Mānoa: Menthol in e-cigarettes could damage lungs, finds UH Research

University of Hawaii at Manoa


Virtual media availability with UH Mānoa Professor Yi Zuo on Sunday, August 7, 10-11 a.m. (Hawaiʻi Standard Time). Contact Marc Arakaki at [email protected] or 808-228-3215 to schedule an appointment.

Menthol in e-cigarettes may harm respiratory health, according to a new study by a team of experts at the University of Hawaii at Mānoa. The findings come as e-cigarette use is increasing among Hawaii’s youth.

Yi Zuo, UH Mānoa Professor of Mechanical Engineering and Associate Professor of Pediatrics, has developed a breakthrough method that enables the study of the health effects of e-cigarette aerosols. This groundbreaking research was published in June 2022 American Journal of Physiology – Cellular and Molecular Physiology of the Lung“Menthol in Electronic Cigarettes Causes Biophysical Inhibition of Lung Surfactant.”

Zuo’s research found that flavorings used in e-cigarettes, particularly menthol, interfere with a lipid-protein film on the air-water surface of the lungs. This film is called pulmonary surfactant. It plays a central role in maintaining the normal respiratory mechanics of the lungs. Therefore, Zuo’s research suggested that menthol in e-cigarette aerosols may have negative effects on the user’s respiratory health.

“E-cigarettes were originally promoted as a healthier and safer alternative to traditional tobacco smoking when they first hit the market in the mid-2000s,” Zuo said. “However, increasing research, particularly long-term (more than 10 years) toxicological data that has only emerged in recent years, suggests that e-cigarettes are not as safe as initially promised.”

E-cigarette use is on the rise among Hawaii’s youth, according to a Youth Behavior Risk Survey from the UH Mānoa College of Education. Survey respondents who reported having used an e-cigarette or vape product at least one day in the last 30 days prior to taking the survey increased from 25.1% to 30.6% between 2015 and 2019 in the last 30 days before taking the survey increased from 3.6% in 2015 to 10.4% in 2019.

Flavor is a major attraction for e-cigarette users, especially youngsters. As of 2018, more than 15,000 different e-cigarette flavor blends were available on the market. Although most flavorings used in e-cigarettes are food additives and fragrances, their respiratory safety and health effects at levels inhaled by e-cigarette users have been largely unknown until now.

Menthol is a substance found in peppermint, spearmint, and other mint plants. It gives a cooling and soothing sensation and is used to relieve minor pain and irritation. Menthol is added to products as a flavoring, including cough drops, beverages, chewing gum, and candy. However, none of these products are smoked or inhaled when used. E-cigarette companies, on the other hand, add menthol to their products to make them more appealing and seemingly less harmful when used.

Zuo hopes that these research results can contribute to a better understanding of the health effects of e-cigarettes, particularly among adolescents, and to better regulation of e-cigarette products. This research was a collaborative effort between Zuo’s lab and Professors Ellinor Haglund and Rui Sun in the Department of Chemistry at UH Mānoa. This research was supported by an award from the National Science Foundation and the George F. Straub Trust and Robert C. Perry Fund of the Hawaii Community Foundation.

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