29 April 2021 | LAUREL WAMSLEY | NPR (original link)
The U.S. Food and Drug Administration says it is moving to ban menthol cigarettes and flavored cigars, based on the evidence of the addictiveness and harm of the products. Tobacco companies have long targeted African Americans with advertising for menthol cigarettes.
“Banning menthol — the last allowable flavor — in cigarettes and banning all flavors in cigars will help save lives, particularly among those disproportionately affected by these deadly products,” acting FDA Commissioner Dr. Janet Woodcock said in a statement Thursday.
“With these actions, the FDA will help significantly reduce youth initiation, increase the chances of smoking cessation among current smokers, and 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,” Woodcock added.
A potential ban by the FDA would only apply to manufacturers, distributors, wholesalers, importers and retailers.
The agency said it will focus on keeping the products off the market, as opposed to targeting individual use: “The FDA cannot and will not enforce against individual consumer possession or use of menthol cigarettes or any tobacco product.”
The move follows previous actions that banned other flavored cigarettes in 2009. While the FDA made a similar announcement to prohibit menthol cigarettes in 2018 during the Trump administration, a ban did not come to pass.
White House spokeswoman Karine Jean-Pierre said Thursday that the proposed ban “is a public health decision that will help curb addiction and save lives.”
“If implemented, these rules affect only commercial activity,” she said, noting the FDA does not regulate tobacco possession.
The FDA said that “menthol masks unpleasant flavors and harshness of tobacco products, making them easier to start using. Tobacco products with menthol can also be more addictive and harder to quit by enhancing the effects of nicotine.”
African American adults have the highest percentage of menthol cigarette use compared with other racial and ethnic groups, according to the Centers for Disease Control and Prevention.
The FDA said about 18.6 million people in the U.S. currently smoke menthol cigarettes, but their use is uneven: Almost 85% of Black smokers use menthol cigarettes, compared with 30% of white smokers.
The NAACP welcomed the FDA’s announcement.
“For decades, data have shown that the tobacco industry has successfully and intentionally marketed mentholated cigarettes to African Americans and particularly African American women as ‘replacement smokers’; that menthol smokers have a harder time quitting smoking; and that tobacco use is a major contributor to heart disease, cancer, and stroke – three leading causes of death among African Americans,” NAACP President and CEO Derrick Johnson said in a statement.
“The ban by the FDA is long overdue to protect the health of African Americans and to reduce the deleterious impact of menthol smoking and tobacco use overall on America’s health,” he said.
But tobacco giant Altria, parent company of Philip Morris USA, argued that a ban won’t work.
“We share the common goal of moving adult smokers from cigarettes to potentially less harmful alternatives, but prohibition does not work,” Altria spokesman George Parman said in a statement to NPR. “A far better approach is to support the establishment of a marketplace of FDA-authorized non-combustible alternatives that are attractive to adult smokers.”
Altria said it will review the FDA’s announcement and engage in the rule-making process “with a focus on the science and evidence.”
But the American Medical Association said the evidence is clear on the harmful impacts of menthols and called the FDA’s decision long overdue. It pointed to an FDA finding that if menthol cigarettes had been removed from the marketplace in 2010, “by 2020, roughly 17,000 premature deaths would have been avoided and about 2.3 million people would not have started smoking.”
The goal of the ban is to reduce tobacco addiction and curb deaths, the FDA said. It cited a study suggesting that banning menthol cigarettes in the U.S. “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.”
The African American Tobacco Control Leadership Council has long pushed to ban menthol cigarettes.
“This is a major step forward in Saving Black Lives; however, this is not the end of this fight, only the next stage,” Phillip Gardiner, the council’s co-chair, said in a statement. “We know that this rule making process could take years and we know that the tobacco industry will continue to do everything in their power to derail any attempt to remove their deadly products from the market.”
The American Civil Liberties Union has argued against a ban, citing the potential for disproportionate impact on communities of color, and sent a letter of concern to the FDA and the U.S. Department Health and Human Services.
“Time and time again, we see encounters with police over minor offenses — for Daunte Wright it was expired tags, for George Floyd it was using a counterfeit bill, for Eric Garner it was selling loose cigarettes — result in a killing,” ACLU senior legislative counsel Aamra Ahmad said in a statement.”There are serious concerns that the ban implemented by the Biden administration will eventually foster an underground market that is sure to trigger criminal penalties which will disproportionately impact people of color and prioritize criminalization over public health and harm reduction.”
The FDA will publish the proposed rule in the Federal Register, allow time for public comment and then make any revisions before publishing the final rule.
The FDA’s announcement is the culmination of years of effort and wait by public health groups – and the work isn’t over yet, said Joanna Cohen, a professor at the Johns Hopkins Bloomberg School of Public Health.
If the FDA publishes a final rule, Cohen said, “the tobacco companies will most likely sue,” as they have with other proposed regulations on tobacco products.
Cohen noted that the FDA’s announcement does not include electronic cigarette cartridges. The FDA banned most flavored cartridges last year (except tobacco and menthol flavors) – which Cohen said spurred vapers instead simply to buy devices that pre-load the flavors.
In that way, she said, tobacco control is like a balloon.
“If you squeeze in one area, the balloon — the tobacco industry — is just going to expand into some other area. So you have to really be thoughtful and comprehensive whenever you do one of these things, because if you’re not careful, it moves the problem.”