Vaping involves heating a liquid solution to create an aerosol for inhalation. This liquid typically contains nicotine, flavorings, and a base of propylene glycol and vegetable glycerin. While vaping is positioned as a reduced-risk alternative to combustible cigarettes, the addition of flavorings, particularly menthol, complicates the overall health risk profile.
Vaping Risks Before Flavoring
E-cigarette aerosols carry baseline health risks, independent of added flavor compounds. The main components of e-liquids are propylene glycol (PG) and vegetable glycerin (VG), which carry nicotine and flavors. When heated, these substances can break down into toxic carbonyl compounds.
These thermal by-products include known carcinogens like formaldehyde and acetaldehyde. The heating element, often a metal coil, can also release heavy metal particles into the aerosol. Inhaling these materials exposes lung tissue to irritants and toxic substances, causing inflammation and cellular damage over time.
How Menthol Affects the Body’s Response
Menthol is a chemical compound naturally found in mint plants. When added to vapes, it significantly alters the physical experience of inhaling the aerosol. It acts as a mild anesthetic by activating the cold-sensitive TRPM8 receptor in the airways. This creates a cooling sensation that masks the harsh, irritating feeling of inhaling concentrated nicotine and other chemicals.
This cooling and numbing effect allows users to take longer, deeper breaths, changing their puffing behavior. The deeper inhalation increases the total dose of nicotine and harmful substances delivered to the lungs. Studies show that menthol-containing condensates can cause increased oxidative stress and cytotoxicity. Menthol exposure has also been linked to the activation of inflammatory pathways, which can impair pulmonary function.
Menthol and the Increase of Nicotine Addiction
Menthol possesses distinct behavioral and neurological properties that intensify the addictive potential of vaping. The pleasant cooling and sensory experience significantly increases the product’s palatability and appeal. This enhanced enjoyment encourages users to vape more frequently and intensely.
Menthol may also enhance nicotine’s effects by modifying nicotinic acetylcholine receptors in the brain, increasing the bioavailability and overall effect of the nicotine dose. This makes the product easier for nicotine-naïve individuals to initiate use and harder for established users to quit. Research shows that menthol flavors result in a longer puff duration compared to tobacco flavors, increasing nicotine exposure and dependence.
Policy Responses to Menthol Vaping
The evidence linking menthol to increased initiation and addiction has made it a central target for public health intervention. The U.S. Food and Drug Administration (FDA) previously proposed banning menthol in combustible cigarettes due to its role in youth use. Historically, the FDA denied marketing applications for non-tobacco flavored e-cigarettes, including menthol.
The regulatory landscape is complex and evolving. In a significant shift in June 2024, the FDA authorized the marketing of four specific menthol-flavored e-cigarette products. This marked the first time a non-tobacco flavor received authorization. The authorization was granted based on manufacturer evidence that the products were appropriate for public health protection under specific use restrictions. Despite this, many local and state governments have implemented their own bans on all flavored e-cigarettes, including menthol, to curb youth vaping rates.