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Opinion | Thanks to the FDA, Biden’s cancer moonshot could succeed

A pile of used cigarette butts. (Phil Noble/Reuters)

Contributing columnist

President Biden’s cancer “moonshot” received a big boost from the Food and Drug Administration, thanks to its aggressive actions aimed at curtailing smoking. Three recent proposals — reducing nicotine in cigarettesordering e-cigarette maker Juul to take its products off the market and banning menthol-flavored cigarettes — have the potential to save many lives.

Every year, nearly 500,000 Americans die from smoking-related diseases — more than the annual number of people dying of covid-19. Smoking is the leading cause of cancer deaths, with more than 160,000 people perishing every year from cancers directly attributed to tobacco.

FDA Commissioner Robert M. Califf explained at a conference last week that the agency’s proposal to reduce nicotine content in cigarettes is based on nicotine’s extremely high addictive potential. “I think it’s every bit as strong as the opioid addiction,” he said.

Companies know this; they deliberately increased nicotine levels in tobacco products so that smokers crave more cigarettes to fuel their addiction. The FDA contends that the reverse is also true: If cigarettes have such low levels of nicotine that they no longer produce the intended “high,” smokers would either quit or turn to other products that don’t have the cancer-causing chemicals found in cigarettes.

This theory is backed by evidence. A randomized, double-blind trial published in the New England Journal of Medicine found that people assigned to receive reduced-nicotine cigarettes smoked less than those who had standard-nicotine cigarettes. After six weeks, the first group reported lower nicotine-dependence symptoms and minimal withdrawal discomfort. Another study in the same journal projected that lowering the nicotine content to sub-addictive levels could prevent about 8 million deaths in the next 80 years.

Could this effort backfire? Might smokers just smoke more cigarettes to achieve the same effect? Otis Brawley, an oncologist and former chief medical and scientific officer of the American Cancer Society, told me in an interview that this is not likely. “The research shows that the more nicotine is in tobacco, the more people smoke,” he said.

Of course, tobacco companies do not like this proposal and inevitably frame the choice of smoking as a matter of free will. Califf offers a particularly compelling rebuttal: Addiction is a disease that alters the chemistry of the brain, so it is not about individual choice. “The evidence is most people want to stop smoking, but they just can’t,” he said.

Equally important to helping smokers quit is preventing nonsmokers from getting hooked in the first place. Youth e-cigarette use has become an epidemic, with as many as 1 in 4 high school students reporting that they vape. Juul, which controls about a third of the e-cigarette market, has come under fire for targeting children, including through ads on the Cartoon Network and Nickelodeon. Its products have an extraordinarily high level of nicotine: A single Juul pod contains as much nicotine as a pack of 20 regular cigarettes.

Such amounts of nicotine can harm adolescent brain development. In addition, nearly 90 percent of adult smokers began smoking before age 18. The worry is that Juul’s products are not being used primarily to wean adults off cigarettes, but rather to hook teens with nicotine and turn them into adult smokers. The FDA’s decision to ban most Juul offerings came after the company failed to show that the benefits of its products outweigh the harms.

The FDA has also proposed that menthol cigarettes be removed from the marketplace. This, too, could have a profound impact. Researchers estimate that menthol cigarettes are responsible for 10 million more people who smoke and almost 10,000 deaths every year. In 2017, Canada banned menthols, and a subsequent study found that more than 20 percent of menthol smokers quit rather than switch to other tobacco products.

It’s notable that these FDA proposals are resoundingly applauded by the American Heart Association, American Lung Association and numerous other public health groups. Brawley makes the point that these regulatory efforts will reduce cancer mortality and close disparities. “By far, the biggest driver of disparity in cancer deaths is caused by smoking,” he told me. “Even disparities by race are heavily driven by disparities in tobacco use.”

Indeed, these efforts could be the biggest factor in achieving Biden’s moonshot goal of reducing cancer deaths by half in 25 years. As Califf said, “If you want to reduce cancer mortality, this will do far more — if we succeed — than any specific chemotherapy that you can name.”

The road ahead is not easy. A federal judge has ordered a temporary stay in Juul’s favor, and other proposals will almost certainly be held up by lawsuits. But the FDA should be commended for taking bold action that can improve health for generations to come.

Former Columbus Mayor Michael Coleman has personal reason to seek menthol cigarette ban

Former Columbus Mayor Michael Coleman remembers when menthol cigarettes left him in the hospital.

