Abstract P102: Menthol Cigarette Use and Subclinical Cardiovascular Disease in African Americans in the Jackson Heart Study

Abstract

Background: African Americans smoke menthol cigarettes at higher rates than other races and have a disproportionate burden of cardiovascular disease (CVD). Whereas smoking is a well described risk factor for CVD, it is unclear if menthol cigarettes are associated with more or less risk. Therefore, our aim was to evaluate the association between menthol cigarette use and subclinical atherosclerosis in the Jackson Heart Study (JHS). Methods: JHS participants (n=5,301) were classified by self-reported smoking status as current, past (smoked ≥400 cigarettes/life), or never smokers at Visit 1 (V1, 2000-2004). Menthol cigarette use data were captured at Visit 3 (V3, 2009-2013). We used multivariable logistic and robust linear regression models to examine the associations between cigarette type and measures of subclinical atherosclerosis [carotid intimal medial thickness (CIMT, Visit 1) and coronary artery calcium (CAC) or aorto-iliac calcium (AIC) by computed tomography (Visit 2, V2, 2005-2008)] to estimate β-coefficients (adjusted differences) comparing menthol to non-menthol (reference group) smoking. Results: There were 401 current smokers with available data on cigarette preference including 326 menthol (81%) and 75 non-menthol (19%) smokers at V3. Menthol cigarette preference in current smokers was not associated with significant differences in measures of subclinical atherosclerosis: CIMT (β -0.003, 95% CI -0.053, 0.046, p=0.90); CAC (β -0.20, 95% CI -1.09, 0.69, p=0.66) or AIC (β -0.32, 95% CI -1.23, 0.59, p=0.48). Conclusion: Our study provides no evidence for an association of menthol cigarette use with subclinical atherosclerosis in African Americans. These findings warrant replication by studies that address the limitations of this study, including the assumption that menthol smokers in V3 were long-term menthol smokers before V1 and V2, potential selection by exclusions of deaths related to smoking and CVD among participants at V3 and lack of longitudinal data on outcomes after the collection of menthol use data at V3.