The danger of menthol cigarettes

More and more people have begun to move away from participating in social media after learning that computer algorithms choose the messages in their feeds, rather than having a personal choice in what they see. Similarly, the general public has become increasingly conscious of the ingredients and sourcing of medications and foods they eat, demanding improved nutritional information on packaging and menus.

These examples serve as evidence that individuals overwhelmingly want to decide for themselves what they see or consume. But if this is true, asks Dr. Asha Devereaux, a pulmonary medicine doctor affiliated with Sharp Coronado Hospital, why do so many Americans allow tobacco companies to tell them what to inhale?

A billion-dollar marketing budget targeted to Black Americans
According to the Centers for Disease Control and Prevention (CDC), cigarette and smokeless tobacco companies spend billions of dollars each year to market their products in the U.S. — spending upward of $9 billion in 2018 alone. What’s more, the American Lung Association reports that tobacco product advertising is more prevalent in Black communities.

One study found that there are 2.6 times as many tobacco advertisements per person in predominately Black neighborhoods than in predominately white neighborhoods. And the likelihood that a billboard advertisement is smoking-related is 70% higher in primarily Black communities.

These campaigns persist, with the sole purpose of encouraging people to smoke, even as health experts and tobacco executives know that smoking harms nearly every organ of the body, affects overall health, and leads to disease, disability and death. In fact, smoking is the leading cause of preventable death in the U.S.

“African Americans historically have higher rates of smoking than white populations,” says Dr. Devereaux. “This population also often has limited access to smoking cessation programs and are more likely to die from smoking-related diseases than white people. And yet, this is the group tobacco companies continuously target.”

The marketing of menthol to select populations
One of the tobacco products most commonly marketed to Black Americans is menthol-flavored cigarettes. It is estimated that 85% of Black smokers use a menthol product. It is also believed that smoking is responsible for the deaths of more than 45,000 Black individuals each year.

The Food and Drug Administration (FDA) wants to do something about these daunting numbers. It has recommended a ban on menthol as a characterizing flavor in cigarettes, and a ban on all characterizing flavors, including menthol, in cigars.

According to Dr. Devereaux, menthol was added to cigarettes to improve the flavor and mask the harshness of the smoke as it enters the lungs. However, while providing a “smooth smoke,” menthol also acts as an anesthetic, allowing deeper nicotine inhalation and absorption, which in turn, reinforces smoking behavior and strengthens addiction to it.

“The history of marketing menthol tobacco products goes back 100 years,” Dr. Devereaux says. “Menthol cigarettes have always been marketed as cool, elegant, attractive and soothing, creating a hook and making it harder to quit.”

Several reasons to support the ban
The tobacco industry’s marketing moves have been calculated every step of the way, Dr. Devereaux says. This includes their successful effort to exclude menthol flavoring from a 2009 federal ban of all other flavorings in cigarettes.

She joins the FDA in recommending the expansion of this previous ban to include menthol, which is the last flavor allowed in cigarettes, and believes it will help save lives, particularly among Black Americans and young people.

“The tobacco industry has been marketing menthol products to select populations, namely African Americans and teens, for years,” Dr. Devereaux says. “They have made millions after targeting our most vulnerable, and it’s time to put a stop to it.”

The research, the FDA reports, shows that banning menthol tobacco products would help people quit smoking and prevent deaths. It is estimated that 923,000 smokers in the U.S., including 230,000 Black people, will quit in the first 13 to 17 months after the ban goes into effect. And approximately 630,000 tobacco-related deaths over 40 years, including the deaths of close to 240,000 Black people, will be avoided.

Furthermore, an FDA study found that the availability of menthol cigarettes increases the number of children who experiment with smoking and become long-term smokers. A ban will also lead to far fewer kids and teens starting to smoke, becoming addicted and continuing to smoke on a regular basis.

Next steps to address this public health crisis
The FDA will work toward issuing the official ban over the next year. The next step will be for the agency to publish the proposed ban and give the general public an opportunity to comment on the recommendation. If implemented, enforcement of the ban will only address manufacturers and vendors of menthol cigarettes and flavored cigars, not individuals who are in possession of or use these products.

“Big tobacco has created more disease, a tremendous public health crisis, a huge burden on health care, and a social justice issue,” Dr. Devereaux says. “Let’s outsmart the process, support the ban and stop feeding this industry at our expense.”

View the CDC fact sheet on the health effects of cigarette smoking. Learn more about smoking cessation classes available through Sharp.