Menthol in Cigarettes Is Linked With Obesity: Presented at SRNT

Smokers who smoke mentholated cigarettes are more likely to be obese than smokers who smoke non-mentholated cigarettes, according to results from a single-site study presented at the 2016 Annual Meeting of the Society for Research on Nicotine and Tobacco (SRNT).

“Smokers are usually regarded as having a lower body mass index [BMI] and lower dietary intake,” stated principal investigator Maria Jose Miguez, MD, PhD, Florida International University, Miami, Florida, speaking here on March 4. “Yet, more and more studies are describing an association between smoking and obesity. Findings are particularly concerning given the possible effect of both on morbidity and mortality, particularly among individuals living with HIV.”

Dr. Miguez and colleagues examined 393 adults at their institution who were enrolled into 1 of 4 arms: HIV-positive patients who smoke, patients without HIV who smoke, HIV-positive patients who do not smoke, and patients without HIV who do not smoke.

Investigators followed subjects for 2 years, and recorded weight, height, waist/hip ratio, and waist circumference at each visit during the study. Since weight is controlled by dietary intake and metabolism, they also measured 24-hour dietary intake, levels of brain-derived neurotrophic factor (BDNF) and interleukin-6 (IL-6). The team also controlled for confounding variables like exercise, sociodemographic status, and health status.

Dr. Miguez and co-investigators found that subjects who smoked mentholated cigarettes, whether or not they had HIV, had a significantly higher BMI than smokers of non-mentholated cigarettes. “People who smoke mentholated [cigarettes] reported higher dietary intake and gained more weight, which contrasted with lower caloric intake and low body mass index observed in smokers of non-mentholated cigarettes,” said Dr. Miguez.

Investigators also observed that smokers of mentholated cigarettes had increased IL-6 levels compared with smokers of non-mentholated cigarettes (P = .005). “IL-6 is a cytokine that is known to alter lipids and glucose metabolism,” said Dr. Miguez.

Levels of BDNF, a known regulator of both appetite and metabolism, also differed between smokers of mentholated cigarettes and smokers of regular cigarettes and non-smokers (P = .03). “We saw that smoking alters BDNF, yet those who used mentholated cigarettes show even greater alterations,” said Dr. Miguez.

The prevalence of overweight was 35% and obesity was present in 38% of the study sample.

The analysis suggests that menthol in cigarettes affects appetite and increases the risk of obesity, regardless of HIV status, Dr. Miguez concluded.

Funding for this study was provided by the Florida Department of Health, Tallahassee, Florida.

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