It was early 2001 — Coleman had been elected to his first term just over a year prior — when his security team shuffled him into the side door of OhioHealth Grant Medical Center. Coleman was sick and wanted to avoid attention from the media.

Coleman had a severe throat infection, he said, from his constant menthol cigarette smoking. He could barely breathe.

Coleman said he remembered hearing the doctors and nurses discussing giving him a tracheotomy, a procedure in which a breathing tube is inserted through the neck, or putting him on a ventilator. He said he thought he was going to die.

“And so I begged them: ‘Don’t give me a tracheotomy — I’m just getting started,'” Coleman said. “I’m just getting started, I got so much to do in life, I’m a new mayor.”

Coleman, who went on to be Columbus’ longest-serving mayor, was lying in the hospital bed gasping for air when he made a promise with God that he would quit smoking if he made it through the night.

“From that moment on, I never smoked another cigarette,” Coleman said. “Didn’t want to be around it.”

A legacy of targeting

Today, Coleman sees himself as a victim of a tobacco industry that has historically and heavily targeted the Black community with advertisements for menthol-flavored tobacco.

In 1950, less than 10% of Black smokers used menthol cigarettes, according to Stopping Menthol, Saving Lives. Today, that number is at 85%.

Menthol is a common cigarette flavor additive with a minty taste and aroma that reduces the irritation and harshness of smoking, according to the Food and Drug Administration. This increases appeal and makes menthol cigarettes easier to use, and possibly enhances nicotine’s addictive effects.

Coleman first started smoking cigarettes at 17. He said he remembered when he was attending University of Cincinnati, being deluged by advertisements he feels were designed to get him hooked on menthol cigarettes.

“I remember cigarettes, cigarettes being passed around in little small little packages, maybe three or four cigarettes in a package. Just passed around free,” Coleman said.

Victor Davis, pastor of Trinity Baptist Church in Columbus, recalled how growing up in North Carolina he was exposed to menthol cigarette advertisements and free events like concerts and giveaways.

From 1975 to the early 1980s, Brown & Williamson (the original manufacturers of Kool brand menthol cigarettes) would hold free jazz concerts and promotional campaigns to entice African-Americans toward Kool cigarettes, according to “Finding the Kool Mixx.”

“I can’t think of more people (from my childhood) that didn’t smoke,” Davis said. “Most people in my family smoked.”

Coleman said menthol cigarette smoking culture was pervasive when he was a young adult.

“And it was you know, people you know dances and parties they had a cigarette and had Kool, K-O-O-L,” Coleman said. “I mean, who doesn’t want to be cool? They even called the cigarette cool.”

Recognizing a problem

Coleman had been Columbus City Council president for three years when he won his first mayoral election in 1999. He said during that time, he was smoking a pack or more of menthol cigarettes a day. Although many people generally knew he smoked, he was hiding his habit while campainging.

He said it wasn’t until he was hospitalized that he realized he felt victimized by the companies that marketed menthol cigarettes to the Black community.

“You know, I started thinking about ‘How did I end up here like this? Why did I end up here like this?” Coleman said. “How did I become addicted the way that I was?”

Imperial Tobacco Group (ITG Brands), declined to comment on the marketing actions of the previous owners of the Kool cigarette brand.

“However, we can affirm that the company takes its commitment as a responsible manufacturer of tobacco products seriously and does not target any individual demographic group as part of its marketing and advertising practices,” ITG brands spokesperson Alexandra Wich said.

The result of marketing campaigns like these, advocates for bans on the sale of flavored tobacco say, has been a steep rise in Black and young smokers using menthol cigarettes. Black adults have the highest percentage of menthol cigarette use compared to other racial and ethnic groups, according to the Centers for Disease Control and Prevention.

Among adult Black smokers, 85% preferred menthol cigarettes, according to a 2018 National Survey on Drug Use and Health. Additionally, more than seven out of 10 Black youth ages 12-17 years who smoke use menthol cigarettes, according to the CDC.

To try and undo some of the targeting, Coleman has partnered with the Coalition to End Tobacco Targeting, a group focused on supporting Columbus in enacting legislation to end the sale of flavored tobacco products, including menthol cigarettes.

