Action needed on menthol cigarette ban

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three generations of The Trisha VetawThe family of smoked menthol cigarettes. It could even be four, since Vetaw knows his great-grandfather smoked but doesn’t know which brand he lit.

It’s a family tradition that Vetaw has long deplored. Prior to her 2021 election to the Minneapolis City Council, she worked as Director of Health Policy and Advocacy for NorthPoint Health and Wellness, a medical center in the city’s North Side neighborhoods. There, she was a strong advocate for tobacco use, especially menthol cigarettes, the green wrappers of which she too often saw growing up in her family and community.

Thanks to advocates like Vetaw, a few states and a growing number communities in Minnesota and elsewhere have taken action to ban sales of menthol cigarettes, with objections such as the mint flavor’s appeal to new users and its heightening of nicotine’s addictive powers. Now, the U.S. Food and Drug Administration (FDA) is poised to build on that work by taking strong and necessary action:

Ban menthol flavor in cigarettes nationwide.

A surprisingly large share of the total market may go up in smoke if the regulator takes action. Menthol flavored products totaled 37% of all cigarette sales in the United States in 2019 and 2020, according to the United States Centers for Disease Control and Prevention (CDC).

The FDA should have stepped in to ban menthol cigarettes for the past decade, but late is better than never. In 2009, Congress passed the Tobacco Control Acta public health milestone that banned cigarette flavors but left the decision on menthol to the regulatory agency.

The agency sounded the alarm over menthol in the years that followed. Finally, in 2018, the agency’s management announced its intention to ban menthol cigarettes. Dr. Scott Gottlieb, a Trump appointee, deserves credit for making the decision. Although he left before completing the vital work, Gottlieb nonetheless created a lasting momentum on which the Biden administration now relies.

In addition to banning menthol-flavored cigarettes, the FDA announced a decision to ban flavored cigars, which could reduce their appeal to new or young smokers. These two measures are currently the subject of a rule-making process. Two “listening” sessions are scheduled on Monday and Wednesday for public participation, with information on participation at this link: tinyurl.com/2rx38b2e.

The new restrictions will save lives. A model from 2011 study published in the American Journal of Public Health assessed the benefits of a menthol ban and concluded: “In a scenario in which 30% of menthol smokers quit and 30% of those who start because menthol smokers do not start, by 2050 the relative reduction in smoking prevalence would be 9.7% overall and 24.8% for blacks; deaths averted would be 633,252 overall and 237 317 for blacks.”

The focus on the impact of a menthol ban on the black community is significant. Near 85% of black smokers use menthol products compared to 30% of white smokers. Additionally, black Americans are “more likely to die of smoking-related illnesses than whites,” according at the CDC.

These stats reflect what Vetaw has seen grow. Advertisements for menthol cigarettes abounded in the stores where his family shopped and in the magazines in their home. Free samples and branded products were often available at events and gathering places. She and other advocates have sounded the alarm that menthol marketing campaigns are “targeting” black consumers.

“We just got bombed,” Vetaw said.

The ban on menthol cigarettes is not only a step forward for public health. It would also be an important step towards addressing the stubborn disparities in health care that affect minority communities.

Said Vetaw: “We need it.”

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