A tale of two stimulants: mentholated cigarettes may play a role in cocaine, but not methamphetamine, dependence

Drug Alcohol Depend. 2013 Dec 15;133(3):845-51. doi: 10.1016/j.drugalcdep.2013.09.002. Epub 2013 Sep 11.


Background: Research suggests that mentholated cigarettes may play a role in cocaine dependence. The purpose of the present study was to expand upon the research on mentholated cigarettes and cocaine dependence and to evaluate the role of mentholated cigarettes in methamphetamine dependence.

Methods: Secondary analysis of a multisite, randomized trial evaluating the impact of smoking-cessation treatment in stimulant-dependent outpatients (N=538). Participants' reasons for concurrent use of cigarettes and illicit stimulants were assessed via self-report. Stimulant-abstinence was measured by self-report and urine drug screens. Smoking cessation was assessed via self-report and carbon monoxide levels.

Results: Of the 301 cocaine-dependent participants, 201 (67%) were menthol and 100 (33%) were non-menthol cigarette smokers. Cocaine-dependent participants who smoked menthol, compared to non-menthol, cigarettes were significantly more likely to report that cigarettes prolong their cocaine high (X(2)(1)=16.3, p<.0001, OR=3.58 [95% CI: 1.88-6.79]) and were less likely to be stimulant abstinent during active treatment (W=3.6, p<0.001, d=.39 [95% CI: 0.16-0.62]), at 3-month follow-up (X(2)(1)=14.4, p<0.001, OR=.32 [95% CI: 0.17-0.58]), and at 6-month follow-up (X(2)(1)=4.6, p=0.03, OR=.53 [95% CI: 0.29-0.95]). No parallel differences were found between menthol and non-menthol methamphetamine-dependent smokers. The prevalence of Caucasian menthol smokers was significantly greater in the cocaine-dependent participants (37.2%) than in the methamphetamine-dependent participants (17.61%), (X(2)(1)=14.4, p<.001, OR=2.77 [95% CI:1.62-4.73]). Smoking cessation was not significantly associated with cigarette type for either cocaine- or methamphetamine-dependent participants.

Conclusions: The present results suggest that mentholated cigarettes play a role in cocaine, but not methamphetamine, dependence.

Trial registration: ClinicalTrials.gov NCT01077024.

Keywords: Cigarettes; Cocaine dependence; Menthol; Methamphetamine dependence.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Amphetamine-Related Disorders / complications*
  • Amphetamine-Related Disorders / epidemiology*
  • Amphetamine-Related Disorders / psychology
  • Amphetamine-Related Disorders / therapy
  • Behavior, Addictive / epidemiology
  • Behavior, Addictive / psychology
  • Behavior, Addictive / therapy
  • Cocaine-Related Disorders / complications*
  • Cocaine-Related Disorders / epidemiology*
  • Cocaine-Related Disorders / psychology
  • Cocaine-Related Disorders / therapy
  • Female
  • Humans
  • Male
  • Menthol / administration & dosage*
  • Menthol / adverse effects*
  • Prevalence
  • Self Administration
  • Self Report
  • Smoking / epidemiology*
  • Smoking / psychology
  • Smoking Cessation / psychology
  • Smoking Cessation / statistics & numerical data
  • Tobacco Products* / adverse effects
  • Treatment Outcome
  • Whites / psychology
  • Young Adult


  • Menthol

Associated data

  • ClinicalTrials.gov/NCT01077024