% lower in Blacks. In subsequent human liver microsome studies,
menthol inhibited the rate of NNAL-O-glucuronidation and NNAL-N-glucuronidation. Collectively, these results show that
menthol does not affect
biological exposure to tobacco
smoke constituents but indicates that
menthol might inhibit the detoxification of the potent lung
carcinogen NNAL.