Sales restrictions on all flavored tobacco products, including all types of menthol products, are gaining momentum at the local and state level, according to the Truth Initiative, an anti-tobacco advocacy group. As many as 361 localities and three Native American tribes have placed some type of restriction on flavored tobacco products, including 108 total bans on menthol flavoring.

The Coalition to End Tobacco Targeting has partnered with other local and medical organizations, including the Columbus Urban League and the Columbus NAACP chapter.

Preventing Tobacco Addiction Foundation/Tobacco 21, another partner in the coalition, has also been documenting a shocking rise in teen nicotine use, driven by easy access to flavored e-cigarettes, Amanda Turner, the group’s executive director, said.

Electronic cigarettes are devices that heat a fluid typically containing nicotine into a vapor that can be inhaled.

In 2021, approximately, 2.55 million (9.3%) students reported using an e-cigarette in the past 30 days; including 2.06 million (13.4%) high school students and 470,000 (4.0%) middle school students, according to the FDA.

“It’s become abundantly clear that the tobacco industry is back to their old tricks with the e-cigarettes,” Turner said.  “It’s obvious — where they used to have candy — that’s where they have these (e-cigarette) devices.”

The federal Food and Drug Administration has also expressed concerns about the need for more regulation on menthol cigarettes and flavored tobacco products. In late April, the FDA announced that it was proposing prohibiting menthol cigarette and flavored cigar sales in order to prevent youth initiation into smoking and prevent additional tobacco-related deaths.

The FDA estimates that 324,000 to 654,000 smoking attributable deaths overall — 92,000 to 238,000 among African Americans — would be avoided over the course of 40 years.

‘Where the rubber meets the road’

In 2020, Columbus City Council declared racism a public health crisis in order to emphasize the city’s “full attention to improving the quality of life and health of our minority residents.”

Coleman said he believes acting on flavored tobacco would be a step toward making good on his successor’s commitment.

“Racism is a public health crisis — well, this is where the rubber meets the road,” Coleman said. “And because as a victim, I can describe how I was targeted. The Black community was targeted and continues to be targeted.”

Dr. Mysheika Roberts, Columbus Health Department commissioner, noted disparities in health among marginalized communities that arise from smoking.

In addition to increased risks of cancer and cardiac issues, diabetes is the fourth leading cause of death among African Americans, according to the CDC. The risk of developing diabetes is 30–40% higher for cigarette smokers than nonsmokers.

Roberts noted “there are health equity issues when we think about how minority communities are targeted with menthol and flavored tobaccos.”

“There is no helpful benefit to smoking tobacco. There are only harms — whatever we can do in our community to reduce smoking,” Roberts said. “(Marginalized communities and young people) are being targeted and being given a product that is more likely to become addictive — we need to improve their health.”

Building a coalition

Members of the coalition emphasized that the work toward advocating for a flavored tobacco ban is still in its infancy, and proposed legislation has yet to be drafted.

If a ban on sale went forward, it would be regulatory only and residents possessing flavored tobacco would not be handled on a criminal basis, Roberts said. Coleman said it was important to ensure this effort targets tobacco licensing only.

“Police will have no role — zero — in any of this,” Coleman said.

Alex Boehnke, public affairs manager at the Ohio Council of Retail Merchant, said while retailers will follow whatever the laws and regulatory frameworks may be, he said retailers prefer consistent regulations on a statewide level rather than a patchwork.

Boehnke also noted consumer demand for flavored tobacco and e-cigarettes, and said a potential demand could drive the products into an unregulated and illegal market.

“These products are legal and within a regulatory environment,” Boehnke said. “A ban could potentially drive this under an illicit market.”

A spokesperson for R.J. Reynolds Tobacco, manufacturer of Newport cigarettes and former manufacturer of Kool cigarettes, said evidence from Canada and Europe where similar bans have been imposed, show little impact on overall cigarette consumption. The spokesperson said in a statement said the company sees harm reduction as a better route to focus attention than banning the sale of menthol cigarettes.

“The FDA rulemaking process is a multiyear, multistep process,” a statement read. “We are reviewing the details of the proposed regulations and will continue to actively participate in the rulemaking process by submitting science-based comments to FDA.”

While the FDA continues to work toward new rules on flavored cigarette tobacco sales, each member of the coalition brings a different perspective to the table for the advocacy process.

“It’s terrifying as a parent when you hear about (e-cigarettes) being found in elementary schools and middle schools,” Turner said.

Davis said Columbus needs to take this step to make “our community more healthy so they live longer.”

