This document does not constitute a decision about what regulatory action, if any, FDA might take with respect to menthol in cigarettes. Health Effects of Menthol vs. Nonmenthol Cigarettes (Executive Summary) by Food and Drug Administration

The FDA might be pressured to make a decision soon after seeing the rapturous press for their report.

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There were consistent findings that menthol smokers are more likely to smoke their first cigarette within five minutes of waking. Health Effects of Menthol vs. Nonmenthol Cigarettes (Executive Summary) by Food and Drug Administration

Given the fact that those who smoke upon waking up have a greater risk of cancer, this adds to the belief that menthols are more dangerous than regular cigarettes.

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No studies found an increased risk of cancer or non- cancer diseases in menthol smokers compared to nonmenthol smokers. Health Effects of Menthol vs. Nonmenthol Cigarettes (Executive Summary) by Food and Drug Administration

The FDA may have missed this study:

As a result of breath holding that results from the stimulation of cold receptors there is a greater opportunity for exposure and transfer of the contents of the lungs to the pulmonary circulation. For the menthol smoker this results in a greater exposure to nicotine and the particulate matter (tar) of the smoked cigarette. This exposure can result in increased nicotine dependence and greater chance of tobacco-attributable disease.

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The weight of evidence supports the conclusion that menthol in cigarettes is likely associated with increased initiation and progression to regular of cigarette smoking. Health Effects of Menthol vs. Nonmenthol Cigarettes (Executive Summary) by Food and Drug Administration

Reuters reported in 2012 that youth who begin with menthol cigarettes are more likely to become habitual smokers than their peers who start out with the regular variety.

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Advertising is a strong driver of brand preference among adolescents Health Effects of Menthol vs. Nonmenthol Cigarettes (Executive Summary) by Food and Drug Administration

U.S. News reported in 2009 that tobacco company ads are reaching teenagers and influencing their desire to smoke and what brands they choose.

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Data support that a majority of African American smokers smoke menthol cigarettes Health Effects of Menthol vs. Nonmenthol Cigarettes (Executive Summary) by Food and Drug Administration

Nearly 75% of African American smokers smoke menthols.

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From the available studies, the weight of evidence supports the conclusion that menthol in cigarettes is likely not associated with increased or decreased levels of biomarkers of exposure. Health Effects of Menthol vs. Nonmenthol Cigarettes (Executive Summary) by Food and Drug Administration

Indeed, several medical journals found that smokers of menthol and nonmenthol cigarettes exhibited similar levels of biomarkers of smoke exposure.

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The evaluations were not an attempt to establish causality. Health Effects of Menthol vs. Nonmenthol Cigarettes (Executive Summary) by Food and Drug Administration

…meaning that the study was conductive with an objective mentality.

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Inherent risks of all tobacco products Health Effects of Menthol vs. Nonmenthol Cigarettes (Executive Summary) by Food and Drug Administration

From the Rhode Island Department of Health:

Tobacco use is known to cause lung and oral cancers and is strongly linked to many other types of cancer, including cancers of the breast, pancreas, colon, and cervix. It is a contributing and complicating factor for diabetes, heart disease, high blood pressure, and many other chronic and debilitating diseases.

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Weight of scientific evidence Health Effects of Menthol vs. Nonmenthol Cigarettes (Executive Summary) by Food and Drug Administration

According to an article on the Social Research Network, the term “weight of evidence” (WOE) is used to characterize a process or method in which all scientific evidence that is relevant to the status of a causal hypothesis is taken into account. Clinicians use a form of WOE in making diagnoses, and judges may defer to it when they offer opinions on the reliability of evidence.

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