Relationship of Menthol Cigarett Smoking with COPD, Comorbidities, and CT Metrics

초록

Rationale: Menthol cigarettes contain higher levels of menthol to produce a characteristic mint flavor and cooling sensation. Compared to non-menthol cigarettes, little information on the effects of menthol cigarette smoking on clinical and radiologic characteristics of chronic obstructive pulmonary disease (COPD). The main objective of the present study was to examine associations between menthol use and the risk of COPD and its characteristics such as exacerbation, comorbidities, and CT abnormalities. Methods: We analyzed the data from 5,699 current smokers in the COPDGene cohort to evaluate whether lung function, comorbidities,exacerbations, and CT parameters would be different between menthol and non-menthol cigarette smokers. Results: 3,758 (65.9%) reported use of mentol cigarettes. Multivariable regression analysis revealed that younger age, female gender, and African-American were significantly associated with smoking of menthol cigarettes. No significant associations were found between menthol cigarette use and COPD, major CT findings, or comorbidities such as coronary artery disease, congestive heart failure, peripheral vascular disease, cerebrovascular disease, hypertension, diabetes, gastroesophageal refulx, and osteoporosis; however, menthol smokers were more likely to experience a severe exacerbation of COPD during longitudinal follow-up (odds ratio 1.29: 95% confidence interval, 1.01-1.54) compared to the non-menthol smokers. Conclusions: These resuls confirm that menthol cigarettes are not safer than traditional cigarettes and suggest that menthol cigarette smokers may have more frequent severe exacerbations than non-menthol smokers.