“I understand that is a strong piece of the economy for the United States, but as contributing as it is to the economics, it also contributes to the health crisis in this country,” Davis said.

A number of area pastors, Davis said, have taken a faith-based approach to raising awareness about the issue.

Davis said Trinity Baptist and other area churches took part in “No Menthol Sunday” on May 14, an annual campaign by The Center for Black Health & Equity that encourages churchgoers to avoid smoking that day.

Coleman said when he was asked to join the coalition, he had a flashback to the time he was in the hospital, gasping for air.

“This is one of the most important things I’ve worked on,” Coleman said. “But this is about saving lives, saving generations in the Black and white community. This impacts everybody.”

Cole Behrens is a reporter at The Columbus Dispatch covering public safety and breaking news. You can reach him at CBehrens@dispatch.com or find him on Twitter at @Colebehr_report.

Michigan lawmakers prioritize tobacco industry over Michigan youth with bills expanding access to tobacco and vaping products

FOR IMMEDIATE RELEASE                                     Contact: Laura Biehl, Resch Strategies
May 24, 2022                                                              laura@reschstrategies.com, 248-921-5008

Michigan lawmakers prioritize tobacco industry over Michigan youth with bills expanding access to tobacco and vaping products

Bills allow for home delivery, lower prices and lax retailer penalties for selling to minors

Lansing, Mich. – Michigan lawmakers are protecting the tobacco industry instead of Michigan youth by advancing legislation that expands access to tobacco and vaping products, the Keep MI Kids Tobacco Free Alliance warned today.

Founded in 2019, the Alliance includes nearly 70 public health and community organizations working to pass comprehensive legislation proven to protect Michigan youth from the dangers of tobacco products, including e-cigarettes.

Legislation that advanced quickly today by the House Regulatory Reform Committee raises the age for tobacco sales without including a meaningful enforcement mechanism to ensure retailers comply. Additionally, Michigan has one of the highest rates of illegal sales to young people in the nation and the largest number of FDA-issued “no sales” orders. According to the FDA, since January 2021, Michigan’s violation rate for underage sales is 42 percent, more than double the allowed rate to continue receiving federal funding.

“While we support bringing Michigan’s age of sale in line with federal law, this legislation is a missed opportunity to truly impact Michigan’s youth tobacco epidemic,” said Shannon Quinby, Eastern Regional Director for Preventing Tobacco Addiction Foundation/Tobacco 21. “With no plan to reduce the alarmingly high number of retailer violations for sales to youth, these bills will not serve their purpose and Michigan’s federal SAMHSA funding remains at risk.”

House Bills 6108 and 6109 are tie-barred to Senate legislation (Senate Bill 720) that allows tobacco products to be ordered for home delivery, which will directly increase youth access to tobacco products. Senate Bill 720 also lowers the state tax on some tobacco products making them more affordable for kids. Cheap tobacco does not benefit anyone except the tobacco industry.

“Our shared priority should be keeping highly addictive tobacco products out of the hands of our kids, not increasing accessibility and lowering the cost of them,” said Paul Steiner, executive director of Tobacco Free Michigan. “Michigan lawmakers are heading down a dangerous path and our kids will be the ones who will suffer the consequences. We strongly urge Michigan lawmakers and Governor Whitmer to reject these bills and show Michigan kids that their health matters more than tobacco industry profits.”

Members of the Keep MI Kids Tobacco Free Alliance include:

