Alexander Linda A, Trinidad Dennis R, Sakuma Kari-Lyn K, Pokhrel Pallav, Herzog Thaddeus A, Clanton Mark S, Moolchan Eric T, Fagan Pebbles
College of Public Health, University of Kentucky College of Public Health, Lexington, KY;
Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA;
Nicotine Tob Res. 2016 Apr;18 Suppl 1(Suppl 1):S91-101. doi: 10.1093/ntr/ntv209.
The disproportionate burden of tobacco use among African Americans is largely unexplained. The unexplained disparities, referred to as the African American smoking paradox, includes several phenomena. Despite their social disadvantage, African American youth have lower smoking prevalence rates, initiate smoking at older ages, and during adulthood, smoking rates are comparable to whites. Smoking frequency and intensity among African American youth and adults are lower compared to whites and American Indian and Alaska Natives, but tobacco-caused morbidity and mortality rates are disproportionately higher. Disease prediction models have not explained disease causal pathways in African Americans. It has been hypothesized that menthol cigarette smoking, which is disproportionately high among African Americans, may help to explain several components of the African American smoking paradox.
This article provides an overview of the potential role that menthol plays in the African American smoking paradox. We also discuss the research needed to better understand this unresolved puzzle.
We examined prior synthesis reports and reviewed the literature in PubMed on the menthol compound and menthol cigarette smoking in African Americans.
The pharmacological and physiological effects of menthol and their interaction with biological and genetic factors may indirectly contribute to the disproportionate burden of cigarette use and diseases among African Americans.
Future studies that examine taste sensitivity, the menthol compound, and their effects on smoking and chronic disease would provide valuable information on how to reduce the tobacco burden among African Americans.
Our study highlights four counterintuitive observations related to the smoking risk profiles and chronic disease outcomes among African Americans. The extant literature provides strong evidence of their existence and shows that long-standing paradoxes have been largely unaffected by changes in the social environment. African Americans smoke menthols disproportionately, and menthol's role in the African American smoking paradox has not been thoroughly explored. We propose discrete hypotheses that will help to explain the phenomena and encourage researchers to empirically test menthol's role in smoking initiation, transitions to regular smoking and chronic disease outcomes in African Americans.
非裔美国人在烟草使用方面负担过重，其原因很大程度上尚不清楚。这种无法解释的差异，即所谓的非裔美国人吸烟悖论，包括几种现象。尽管非裔美国人处于社会劣势，但非裔美国青少年吸烟率较低，开始吸烟的年龄较大，而在成年期，吸烟率与白人相当。与白人和美国印第安人及阿拉斯加原住民相比，非裔美国青少年和成年人的吸烟频率和强度较低，但烟草导致的发病率和死亡率却高得不成比例。疾病预测模型尚未解释非裔美国人的疾病因果途径。据推测，薄荷醇香烟在非裔美国人中的使用比例过高，这可能有助于解释非裔美国人吸烟悖论的几个方面。
本文概述了薄荷醇在非裔美国人吸烟悖论中可能发挥的作用。我们还讨论了为更好地理解这一未解决难题所需开展的研究。
我们查阅了先前的综合报告，并在PubMed上检索了关于非裔美国人中薄荷醇化合物和薄荷醇香烟使用的文献。
薄荷醇的药理和生理作用及其与生物和遗传因素的相互作用可能间接导致了非裔美国人在香烟使用和疾病方面负担过重。
未来研究味觉敏感性、薄荷醇化合物及其对吸烟和慢性病的影响，将为如何减轻非裔美国人的烟草负担提供有价值的信息。
我们的研究突出了与非裔美国人吸烟风险状况和慢性病结局相关的四个违反直觉的观察结果。现有文献有力证明了它们的存在，并表明长期存在的悖论在很大程度上未受社会环境变化的影响。非裔美国人中薄荷醇香烟的使用比例过高，薄荷醇在非裔美国人吸烟悖论中的作用尚未得到充分探索。我们提出了一些具体假设，将有助于解释这些现象，并鼓励研究人员通过实证检验薄荷醇在非裔美国人吸烟起始、转变为常规吸烟以及慢性病结局中的作用。
