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FDA begins deliberations on menthol cigarette ban

A ban would halt the manufacture and sale of peppermint-flavored cigarettes and cigars. The cigarettes, which are used by 18.5 million Americans and 85% of Black smokers, are known to appeal to young users, increase tolerability, and make it harder to quit. Health officials say the ban would not result in the targeting of individual smokers for enforcement.

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ROCHESTER, Minn. — The director of the Mayo Clinic nicotine dependence center says the proposed Food and Drug Administration plan to ban menthol cigarettes now under final review "would probably save hundreds of thousands of lives over the next three or four decades."

"The FDA is moving to eliminate menthol in tobacco," said Dr. J. Taylor Hays during a media call on Monday, Aug. 1. "It is long in coming, and I think it is the right move for public health."

Menthol cigarettes are manufactured when peppermint flavoring is added to some brands as a means to reduce throat irritation and harshness. It is known to increase adoption of smoking among young people.

"It provides a local anesthetic, if you will, a cooling effect," Hays said. "That reduces irritability and the cough reflex and, frankly, makes it easier to smoke what otherwise would be a very harsh smoke ... making it easier to start, easier to continue, and quicker to get hooked, because it increases your nicotine exposure."

Modeling studies show eliminating menthol cigarettes would result in 15% fewer smokers within 40 years, a drop resulting in between 324,000 and 654,000 fewer deaths during that time period. The proposed ban would include all flavored cigars as well.

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A ban has been a long time in the works.

Menthol has been added to cigarettes for over a hundred years but the practice increased in the 1950s. In 2009 the Family Smoking Prevention and Tobacco Control Act prohibited all other flavors in cigarettes, but excluded tobacco and menthol flavoring.

The current proposal did not gain traction until a 2013 lawsuit sought to ban menthol in tobacco, Hays said. With the passage on Monday of a comment submission deadline, a final review period has begun. The FDA has given no timeline for when they will render their decision.

Menthol cigarettes are used by 18.5 million Americans, according to federal officials, and are purchased by 85% of non-Hispanic Black smokers, compared to 30% of white smokers. Following a ban, between 92,000 and 238,000 fewer Black Americans are expected to die of smoking-related illness over the ensuing decades, according to federal research.

Though some Black leaders have opposed the ban as discriminatory, it is hailed by others as a correction to years of menthol cigarette marketing targeting Black Americans.

"I don't think there's anything about menthol and menthol containing tobacco that would be particularly attracting African Americans, other than the tobacco industry is targeting them in their marketing," Hays said.

"And that's been shown in a number of empirical studies looking at point-of-sale and price point marketing of menthol-containing cigarettes to the African American community."

Health officials say the change will not result in action at the individual level, stating that the agency "cannot and will not enforce against individual consumers for possession or use of menthol cigarettes or flavored cigars."

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"State and local law enforcement agencies do not independently enforce the Federal Food, Drug and Cosmetic Act and do not, and cannot, take enforcement actions against any violation of FDA’s tobacco authorities," the FDA statement said.

It is an important concession for those concerned that, in outlawing the cigarette overwhelmingly favored by Black Americans, the change could increase potentially perilous contacts between users of black market menthol products and law enforcement. In 2014, a New York man named Eric Garner was killed by Staten Island police after they approached him for selling loose cigarettes.

"I know this has been an argument," Hays said. "It seems ironic that a predatory industry like the tobacco industry can market in this way and then we say we can't take the step to eliminate this product that we know is causing dependence among a large number of African American youth and adults, because we’re concerned about the way it will be enforced."

"I do understand that in the current atmosphere, that's an issue, [but] the enforcement is not against individuals ... the enforcement is at the production level. If there is a black market, it will only happen because the tobacco industry is cooperative."

Paul John Scott is the health correspondent for NewsMD and the Forum News Service. He is a novelist and was an award winning magazine journalist for 15 years prior to joining the FNS in 2019.
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