title: Smoking, menthol cigarettes, and peripheral artery disease in U.S. adults.
abstract: BACKGROUND
  Cigarette flavorings, with the exception of menthol, have been banned in the United States under the Family Smoking Prevention and Tobacco Control Act. Given the large number of menthol cigarette smokers in the United States, we investigated whether cigarette type (nonmenthol or menthol) is associated with peripheral artery disease (PAD).
  
  
  METHODS
  The authors studied 5,973 adults, 40 years of age and older, who participated in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2004. Smoking status and cigarette type were derived from self-reported questionnaires. PAD was defined as an ankle-brachial blood pressure index <0.9 in at least 1 leg.
  
  
  RESULTS
  Fifty percent of participants were never-smokers compared to 31%, 14%, and 5% of former, current nonmenthol, and current menthol cigarette smokers, respectively. The weighted prevalence of PAD in the study population was 5%. After multivariable adjustment, the odds ratios for PAD were 1.44 (95% CI: 0.97, 2.15), 3.65 (95% CI: 1.57, 8.50), and 2.51 (95% CI: 1.09, 5.80) comparing former, current nonmenthol cigarette smokers, and current menthol cigarette smokers to never-smokers. The associations between smoking and PAD were similar for smokers of nonmenthol and menthol cigarettes (p value for heterogeneity = .59).
  
  
  CONCLUSIONS
  In a representative sample of the U.S. population, current use of both menthol and nonmenthol cigarettes was associated with increased prevalence of PAD, with no difference in risk between cigarette types.
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA. mijones@jhsph.edu
authors.forename: Miranda R
authors.initials: MR
authors.lastname: Jones
authors.forename: Benjamin J
authors.initials: BJ
authors.lastname: Apelberg
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Samet
authors.forename: Ana
authors.initials: A
authors.lastname: Navas-Acien
mesh_terms: D005260:Female; D006801:Humans; D008610:Menthol; D008875:Middle Aged; D016017:Odds Ratio; D058729:Peripheral Arterial Disease / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology*; D057566:Self Report; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology* / Q000208:ethnology; D011795:Surveys and Questionnaires; D062789:Tobacco Products; D014481:United States / Q000453:epidemiology
chemical_list: D008610:Menthol