  • Allegiance Health
  • Alliance of Coalitions for Healthy Communities
  • American Cancer Society – Cancer Action Network
  • American Heart Association
  • American Indian Veterans of Michigan
  • American Lung Association
  • Arbor Circle
  • Ascension Michigan
  • Beaumont Teen Health Center
  • BreatheWell Newaygo County
  • Campaign for Tobacco-Free Kids
  • CARE of Southeastern Michigan
  • Cherry Health
  • Community Mental Health Association of Michigan
  • Genesee Health Plan
  • Genesee County Medical Society
  • Genesee County Prevention Coalition
  • Henry Ford Health System
  • Hurley Medical Center
  • Ingham County Medical Society
  • March of Dimes
  • Mercy Health
  • McLaren Health Care
  • Michigan’s Children
  • Michigan Academy of Family Physicians
  • Michigan Association of Local Public Health
  • Michigan Black Caucus Foundation
  • Michigan Catholic Conference
  • Michigan Chapter of American Academy of Pediatrics
  • Michigan Chapter of American College of Cardiology
  • Michigan Council for Maternal and Child Health
  • Michigan Council of Nurse Practitioners
  • Michigan Health and Hospital Association
  • Michigan League for Public Policy/Kids’ Count
  • Michigan Nurses Association
  • Michigan Osteopathic Association
  • Michigan Public Health Coalition
  • Michigan Society of Hematology and Oncology
  • Michigan State Medical Society
  • Michigan State University – College of Human Medicine
  • Michigan State University Extension
  • Michigan Thoracic Society
  • Newaygo County Great Start Collaborative
  • Parents Against Vaping
  • Prevention Network Michigan
  • Preventing Tobacco Addiction Foundation
  • Sacred Heart Center
  • Saint Joseph Mercy Health System
  • School-Community Health Alliance of Michigan
  • South Eastern Michigan Indians
  • Spectrum Health
  • Tobacco Free Michigan
  • Trinity Health
  • Washtenaw County Medical Society

For more information on the Keep MI Kids Tobacco Free Alliance, visit keepmikidstobaccofree.com.

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How the Tobacco Industry Hooked Black Smokers on Menthols

How the Tobacco Industry Hooked Black Smokers on Menthols

Guest Essay by Keith Wailoo

Dr. Wailoo is a professor of history and public affairs at Princeton University and the author of “Pushing Cool: Big Tobacco, Racial Marketing, and the Untold Story of the Menthol Cigarette.”

As regulation of the tobacco industry has grown more and more extensive in recent decades, menthol cigarettes have been an exception. They account for more than one-third of cigarette sales in the United States and are especially dangerous because the menthol enhances nicotine’s already potent addictive effects.

Now the Food and Drug Administration is moving to ban these cigarettes, smoked by more than 18 million people ages 12 and over. Among Black smokers, 85 percent smoke menthol cigarettes, compared with 30 percent of white smokers. Banning them in the United States is a crucial step in the decades-long effort to reduce smoking, especially among young people. The toll is enormous: Nearly a half-million people die every year from smoking-related illnesses.

From the start, the marketing of menthol cigarettes, targeted at Black people over the past half-century, was built on an underlying, deeply cynical deception: They were healthy and restorative. First promoted in the 1920s and 1930s, menthol cigarettes were trumpeted by the tobacco industry with a false therapeutic promise that they would relieve what was called “smoker’s throat.” In the 1940s, regulators with the Federal Trade Commission ordered the makers of Kool menthol cigarettes to cease linking its product to deceitful health claims such as “doctors know the beneficial head clearing quality of menthol.”

The fortunes of menthol brands nevertheless rose in the 1950s. As the tobacco industry was buffeted by studies directly linking smoking and cancer, industry psychologists concluded that menthol cigarettes, masquerading as a healthful choice, were gaining in sales because they signified security for anxious smokers. Menthol’s therapeutic messaging became the basis for huge growth in cigarette sales in the 1950s and 1960s.

It wasn’t until the 1960s that these false health appeals were specifically aimed at Black consumers. Facing threats of regulation for its youth-oriented advertising and seeking new opportunities for growth, the tobacco industry turned from aggressive college marketing campaigns to building markets in Black communities.

Industry documents from 1967, for example, describe influence campaigns among young Black men in St. Louis: handing out free samples to those who were the “kingfish” in the community and building brand following through barbers, bellhops and taxi drivers, who also distributed free samples. Class was also at play in the industry’s strategy. Industry documents described Newark, for instance, as a leading “poverty market” for building menthol sales.

When Congress voted in 1970 to ban national television and radio ads for cigarettes beginning in 1971, industry records reveal how tobacco companies gradually pivoted to Black periodicals and intensified urban billboard advertising. The documents also outlined how to reach public transit riders in Pittsburgh with Black-themed ads (but only on the inside of certain buses carrying large percentages of Black commuters, and not on the buses’ exteriors since they traveled through majority-white neighborhoods).

Industry efforts to cultivate influencers in the Black community extended to local media dependent on advertising revenue, organizations seeking tobacco industry funding and politicians reliant on campaign contributions. Menthol’s web expanded from the 1960s through the 1990s — even as Black communities suffered and rallied in opposition. In the 1990s, this targeting of Black communities reached a turning point with R.J. Reynolds’s ill-fated Uptown, a new menthol brand test-marketed in Philadelphia’s Black neighborhoods. A fierce backlash ensued as Dr. Louis Sullivan, the secretary of health and human services in the George H.W. Bush administration, joined grass-roots activists in denouncing the scheme as “slick and sinister.”

