The U.S. Food and Drug Administration (FDA) is moving forward with plans to ban menthol cigarettes and all flavored cigars—policies that agency officials say could help prevent some of the roughly 500,000 U.S. deaths linked to tobacco each year.
“The actions we are proposing can help significantly reduce youth initiation and increase the chances that current smokers quit,” FDA Commissioner Dr. Robert Califf said in a statement. “It is clear that these efforts will help save lives.”
But whether the proposed menthol ban will work as intended is a matter of active debate.
Many influential public-health groups support the policy. Menthol adds a minty flavor and cooling feeling to cigarettes, masking their harshness. As a result, menthol cigarettes are thought to be both more appealing to new smokers and harder for current smokers to quit, which justifies their prohibition, according to many public health experts. (A new study, however, calls into question whether menthols are actually harder to quit than regular cigarettes.)
Black Americans are disproportionately likely to smoke menthols, in large part due to decades of targeted marketing from tobacco companies. Supporters of a menthol ban, including the NAACP, argue that the move would improve the health of Black Americans, while critics argue it is a racial justice issue and could result in discriminatory policing by criminalizing a product disproportionately used by people of color. In a joint letter sent to the U.S. Department of Health and Human Services secretary last year, the ACLU and other signatories wrote that a menthol ban would “prioritize criminalization over public health and harm reduction” and could create an illicit market for menthol products. (The FDA has said it would enforce penalties against retailers and manufacturers that violate the ban, not individuals.)
Others who don’t support the ban argue that it will simply push menthol smokers to use unflavored tobacco products.
After San Francisco in 2018 banned all flavored tobacco products, including menthols and e-cigarettes, fewer young adults used vaping products but more smoked cigarettes, one small 2020 study found. While other societal factors may explain that shift—including an outbreak of vaping-related lung disease beginning months after San Francisco’s policy went into full effect—the authors concluded that flavor bans could lead to more traditional cigarette smoking.
Still, a number of recent real-world studies suggest that menthol bans do have positive effects on public health.
In 2020, menthol cigarettes were banned in the U.K. A paper published in JAMA Network Open on May 3 examined how the regulation affected teenage menthol smoking, using national surveys conducted before and after it took effect. Before the policy went into place, roughly 12% of teenage smokers in the U.K. said they used menthol-flavored products. After it took effect, that number dropped to 3%—a clear sign that the ban led to a drop in youth menthol use, the authors write. (The 3% who said they continued to smoke menthols may have purchased them illegally or used products like sprays and filter tips that add a minty flavor.)
That finding, though intuitive, could strengthen support for menthol bans, since public-health authorities including the U.S. Centers for Disease Control and Prevention argue that use of flavored tobacco products can lure young people into a lifetime of addiction. However, the JAMA Network Open study didn’t look into whether former teen menthol users quit smoking altogether or simply switched to another type of tobacco product.
Jamie Ducharme – Time – 2022-04-28.
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