Menthol cigarettes and the cardiovascular risks of people living with HIV

J Assoc Nurses AIDS Care. Sep-Oct 2014;25(5):427-35. doi: 10.1016/j.jana.2014.01.006. Epub 2014 Feb 26.


The possibility that menthol cigarettes add to the deleterious cardiovascular effects of smoking has been barely discussed. Although cardiovascular diseases (CVD) are at the forefront of medical concerns of people living with HIV (PLWH), an important, yet unknown, issue for clinicians and public health authorities is whether use of menthol-flavored cigarettes heightens CVD risk factors. Our study aims to assess traditional (10-year risk using the Framingham Risk Model) and nontraditional CVD risk factors and to contrast the effects of menthol-flavored versus non-menthol-flavored cigarettes on these risk factors. Compared to controls, menthol smokers were twice as likely to have hypertension. Users of menthol-flavored cigarettes had higher body mass index values, and increased risk of abdominal obesity. Multivariate analyses indicated that menthol smokers doubled the odds of having moderate to high CVD risk. This finding is highly significant given the widespread use of menthol-flavored cigarettes, particularly among women, minorities, and PLWH.

Keywords: HIV; blood pressure; cardiovascular risks; mentholated cigarettes; obesity.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Anti-HIV Agents / therapeutic use
  • Antiretroviral Therapy, Highly Active
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / etiology
  • Case-Control Studies
  • Female
  • Florida / epidemiology
  • HIV Infections / complications*
  • HIV Infections / drug therapy
  • HIV Infections / epidemiology
  • Humans
  • Longitudinal Studies
  • Male
  • Menthol*
  • Multivariate Analysis
  • Prevalence
  • Risk Factors
  • Smoking / adverse effects*
  • Smoking / epidemiology
  • Socioeconomic Factors
  • Surveys and Questionnaires
  • Tobacco Use Disorder / complications*
  • Tobacco Use Disorder / epidemiology
  • Young Adult


  • Anti-HIV Agents
  • Menthol