This resistance halted the Uptown campaign, but not before the industry called on some of its allies for support, among them the N.A.A.C.P.’s executive director, Benjamin Hooks. The civil rights group had grown reliant on tobacco industry support, and Mr. Hooks was keen to defend the industry’s right to use urban billboards or sell Uptown as an exclusively Black brand. Mr. Hooks also lambasted industry critics as themselves racist and paternalistic for suggesting that Black people needed “guardian angels” to make consumer decisions for them.

In the end, Dr. Sullivan’s argument prevailed against Uptown’s “promoting a culture of cancer,” as he called it. Efforts to ban tobacco billboards in the name of safeguarding the public’s health also prevailed, incorporated into the 1998 agreement between 46 states and the major tobacco companies to pay the states billions of dollars in compensation for the costs of smoking-related diseases.

Yet, new shrewd and deceitful practices allowed menthol cigarettes to flourish. Big Tobacco’s strategy of supporting civic causes, organizations, cultural events and politicians in the Black community paid off when Congress gave the F.D.A. authority to regulate tobacco products in 2009 but exempted menthol from the flavors that would be banned. At the time, the Congressional Black Caucus was split on the menthol question, with some beneficiaries of industry dollars opposing a ban while other caucus members voiced deep concerns about the health toll of targeted marketing on Black communities.

The exemption was seen as a way to win broad support in Congress for the bill. Lawmakers instead authorized the agency to study the additive and ban it if the findings supported such a step. The F.D.A. sought to move against menthols twice since then, facing opposition from the industry as well as the influencers they financed. In recent years, those influencers have trafficked in fears that banning menthol cigarettes will produce bootleg menthol products, ramped-up police surveillance and more tragic episodes like that of Eric Garner, who was strangled in a police chokehold while being arrested for selling loose cigarettes on a street on Staten Island.

In making the case against the menthol ban, such figures are working from an old tobacco playbook. Relying on industry funding, they use legitimate civil rights concerns about biased policing and racial discrimination to help Big Tobacco defend its lucrative menthol markets. Their argument, like menthol itself, is a cynical distraction.

The truth is that menthol cigarettes and the death of Mr. Garner are linked by his plaintive cry of “I can’t breathe,” part of a long history of systemic targeting of Black people. The story of Big Tobacco and menthol is a rolling tragedy where the violence occurs off camera. It is a slower extraction of health and wealth, playing out not over minutes but decades and generations. But make no mistake, menthol cigarette smoking often leads to decimated lungs, emphysema, cancer and a range of other ailments, ending too often in a tragic plea for air.

After decades of outcries from communities and public health experts about the health inequities and dangers posed by menthol marketing (with the N.A.A.C.P. now urging a ban), the F.D.A.’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. The agency is now accepting public comments and will hold two hearings before finalizing its rule.

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.

Keith Wailoo is a professor of history and public affairs at Princeton University and the author of “Pushing Cool: Big Tobacco, Racial Marketing, and the Untold Story of the Menthol Cigarette.”

 

FDA’s Proposed Rules to Prohibit Menthol Cigarettes and Flavored Cigars Will Protect Kids, Advance Health Equity and Save Lives, Especially Among Black Americans

WASHINGTON, D.C. – By issuing proposed rules today to prohibit menthol cigarettes and all flavored cigars, the FDA is taking historic and long-overdue action to protect our nation’s kids, advance health equity and save lives, especially among Black Americans and other populations that have been targeted by the tobacco industry and suffered enormous harm from the predatory marketing of these products.  For decades the tobacco industry has deliberately targeted Black communities with marketing for menthol cigarettes, with tragic consequences. The industry also uses these flavored products to lure kids into a deadly addiction. These rules will, once and for all, put an end to these predatory and deadly practices.

The Covid-19 pandemic has further exposed the stark health disparities that exist in the United States. Tobacco use is a significant contributor to these disparities, and Black Americans die at higher rates from tobacco-related diseases such as cancer, heart disease and stroke. The FDA’s proposal to ban menthol cigarettes and flavored cigars will have a profound and certain impact in reducing these health disparities.

