The U.S. Food and Drug Administration on Thursday proposed a ban on menthol cigarettes, a move that the agency has tried before and one that public health experts and civil rights groups have pushed for years.
Menthol cigarettes have been marketed aggressively to Black Americans for decades: About 85% of Black smokers use menthol brands, the FDA said, and research shows menthol cigarettes are harder to quit than plain tobacco products.
The agency said it will also seek to ban menthol and other flavors in mass-produced cigars, including small cigars popular with young people.
The action will "address health disparities experienced by communities of color, low-income populations and LGBTQ individuals, all of whom are far more likely to use these tobacco products," Acting FDA Commissioner Dr. Janet Woodcock said during a morning media briefing on the proposed ban.
And "flavored tobacco, including flavors found in some cigars and cigarillos, makes smoking more appealing by reducing initial aversive responses, particularly for young people," she added.
Mitch Zeller, director of the FDA's Center for Tobacco Products, said during the briefing that the health costs of menthol cigarettes has been particularly punishing for Black Americans.
"For far too long, certain populations have been targeted and disproportionately impacted by tobacco use. Furthermore, 85% of all Black smokers use menthol cigarettes, compared to just 30% of white smokers," Zeller said.
"One study showed that from 1980 to 2018, menthol cigarette smoking was linked to 378,000 premature deaths, 3 million life-years lost, and 10.1 million new smokers," he added. "Another study suggests that banning menthol cigarettes in the United States would lead an additional 923,000 smokers to quit -- including 230,000 African Americans -- in the first 13 to 17 months after a ban goes into effect."
Anti-smoking and civil rights advocates alike applauded the move.
"Banning menthol would be an important step in reducing the initiation of smoking and increasing smoking cessation attempts," said Patricia Folan, director of the Center for Tobacco Control at Northwell Health, in Great Neck, N.Y. "This proposal will help protect Black health and save lives. There is overwhelming evidence documenting the immense harm caused by the marketing and sale of menthol tobacco products. I hope this long anticipated ban takes effect."
Delmonte Jefferson, executive director of the Center for Black Health and Equity, called the decision a victory for all people of color.
"This has been a long time coming," Jefferson told The New York Times. "We've been fighting this fight, since back in the 1980s. We told the industry then, we didn't want those cigarettes in our communities."
Advocacy groups support ban
Matthew Myers, president of Campaign for Tobacco-Free Kids, noted that menthol and other flavors also appeal widely to teenagers.
"The Administration's new policy has the potential to be the strongest action 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," Myers said in a statement.
"It will crack down on the tobacco industry's most pernicious tactic for luring and addicting kids -- the marketing of flavored products like menthol cigarettes and flavored cigars. And it will end the industry's predatory targeting of Black communities with menthol cigarettes -- a form of institutional racism that has taken a devastating toll on Black lives and health, is a major cause of health disparities, and must be stopped once and for all," he continued.
"This decision is supported by overwhelming scientific evidence. As the FDA itself concluded in a 2013 scientific report, menthol cigarettes are easier for kids to start smoking, more addictive and harder for smokers to quit. Half of all kids who ever try smoking start with menthol cigarettes. And because of the tobacco industry's targeted marketing, 85% of Black smokers now smoke menthol cigarettes, compared to less than 10% in the 1950s. Menthol cigarettes are a major reason why Black Americans have a harder time quitting smoking and are more likely to die from tobacco-related diseases like lung cancer, heart disease and stroke," Myers added.
According to Nancy Brown, CEO of the American Heart Association, "A prohibition on menthol cigarettes and flavored cigars would mark a historic turning point in the decades-long battle against tobacco use and the epidemic of tobacco-related disease.
"The FDA's announcement today will begin a process intended to prohibit products that for decades have enticed tobacco users into a lifetime of nicotine addiction and condemned a disproportionate number of Black smokers to serious illness and premature death," Brown said in a statement.
"We commend the FDA for moving, at long last, to prevent tobacco companies from targeting Black communities, youth and others with menthol cigarettes that make smoking easier to start and harder to quit," Brown added.
But Steven Callahan, a spokesman for Altria, which owns Philip Morris USA, told the Times that the company remained opposed to a menthol ban.
"We share the common goal of moving adult smokers from cigarettes to potentially less harmful alternatives, but prohibition does not work," Callahan said.
An April 29 court deadline is forcing the FDA to act on a citizens' petition to ban menthol, but the proposed ban is expected to face a lengthy legal challenge from tobacco companies, the Washington Post reported.
The ban would not apply to electronic cigarettes, which are currently considered tools to help smokers of regular menthol cigarettes quit. Most e-cigarette brands, including Juul, are undergoing an FDA review that will determine whether they are sufficiently beneficial to public health to be allowed to stay on the market, the Times reported.
Dr. Scott Gottlieb, President Donald Trump's first FDA commissioner, proposed a similar menthol ban three years ago, but the Trump administration backed down after intense resistance from tobacco state lawmakers, the Timesreported.
But pressure to resurrect the effort has been building since President Joe Biden's election, and as the coronavirus pandemic and the Black Lives Matter movement further exposed sharp racial disparities in the country's public health and medical systems.
Visit the U.S. Centers for Disease Control and Prevention for more on the dangers of menthol cigarettes.
SOURCES: April 29, 2021, media briefing with: Janet Woodcock, MD, Acting U.S. Food and Drug Administration Commissioner, and Mitch Zeller, director, FDA's Center for Tobacco Products; Patricia Folan, director, Center for Tobacco Control, Northwell Health, Great Neck, N.Y.; Matthew Myers, president, Campaign for Tobacco-Free Kids, statement, April 29, 2021; Nancy Brown, CEO, American Heart Association, statement, April 29, 2021; Washington Post, The New York Times