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.
June 21, 2022