May 12, 2021 – The United States Food and Drug Administration (FDA) recently announced that it will take action to ban menthol cigarettes. Three experts from the Harvard TH Chan School of Public Health share their views on the importance of the ban, its potential impact on public health, and why this step is long overdue.
Director of Center for Global Tobacco Control, Senior Lecturer in Social and Behavioral Sciences
Scientists and tobacco control advocates have worried about the influence of menthol cigarettes for decades. Menthol is added to cigarettes by manufacturers to create a cooling sensation that reduces the harshness of cigarette smoke. Menthol also has bronchodilator properties, allowing smoke to penetrate deeper into the lungs. The feeling of freshness and reduced harshness of menthol smoke leads consumers to perceive these cigarettes as presenting a lower health risk compared to non-menthol cigarettes. But the truth is, by making cigarettes smoother, cooler, and easier to inhale, tobacco manufacturers have created a product that has higher addictive potential and is harder to quit than non-menthol cigarettes. For example, a recent analysis of adult smokers in the FDA’s Population Assessment Tobacco and Health study found that menthol smokers had a lower likelihood of staying abstinent than non-menthol smokers.
This same study showed that menthol cigarettes are the preferred type of cigarette among young people and black smokers. According to the data, 39% of youth overall and 81% of black youth prefer menthol cigarettes. Most notably, menthol cigarettes are preferred by 86% of black smokers. This is not surprising, given that cigarette companies have historically targeted African American communities with menthol marketing campaigns. The proposed ban on menthol cigarettes will help tackle a major contributor to smoking among African Americans, while eliminating a design feature that misleads smokers about health risks while making it harder for smokers to smoke. ‘stop smoking.
It is important to stress that the bans on menthol cigarettes are not new. In 2017, Canada was one of the first countries in the world to introduce a national ban on menthol cigarettes, as well as most cigars and blunt wraps (hollowed out cigar wraps often filled with marijuana). Ethiopia, Senegal, Uganda, Nigeria, Moldova, Turkey and the European Union have implemented similar bans. It is very encouraging to see the US FDA acting on science and joining the efforts of the global tobacco control community.
Director of FranÃ§ois-Xavier Bagnoud Center (FXB) for Health and Human Rights; FXB Professor of Health and Human Rights Practice
The tobacco industry has identified menthol cigarettes as a product that it would preferentially market to the African American population. If you watch the ads over time you can absolutely see the menthols positioned like the “black” cigarette and that is really shameful and disproportionately life threatening. In one recent editorial As I co-wrote on this topic, we noted that there is this lingering perception in the United States that black people prefer menthol cigarettes. But in fact, it is the result of racist marketing.
They are deadly products. Cigarettes, especially menthol, kill 45,000 black people each year, a population already struggling with higher rates of heart disease, asthma and other conditions that smoking can exacerbate. Smoking also makes people more vulnerable to the worst outcomes of COVID-19 and, as we know, the pandemic has disproportionately harmed black communities.
I am pleasantly surprised that the FDA is taking action to ban mints, but I hope they move quickly and establish a timeline for the ban. The tobacco industry is not flinching and it will surely mobilize efforts to attack the scientific and legal merits of a ban on menthol cigarettes.
Harvey V. Fineberg Professor of Public Health Leadership Practice
On my very first day as US Assistant Secretary of Health in June 2009, I will never forget to join a delegation at the White House Rose Garden to support President Obama as he signed the law. on family smoking prevention and tobacco control. This law allowed the authority of the FDA to regulate tobacco products for the very first time. So it was not only a beautiful and historic day for public health, but an unforgettable day for me personally. As part of the enactment, the law banned flavors in cigarettes, such as candy, chewing gum, or chocolate, but specifically exempted menthol. It was left for another day. So the new menthol ban that the FDA just proposed actually lasted for at least 12 years.
As a physician trained in many fields, including cancer, I have witnessed far too much suffering and death caused by tobacco products, which are expected to cause one billion deaths worldwide on the 21st century. Eighty-five percent of black smokers use menthol cigarettes. Studies show that menthol cigarettes increase smoking initiation, decrease withdrawal, and make it harder for black smokers to quit compared to non-black smokers. This menthol ban will save huge numbers of lives – one study estimates it could prevent more than 600,000 deaths by 2050. Importantly, this ban will also address the health inequity issues that stem from the long history of flavor manipulation by the tobacco industry as part of targeting youth and minority populations.
Despite so many challenges, tobacco control can save lives. It is an honor to have been a part of these efforts for several decades now in Massachusetts and nationally. During my time at the Department of Health and Human Services (HHS), we created and implemented the Department’s first-ever Tobacco Control Strategic Action Plan titled âEnd the Epidemicâ. In the era of the new Affordable Care Act, the plan has helped unite HHS to take advantage of the FDA’s new tobacco control authority. We are proud to see progress in the denormalization of these products and their use. But there is still a lot of work to be done. The ban on menthol, which includes flavored cigars, does not apply to electronic cigarettes, for example. The tobacco industry maintains that smoking is a choice when in fact it remains a devastating addiction. The FDA’s proposed menthol ban is a step forward in the long and difficult history of tobacco control.
– Chris Sweeney