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Tuesday, May 10, 2022

FDA proposes ban on menthol cigarettes and cigars, popular among Blacks, whose leaders are divided on the matter

Photo from ash.org
Last week the U.S. Food and Drug Administration announced its long-anticipated plan to ban menthol cigarettes and all flavors in cigars. 

“The proposed rules would help prevent children from becoming the next generation of smokers and help adult smokers quit,” Health and Human Services Secretary Xavier Becerra said in a news release. “Additionally, the proposed rules represent an important step to advance health equity by significantly reducing tobacco-related health disparities.”

When added to cigarettes and cigars, menthol's minty taste and cooling effect limits throat irritation, thereby making the products more appealing to smokers -- especially new and young smokers. The  release adds that menthol also interacts with nicotine in the brain to enhance nicotine's addictive effects and makes it more difficult to quit smoking. 

One study estimates that banning menthol in cigarettes and cigars in the U.S. would lead to a 15% reduction in smoking as early as 2026 and prevent upwards of 650,000 deaths by 2060.

The Washington Post reports on another study published in the peer-reviewed journal Tobacco Control that "found that if a menthol-cigarette ban in the United States were to have the same effect as a Canadian menthol ban, more than 1.3 million additional smokers would quit, including more than 381,000 African Americans." Nearly 85% of Black smokers smoke menthol cigarettes, compared to 30% of white smokers who smoke menthols, says the FDA. 

The proposed menthol ban has divided Black leaders. Ben Crump, a Black civil-rights attorney, told Politico, “There’s a difference between theory and reality. The reality is, we know once you make laws and such then you have local and state actors who use those as weapons to marginalize Black people.”

FDA says it "cannot and will not enforce against individual consumers for possession or use of menthol cigarettes or flavored cigars" and enforcement will only address the industry, but some Black leaders, including Rev. Al Sharpton and others, disagree that this will be the reality. 

The African American Tobacco Control Leadership Council supports the proposed rule. "This is a major step forward in saving Black lives." Dr. Phillip Gardiner, co-chair of the council, said in a statement.   

Gardiner went on to encourage tobacco control activist to continue to fight to ban the sale of menthol tobacco products at the local, state and federal level, noting that the rule-making process and court challenges by the tobacco industry could mean it will be years before this ban could becomes effective.

Stanton Glantz, who continues to conduct tobacco research even after retiring from the University of California San Francisco in 2020, writes on his blog that "FDA has built a strong foundation to justify prohibiting menthol as a characterizing flavor in cigarettes," but its justification for granting exceptions for heated tobacco products and low nicotine-cigarettes "is very weak" and "should be dropped."  

The New York Times published an essay written by Keith Wailoo, a professor of history and public affairs at Princeton University, that provides a detailed walk through the history of how the tobacco industry hooked black smokers on menthols. He is the author of "Pushing Cool: Big Tobacco, Racial Marketing, and the Untold Story of the Menthol Cigarette." 

"After decades of outcries from communities and public health experts about the health inequities and dangers posed by menthol marketing (with the NAACP now urging a ban), the FDA’s proposed rule that would impose the ban, announced April 28, is a long-awaited step that will save hundreds of thousands of lives in the decades to come," Wailoo writes. "We should not be distracted by those who work on behalf of the tobacco industry while claiming to speak for Black health and well-being. They are part of the web that has maintained the stranglehold, enticing consumers with deceptive promises."

The FDA says that in 2019 there were more than 18.5 million menthol cigarette smokers aged 12 and older in the U.S. which included high rates of youth, young adults, African Americans and other racial and ethnic minorities. In 2020 menthol made up 37% of the cigarette market in in the U.S., up from 26% in 2000, according to The Truth Initiative menthol fact sheet. 

The FDA is accepting public comments on its proposed rules for menthol cigarettes and flavored cigars through July 5. 

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