Yesterday, the FDA released two proposed rules prohibiting menthol as a characterizing flavor in cigarettes and all characterizing flavors in cigars.
This action represents a huge and long overdue step forward for public health and health equity. When implemented, these changes will save lives, especially Black lives, and help protect kids from tobacco addiction. Scientific evidence shows that menthol cigarettes are more addictive, easier to start, and harder to quit.
The tobacco industry has extensively targeted its predatory marketing for menthol to African American communities, causing disproportionate harm to Black Americans. Menthol cigarettes alone were responsible for more than 10 million extra smokers, 3 million life years lost, and 378,000 premature deaths between 1980 and 2018. While 12% of the US population is African American, African Americans account for 41% of the premature deaths and 50% of the life-years lost during this same time period.
Eliminating menthol cigarettes will also improve the health of other groups that have been targeted by the tobacco industry. Use of menthol cigarettes is disproportionately high among communities of color; lesbian, gay, and bisexual smokers; socioeconomically disadvantaged populations; and pregnant women.
Menthol cools and numbs the throat and masks the harshness of tobacco smoke, which makes it easier for kids to start smoking and eventually become addicted. Half of all kids who have ever tried smoking started with menthol cigarettes, and 41% of all current high school smokers use menthol cigarettes.
Cheap, flavored cigars are sold in over 250 flavors – like banana smash, cherry dynamite and chocolate, as well as menthol. 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.
It is thanks to tireless advocates who have been working towards this goal for decades, and a result of a recent lawsuit led by the African-American Tobacco Control Leadership Council (AATCLC), Action on Smoking and Health, the American Medical Association, and the National Medical Association to compel the FDA to respond to a citizen petition submitted by the Public Health Law Center, the Center for Black Health and Equity, and AATCLC originally in 2013 after menthol was excluded from the ban on all other flavored in cigarettes in the 2009 Family Smoking Prevention and Tobacco Control Act and after the FDA’s own studies concluded based overwhelming scientific evidence that removing menthol would benefit public health. Read a joint statement from the plaintiffs on the FDA’s response here.
While this news is a major victory, state and local policy change is still as critical as ever. It could still take years for the FDA to implement these product standards, especially given delays that would result from likely tobacco industry litigation. However, state, local jurisdictions, and Tribes do not have to wait for the federal rule to be implemented – they can pass their own policies that protect their communities today. At least 150 places across the country have already restricted or prohibited the sale of menthol cigarettes. Massachusetts led the way when it became the first state in November 2019 to prohibit the sale of all flavored tobacco products, including menthol cigarettes, and residents in California will vote on a similar statewide policy this fall.
It is also important to note that the FDA will not enforce these proposed rules on an individual level. As stated in the agency’s press release, “FDA enforcement will only address manufacturers, distributors, wholesalers, importers and retailers who manufacture, distribute, or sell such products within the U.S. that are not in compliance with applicable requirements. These proposed regulations do not include a prohibition on individual consumer possession or use.” Read more about equitable enforcement of commercial tobacco here or listen to our podcast episode on the topic.
While there remains work to do, removing menthol and all flavors from combustible products, the number one cause of preventable death and disease, is a huge step forward for public health, health equity, and the commercial tobacco endgame.
Read the FDA’s full press release here. As it notes, public comment on the rules begins May 4th and ends July 7th. The FDA will also hold two public listening sessions on the proposed rules in June.