Does menthol attenuate the effect of bupropion among African American smokers?

Addiction. 2003 Oct;98(10):1387-93. doi: 10.1046/j.1360-0443.2003.00443.x.


Background: African Americans have higher tobacco-related morbidity and mortality and are more likely to smoke menthol cigarettes than their white counterparts. This study examined differences between African American menthol and non-menthol smokers in smoking characteristics and cessation.

Methods: The study sample consisted of 600 African American smokers enrolled in a clinical trial that assessed the efficacy of sustained-release bupropion for smoking cessation. Menthol (n = 471) and non-menthol (n = 129) smokers were compared on smoking-related characteristics and abstinence rates at 6 weeks and 6 months.

Results: Menthol smokers were younger (41.2 versus 52.9 years), more likely to be female (73.7% versus 56.6%) and more likely to smoke their first cigarette within 30 minutes of waking up (81.7% versus 69.8%) compared to non-menthol smokers (all P < 0.01). Cigarette taste (50% versus 40%, P = 0.054) was rated non-significantly higher by menthol smokers. Seven-day point-prevalence abstinence from smoking at 6 weeks were 28% and 42% (P = 0.006) and at 6 months were 21% and 27% (P = 0.21) for menthol and non-menthol smokers, respectively. At 6 weeks follow-up, stepwise logistic regression revealed that among those younger than 50 years, non-menthol smokers were more likely to quit smoking (odds ratio = 2.0; 95% CI = 1.03-3.95) as were those who received bupropion (odds ratio = 2.12; 95% CI = 1.32-3.39).

Conclusion: African American menthol smokers had lower smoking cessation rates after 6 weeks of treatment with bupropion-SR, thereby putting menthol smokers at greater risk from the health effects of smoking. Lower overall cessation rates among African Americans menthol smokers may partially explain ethnic differences in smoking-related disease risks.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Black or African American*
  • Bupropion / therapeutic use*
  • Double-Blind Method
  • Drug Interactions
  • Female
  • Humans
  • Male
  • Menthol / pharmacology*
  • Middle Aged
  • Odds Ratio
  • Smoking / ethnology*
  • Smoking Cessation / ethnology*
  • Smoking Cessation / methods


  • Bupropion
  • Menthol