No action the Food and Drug Administration and the Obama administration could take would do more to save lives, reduce health-care costs and curb the tobacco industry’s exploitation of children and minority teens than to ban menthol flavoring in cigarettes.
Consider these findings from a March report by an FDA panel:
l Eighty percent of adolescent African American smokers use menthol cigarettes.
l Most adolescent Hispanic American smokers use menthol cigarettes.
l Most Asian American middle-school smokers use menthol cigarettes.
l Almost half of 12- to 17-year-old smokers use menthol cigarettes (and, as other research has found, more than 90 percent of adult smokers are hooked as teens).
The Family Smoking Prevention and Tobacco Control Act, enacted in 2009, bans flavoring a cigarette with any herb or spice, or strawberry, grape, orange, clove, cinnamon, pineapple, vanilla, coconut, licorice, cocoa, chocolate, cherry or coffee flavor — except for menthol. Why was menthol flavoring not prohibited as we and many public health professionals urged when Congress considered the bill?
Here’s what senior members of Congress told us: If the bill bans menthol flavoring, Philip Morris will withdraw its support and the legislation will not pass. After all, Philip Morris and the other tobacco companies have spent about $20 million a year lobbying for the past 12 years. The tobacco companies also sprinkle campaign contributions to legislators across party lines; last year alone, it gave $1.5 million to Republican members and $800,000 to Democratic members.
The 2009 law did establish a scientific advisory committee to evaluate health issues and make recommendations to the FDA. At our urging, it required the committee to act promptly on menthol flavoring in cigarettes. The committee’s recently issued reportputs the ball of banning such flavoring in the FDA’s court because it concluded that menthol cigarettes have an “adverse impact on public health by increasing the numbers of smokers with resulting premature death and avoidable morbidity.”
Thanks to the committee’s work, we know why Philip Morris, R.J. Reynolds and the rest of the tobacco industry fought so fiercely to keep menthol flavoring in cigarettes. The committee found that menthol reduces “the harshness of smoke and the irritation from nicotine, and may increase the likelihood of nicotine addiction in adolescents . . . who experiment with smoking.” The committee charged the industry with exploiting teens and children: “[I]ndustry documents . . . confirm that the industry developed menthol marketing to appeal to youth.” While aiming this charge specifically at the Newport brand, the committee found “that strategy was also adopted by other tobacco companies. Marketing messages positioned menthol cigarettes as an attractive starter product for new smokers who are unaccustomed to intense tobacco taste. . . .” The committee noted that “adolescent menthol cigarette smokers are more dependent on nicotine than adolescent non-menthol cigarette smokers.”
The committee also found that the tobacco industry cynically targeted black people and “developed specialized brands and tailored marketing strategies to promote menthol cigarettes to African Americans”; that “menthol cigarettes are disproportionately marketed per capita to African Americans”; as a result, “menthol cigarettes are disproportionately smoked by African American smokers.”
More than 80 percent of black smokers use menthol cigarettes, compared with 24 percent of white smokers. More than 47,000 black Americans die each year from smoking-related diseases. More black women get lung cancer than get breast cancer, and black men are 50 percent more likely to get lung cancer than white men are.
Lorillard (maker of Newport, Kent and others) and R.J. Reynolds have gone to court to block the FDA from considering the committee’s report. They allege that the membership of the committee “lacks fair balance.” That the tobacco companies would question the integrity of committee members after having been found by a U.S. district judge to have lied to the American public for 50 years about the health hazards of smoking is beyond chutzpah.
The FDA response to the committee’s recommendation will be a test of the Obama administration’s commitment to health care and reducing its costs. In the Tobacco Control Act, Congress found: “Reducing the use of tobacco by minors by 50 percent would prevent well over 10 million of today’s children from becoming regular, daily smokers,” and “Such a reduction in youth smoking would also result in approximately $75 billion in savings attributable to reduced health care costs.”
A ban on menthol flavoring in cigarettes would be a slam-dunk for an administration that trumpets its commitment to cutting health-care costs and protecting children.
Joseph A. Califano Jr. is founder and chairman of the National Center on Addiction and Substance Abuse at Columbia University. He was secretary of health, education and welfare during the Carter administration. Louis W. Sullivan is president emeritus of the Morehouse School of Medicine. He was secretary of health and human services under President George H.W. Bush.