Menthol Cigarettes and Quitting: A Guide for Black Smokers

Most Black Americans who smoke smoke menthol. About 81% of Black adults who smoke use menthol cigarettes, compared with 34% of white adults, according to the CDC. That gap is not an accident or a matter of taste. The tobacco industry spent decades aiming menthol marketing at Black neighborhoods, and the cooling flavor it sold makes cigarettes easier to start and harder to put down. If you smoke menthol and you want out, the path is medication plus counseling, free phone coaching, and a willingness to try more than once.

Menthol use among Black smokers is the product of a targeted campaign. Tobacco companies placed more ads in Black neighborhoods, bought space in Black publications, and sponsored jazz and hip-hop events to tie their brands to Black culture. Truth Initiative researchers documented up to ten times more tobacco advertising in predominantly Black areas of Washington, D.C. than in areas with fewer Black residents. The result is measurable: roughly 93% of Black smokers used a menthol cigarette the first time they smoked, versus 44% of white smokers.

Public-health groups now treat tobacco as a racial-justice issue rather than a lifestyle choice. The CDC's tobacco health-equity work frames the disparity as the product of unfair and unjust marketing practices. The point is not to assign blame to people who smoke. The point is that the deck was stacked, and quitting is harder by design.

Menthol does two things that lock in the habit. First, its cooling, mild-anesthetic effect masks the throat pain, burning, and cough that would otherwise make a first cigarette unpleasant, which lowers the barrier to starting. Second, it works on the brain. A 2015 review in the Yale Journal of Biology and Medicine (PMID 26339211) describes how menthol acts on nicotinic acetylcholine receptors and can change how the body processes nicotine, increasing its reinforcing pull. People who smoke menthol tend to show higher nicotine dependence than people who smoke non-menthol cigarettes.

That biology shows up in quit attempts. Black smokers are more likely than white smokers to want to quit and to try, yet they succeed less often. A systematic review by Foulds and colleagues in Nicotine & Tobacco Research (PMID 21177366) found that the link between menthol smoking and lower quit success was strongest among racial and ethnic minorities and younger smokers. More attempts, fewer successes, is the menthol signature. The takeaway is not that quitting is hopeless. It is that you need real tools, not willpower alone.

Smoking is a leading driver of the cancer and heart-disease gaps that hit Black communities hardest. The CDC estimates that between 1980 and 2018, menthol cigarettes were responsible for about 157,000 premature deaths among Black Americans. Tobacco smoke damages blood vessels and raises the risk of heart attack, stroke, and peripheral artery disease; the CDC notes that smoking is a major cause of cardiovascular disease and causes roughly one in four deaths from it.

The lung toll is just as direct. Smoking causes the large majority of lung-cancer deaths and is the leading cause of chronic obstructive pulmonary disease, or COPD. If you already have breathing trouble, the single most effective step you can take is to stop smoking. We cover the disease in detail in our guide to COPD in Black adults. Because tobacco also pushes blood pressure higher, quitting is one of the highest-yield moves for cardiovascular health, a theme that runs through our reporting on high blood pressure in Black men.

For a moment it looked like the product itself might change. In April 2022 the FDA proposed a rule to prohibit menthol as a flavor in cigarettes, citing its power to hook new smokers and its outsized harm to Black communities. The agency received nearly 250,000 public comments. The Biden administration then delayed the final rule indefinitely in 2024, and in early 2025 the FDA formally withdrew the proposal. Menthol cigarettes remain legal and on shelves. Litigation continues, but you should not wait on policy. The tools to quit are available now.

The evidence is clear on what raises your odds: combine an FDA-approved medication with counseling. Used together, they roughly triple the chance of quitting for good compared with going it alone. Here is the core of the plan.

1. Use a quit medication. Three FDA-approved options work, and they can be combined under a clinician's guidance:

• Nicotine replacement therapy (NRT): patches, gum, lozenges, inhalers, and nasal spray. A long-acting patch plus a fast-acting gum or lozenge handles both steady cravings and sudden urges.
• Varenicline (Chantix): a prescription pill that blunts cravings and reduces the reward from smoking. It is the single most effective medication in head-to-head studies.
• Bupropion (Zyban): a prescription pill, also used as an antidepressant, that reduces cravings and withdrawal.

2. Add counseling or coaching. Medication plus behavioral support beats either alone. The free national quitline, 1-800-QUIT-NOW, connects you to a trained quit coach, and many state quitlines ship a free starter supply of nicotine patches, gum, or lozenges to your home. Online, CDC's quit resources and SmokeFree.gov offer text-message programs and step-by-step plans at no cost.

3. Make a plan and know your triggers. Pick a quit date within two weeks. List the moments that make you reach for a cigarette, the first coffee, the drive home, a phone call, stress, and decide in advance what you will do instead. Tell the people around you so they can back you up. Get cigarettes, lighters, and ashtrays out of the house and car before your quit date.

4. Expect to try more than once. Most people who quit for good do it only after several attempts. If you slip, you have not failed. Note what triggered it, adjust the plan, and set a new quit date. Each attempt teaches you something the next one uses.

The fastest route to a real quit plan is a clinician who can prescribe varenicline or bupropion, help you stack NRT correctly, and follow up when the first try gets hard. A primary care visit is enough; you do not need a specialist. If you want a clinician who understands your community, you can find a Black primary care doctor in our directory and ask, at your next visit, to build a quit plan and get a prescription. Pair that with one call to 1-800-QUIT-NOW for free coaching and, in many states, free nicotine patches. Quitting at any age pays off fast: heart-attack risk drops sharply within one to two years, lung-cancer risk falls by about half within 10 to 15 years, and quitting can add as much as 10 years to your life.