Years of targeted advertising by big tobacco have turned menthol cigarettes into a racial issue, hooking mostly black Americans to mint-flavored tobacco products. Today, public health experts at the University of Colorado’s Anschutz Medical Campus have rallied a powerful community effort to reverse a deadly trend and social injustice.
The popularity of menthol cigarettes has grown steadily since the product was introduced to the market in the mid-1920s, but the reasons for its ubiquitous use in the black community are no mystery. While menthols make up just 30% of cigarette sales in the United States, they are the preferred choice of 88% of black smokers – and 57% of smokers under 18, according to a study cited by the Centers for Disease Federal Control and Prevention (CDC).
Approximately 45,000 black Americans die prematurely each year from diseases caused by tobacco.
The Center for Public Health Practice (CPHP) at the Colorado School of Public Health (ColoradoSPH) has a longstanding partnership with community groups working to counter years of targeted promotion of menthols to the Black community in Colorado to to reverse a problem that he considers both tragic and unjust.
“One of CPHP’s successes in our tobacco control initiatives is our genuine community engagement not only in the Denver metro area, but throughout the Rocky Mountain region,” said Cerise Hunt, PhD, MSW, director of the CPHP, Associate Dean for Equity, Diversity and Inclusion. , and assistant professor in the Department of Community and Behavioral Health at ColoradoSPH.
CPHP’s mission is to create and foster practitioner excellence to improve public health practice at the system, community, and organizational levels. One of its units, the Policy + Systems Change Network, works on local tobacco control policy and education efforts statewide. The team partners with the Colorado Black Health Collaborative (CBHC) on educational campaigns highlighting the dark history of menthols in the black community.
Make a cigarette easier to smoke
In the 1960s, the black community became an attractive target market for businesses. Tobacco companies, primarily Lorillard, makers of Kool and Newport menthols, ran print and television ads directly targeting black consumers. Advertisements described menthols as a trendy, healthy and refreshing tobacco product.
Chart from the Colorado Black Health Collaborative.
“The special thing about menthol and the reason it was developed is that it alters the cold receptors for both your lips and your throat etc. to create a cooling effect,” said Kamal Henderson, MD, Cardiologist at the VA Eastern Colorado Health Care System and Assistant Professor of Cardiology at the University of Colorado School of Medicine. “It makes smoking much more tolerable. And in the 1970s, cigarette companies called menthols healthier, but they were just easier to smoke.
Henderson works with the VA’s Tobacco Clinic and finds that many people trying to quit smoking miss the menthol sensation long after they’ve been weaned off nicotine. “Menthol is milder and helps even young smokers get used to cigarettes,” he said. “If anything, menthol gets people started smoking sooner and keeps them smoking longer.”
When the U.S. Food and Drug Administration banned flavored cigarettes in 2011, its report and recent studies back up Henderson’s comments: Although menthol doesn’t make cigarettes more addictive, its cooling quality does make them easier to drink. smoking and therefore more difficult to quit.
Over decades of local attempts to ban the sale of menthol tobacco products, the tobacco industry has perpetuated misinformation, including stories that these policies are racist and lead to the criminalization of people who possess or smoke these products. .
“Yes, tobacco companies say adults should be able to smoke whatever they want, but a lot of people don’t know how the popularity of menthols started,” said Terri Richardson, MD, vice president of CBHC. “It was a very manipulative and targeted campaign that led black people to have a preference for menthol flavored tobacco.”
“It’s a matter of social justice,” Hunt said. “If we want to dismantle inequality and promote justice, we need to educate our community about how menthol harms the black community.”
Mobilize and educate the community
As part of a four-year grant from the CDC’s REACH program, CBHC surveyed members of the black community and discovered how little the community knew about the history of menthols and tobacco company marketing in 2014 Both CBHC and CPHP have a strong focus on educating community members. on the history of this targeted marketing in relation to the traditional negative effects of tobacco use on health.
“For some reason people aren’t as interested in the health aspect, but having someone intentionally market a toxic product is very appealing and interesting to people,” Richardson said.
CPHP has partnered with CBHC since 2009 and has supported its REACH grant work by conducting community needs assessment and focus groups. The Policy + System Change Network provides extensive technical assistance to groups such as CBHC, focusing on the tobacco industry‘s historical and systemic targeting of the black community in Colorado communities and how to fix the systems. that perpetuate inequalities through local policy change.
The CPHP Policy + System Change Network has helped CBHCs and youth smoking prevention groups such as UpRISE develop communications and social media campaigns, and co-hosted virtual town halls to mobilize the Black community around of the dangers of menthol.
“I think it’s hard to measure the outcome of education efforts, but I think more and more people are starting to understand what a problem this is and how it was created,” Richardson said. . “Education is really the first step to moving forward and solving a problem.”
“The university has a responsibility to use our multifaceted platforms to be at the forefront of this issue,” Hunt said. “We talk a lot about advancing health equity, the need to have meaningful community-campus partnerships. We need to work with our community partners to collectively educate the community (e.g. citizens and policy makers) about the historical harms of menthol in the Black community and support systemic change. It is a way to go beyond the performative aspects of this work, to realize our commitment to promoting health equity.