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Prev Med Rep. 2015 Oct 30;2:946-52. doi: 10.1016/j.pmedr.2015.10.010. eCollection 2015.

Menthol cigarette smoking and obesity in young adult daily smokers in Hawaii.

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University of Hawaii Cancer Center, University of Hawaii at Manoa, 701 Ilalo Street, Honolulu, HI 96813, USA.
University of Washington, Box 357630, H375 Health Science Building, Seattle, WA 98195-7630, USA.
University of Hawaii at Manoa, School of Nursing and Dental Hygiene, 2528 McCarthy Mall, Webster Hall, Honolulu, HI 96822, USA.
TMF Health Quality Institute, 5918 W Courtyard Drive, Austin, TX 78730, USA.
325 Elm Street Cambridge, MA 02139, USA.
University of Kentucky College of Public Health, 151 Bowman Hall 343, Lexington, KY 40506, USA.


This study investigates 1) the relationship between menthol cigarette smoking and obesity and 2) the association of body mass index with the nicotine metabolite ratio among menthol and non-menthol daily smokers aged 18-35 (n = 175). A brief survey on smoking and measures of height and weight, carbon monoxide, and saliva samples were collected from participants from May to December 2013 in Honolulu, Hawaii. Multiple regression was used to estimate differences in body mass index among menthol and non-menthol smokers and the association of menthol smoking with obesity. We calculated the log of the nicotine metabolite ratio to examine differences in the nicotine metabolite ratio among normal, overweight, and obese smokers. Sixty-eight percent of smokers used menthol cigarettes. Results showed that 62% of normal, 54% of overweight, and 91% of obese smokers used menthol cigarettes (p = .000). The mean body mass index was significantly higher among menthol compared with non-menthol smokers (29.4 versus 24.5, p = .000). After controlling for gender, marital status, educational attainment, employment status, and race/ethnicity, menthol smokers were more than 3 times as likely as non-menthol smokers to be obese (p = .04). The nicotine metabolite ratio was significantly lower for overweight menthol smokers compared with non-menthol smokers (.16 versus .26, p = .02) in the unadjusted model, but was not significant after adjusting for the covariates. Consistent with prior studies, our data show that menthol smokers are more likely to be obese compared with non-menthol smokers. Future studies are needed to determine how flavored tobacco products influence obesity among smokers.


Body mass index; Menthol; Obesity; Smoking; Young Adults

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