The Biden Administration and the FDA deserve immense credit for standing up to the tobacco industry and moving forward with this bold, lifesaving policy, as they promised to do one year ago. Once implemented, these rules will represent some of the strongest actions our nation has ever taken to drive down the number of kids who start smoking and the number of Americans who are sickened and killed by tobacco.

Once again putting profits before lives, the tobacco industry is going all-out to fight these rules and push false claims that they will subject Black Americans to more law enforcement abuse. The FDA has made it crystal clear that these claims are without merit. The FDA has stated that its rules will apply to manufacturers and retailers and that it “cannot and will not enforce against any individual consumer possession or use of menthol cigarettes or any tobacco product.” Racial bias in policing is a critical issue that must be addressed. But the tobacco industry’s cynical fearmongering cannot hide the fact that the industry itself has caused so much harm to Black Americans through the targeted marketing of menthol cigarettes.

There is strong support for prohibiting menthol cigarettes and flavored cigars from a wide range of organizations, scientists and elected officials – including from leading Black organizations and members of Congress. Supporters include the NAACP, other Black civil rights and public health organizationsmembers of the Congressional Black Caucus, and a broad coalition of 77 public health, medical, education and community organizations. In a letter this month, NAACP President and CEO Derrick Johnson powerfully stated, “We do not agree with the tobacco industry’s message and strategy presented by a few Black leaders: prohibiting menthol cigarettes would be discriminatory. We reject this view. The failure to prohibit the sale of menthol cigarettes and products would be discriminatory and counter the goal and function of the FDA to protect and promote public health for all, including the African-American community.”

Because of the profound impact these rules can have on our nation’s health, the FDA has an obligation to finalize and implement them with utmost urgency. The faster these rules are implemented, the faster we can stop the tobacco industry’s lethal targeting of Black and other communities, the more kids we will prevent from smoking, and the more lives we will save.

ADDITIONAL INFORMATION: WHY MENTHOL CIGARETTES AND FLAVORED CIGARS MUST BE ELIMINATED

These rules are long overdue and supported by overwhelming scientific evidence. It has been more than a decade since the FDA’s Tobacco Products Scientific Advisory Committee concluded in a landmark 2011 report that the removal of menthol cigarettes from the marketplace would benefit public health in the United States. Based on the scientific evidence, the FDA has found that menthol cigarettes are easier for kids to start smoking, more addictive and harder for smokers to quit.

Eliminating menthol cigarettes will protect kids from tobacco addiction. Menthol cools and numbs the throat and masks the harshness of tobacco smoke, making it easier for kids to start smoking and eventually become addicted. According to the 2021 National Youth Tobacco Survey, 41% of all current high school smokers use menthol cigarettes. 

Eliminating menthol cigarettes will save lives and reduce health disparities, especially among Black Americans. For more than 60 years, the tobacco industry has deliberately targeted Black communities with marketing for menthol cigarettes through magazine ads, sponsorship of community and music events, free samples and other tactics.  In the 1950s, less than 10% of Black smokers used menthol cigarettes. Today, that number is 85%.

The industry’s targeted marketing of menthol cigarettes has caused enormous harm to the health of Black Americans. Tobacco use is the number cause of preventable death among Black Americans, claiming 45,000 Black lives each year. Largely because of more addictive menthol cigarettes, Black smokers have a harder time quitting smoking and die at higher rates from tobacco-related diseases like cancer, heart disease and stroke.

2021 study found that menthol cigarettes were responsible for 10.1 million additional smokers and 378,000 premature deaths in the U.S. from 1980 to 2018. This research underscores that Black Americans have been disproportionately harmed: While making up 12% of the U.S. population, Black Americans represented 15% of the additional smokers and a staggering 41% of the premature deaths due to menthol cigarettes – 157,000 premature deaths among Black Americans altogether.

Eliminating flavored cigars will also protect kids and reduce health disparities. Cheap, flavored cigars are sold in over 250 flavors – like banana smash, cherry dynamite and chocolate, as well as menthol. These flavored products have flooded the market in recent years and fueled the popularity of cigars with kids. 74% of youth cigar smokers report that they smoke cigars “because they come in flavors I like.” The 2021 National Youth Tobacco Survey shows that cigars are the second most popular tobacco product (after e-cigarettes) among all high school students and are especially popular among Black high school students.