Menthol cigarettes, flavored cigars and the FDA

It’s a remarkable fact that tobacco, known for decades to cause lung and other cancers, heart disease, COPD and emphysema, has only been regulated in this country since 2009, when Congress passed the Tobacco Control Act, giving the Food and Drug Administration authority to regulate the content, marketing, and sale of tobacco products. One of the provisions of the law required the agency to ban all flavored cigarettes, but menthol brands were exempted, “pending further review.” The flavor ban also did not apply to other tobacco products, such as smokeless, cigars and cigarillos.

In 2011, the FDA completed its review of menthol cigarettes, which found that they are more addictive, create more dependence, and are harder to quit than unflavored brands. The report estimated that within 10 years a menthol ban would cause 39% of all menthol smokers and 47% of African-American menthol users to quit; prevent 17,000 premature deaths; and prevent 2.3 million new youth smokers. The final conclusion: “Removal of menthol cigarettes from the marketplace would benefit public health in the United States.”

Now, a decade later, the FDA has announced that it plans to do just that, and for good measure will ban all mass-produced flavored cigars and cigarillos too. For the large number of public health organizations that have long pressed the FDA on a menthol ban, this is cause for celebration, tempered with the full expectation that the tobacco industry will not take it lying down.

For black-led organizations in particular, such as the African-American Tobacco Control Leadership Council, the Center for Black Health & Equity, the NAACP, and the National Medical Association, the announcement is not just about public health but also one of social equity. Smoking-related illnesses are the number one cause of death in the black community; 85% of black smokers use menthol brands. Neither of these statistics is a coincidence. The short film “Black Lives, Black Lungs” chronicles the calculated ways in which tobacco companies targeted black communities and cultivated a strong customer base among African-Americans going back to the 60s and 70s, with deadly results. In 1953, only 5% of African-American smokers were menthol users; from there, the percentages rose by startling increments—14% in 1968; 42% in 1976; 80% by 2000. By contrast, only 30% of white smokers use menthol.

Menthol and other flavors are also especially appealing to young people because they improve taste and reduce the harshness of inhaling. FDA data from 2014 shows that among current users, 80% of adolescents 12-17 and 75% of young adults 18-25 said the first tobacco product they ever tried was flavored. Over half of smokers 12-17 use menthol cigarettes. After flavored cigarettes were banned in 2009, sales of flavored cigars in all sizes increased by 50%. Little cigars and cigarillos are sold in a variety of sweet and fruity flavors and are cheaper than cigarettes, making them the perfect “starter” product for kids. Low cost packs of 3-5 increased from 1% of cigar sales in 2008 to 40% in 2015. With flavors like grape and wild cherry, these are not your grandfather’s cigars, and it’s not grandfathers who are smoking them either.

It’s a sure bet that tobacco companies will fight these restrictions with all the financial and political power they can muster because so much of their profits depend on the sale of flavored products. Menthol brands constitute 36% of cigarette sales; flavored cigars make up more than half of the domestic cigar market. Expect a full display of the deceptive practices they have perfected and rely on. For example, already there are claims that these regulations will “criminalize” menthol and be another target on the backs of the black community. On the contrary, the FDA ban applies only to manufacturers, distributors and retail stores. It does not make it illegal for an individual to buy, possess or use any of the regulated menthol products. Tobacco companies have also taken the position that a ban on menthol cigarettes would be paternalistic, robbing African-American smokers of their freedom of choice. The NAACP, which has long advocated for a menthol ban, calls this “so hypocritical it’s unbelievable” because “addiction is the absolute opposite of choice.”

The FDA announcement is only the first step in a process that will likely take two to three years to complete before the menthol and flavor ban goes into effect. Along the way, tobacco companies will do whatever they can to derail it. Public health organizations are fortified with resolve to help see it through. Important business was left unfinished in 2009; it’s time to get it done.

The Healthcare Consortium is a local charitable organization with a mission of improving access to healthcare and supporting the health and well-being of the residents in our rural community. The agency is located at 325 Columbia St. in Hudson. For information visit www.columbiahealthnet.org or call 518-822-8820.

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