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Research Letter
September 16, 2019

Risk Analysis for the Carcinogen Pulegone in Mint- and Menthol-Flavored e-Cigarettes and Smokeless Tobacco Products

Author Affiliations
  • 1Department of Anesthesiology, Duke University School of Medicine, Durham, North Carolina
JAMA Intern Med. 2019;179(12):1721-1723. doi:10.1001/jamainternmed.2019.3649

Pulegone, a constituent of oil extracts prepared from mint plants, including peppermint, spearmint and pennyroyal, is a carcinogen that causes hepatic carcinomas, pulmonary metaplasia, and other neoplasms on oral administration in rodents.1 In 2018, the US Food and Drug Administration (FDA) banned synthetic pulegone as a food additive.2 Studies by the Centers for Disease Control and Prevention (CDC) detected substantial amounts of pulegone in mint- and menthol-flavored e-cigarette liquids and smokeless tobacco products marketed in the United States.3,4 The tobacco industry has minimized pulegone levels in cigarette flavorings because of toxicity concerns. Mint- and menthol-flavored e-cigarettes may be exempt from proposed federal regulations; therefore, the health risk associated with pulegone in these products should be considered.

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