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Vaping: Banned Food Additive Found in Mint- and Menthol-Flavored E-Cigarettes

MedicalResearch.com Interview with:

Sairam Jabba, Ph.D Senior Research Associate Department of Anesthesiology Duke University Durham, NC 27710

Dr. Jabba

Sairam Jabba, Ph.D
Senior Research Associate
Department of Anesthesiology
Duke University
Durham, NC 27710

MedicalResearch.com: What is the background for this study?

Response: Pulegone is a potential carcinogen contained in several mint oils. Due to its carcinogenic properties, FDA banned pulegone last year as a food additive. Previous chemical analytical studies from CDC have demonstrated that several mint/menthol-flavored e-cigarette liquids and snuff tobacco products contain pulegone in significant amounts. FDA currently does not regulate pulegone in e-cigarettes and snuff products and the health risk associated with it for the users is not well understood. 

MedicalResearch.com: What are the main findings?

Response: We calculated that vapers, if using mint- and menthol-flavored e-cigarettes or users of mint snuff, take in much more pulegone than considered safe by FDA in food. This raises serious health concerns for vapers using these products.

MedicalResearch.com: What should readers take away from your report? 

  1. Our risk analysis suggests that mint- and menthol-flavored e-cigarette and smokeless tobacco product users are exposed to pulegone levels that are higher than what FDA considers unacceptable for food products, lead to potential health concerns.
  2. The fact that menthol cigarettes contain only very low amounts on pulegone doesn’t mean they are safe. However, the tobacco industry apparently knew early on about the potential harmful properties of pulegone and made efforts to minimize its levels in menthol cigarettes. It’s likely that many e-cigarette manufacturers are unaware of the dangers associated with pulegone, and use ingredients that contain significant pulegone amounts.
  3. The fact that FDA bans a carcinogen in food, but not in e-cigarettes, illustrates the inadequate regulatory situation in the US related to e-cigarette additives. FDA needs to implement new regulations quickly, to exclude hazardous chemicals and reduce harm.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

1. Analytical studies should be mandated to determine the pulegone levels for all mint- and menthol-flavored e-cigarette liquids and smokeless tobacco products.

2.To understand the short-term and long-term effects of pulegone exposure on respiratory and overall health (like carcinogenicity), future research should involve animal inhalation exposure studies for pulegone.

3.FDA should conduct and support research that will aid in mitigating the health concerns associated with pulegone exposure from mint/menthol- flavored tobacco products use before recommending them as harm reduction alternatives to combustible cigarettes.

No disclosures to mention for Sairam Jabba. 


Jabba SV, Jordt S. Risk Analysis for the Carcinogen Pulegone in Mint- and Menthol-Flavored e-Cigarettes and Smokeless Tobacco Products. JAMA Intern Med. Published online September 16, 2019. doi:10.1001/jamainternmed.2019.3649



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Last Updated on September 17, 2019 by Marie Benz MD FAAD