The Food and Drug Administration is poised to ban menthol in cigarettes this week, a decision that experts believe has been in the works for years and may have a direct positive effect on the health of Black Americans.
Lung Cancer: Ban On Menthol Cigarettes
The FDA’s decision would not automatically ban menthol but would instead initiate the rule-making process, which could take years. “The winds are clearly in our favor,” said Delmonte Jefferson, executive director of the Center for Black Health & Equity, citing decades of research indicating that the cooling taste of cigarettes makes it easier to resume smoking, as well as the recent societal movement toward bettering the lives of Black Americans.
Menthol creates a cooling feeling in the mouth when inhaled, reducing the harsh flavor of smoke and the inflammation caused by nicotine. Menthol cigarettes are used by the vast majority of Black smokers (85%). Furthermore, black men and women are much less likely than white Americans to be diagnosed with lung cancer at an early, potentially treatable stage.
Black men have the highest rate of lung cancer mortality in the world.
“When you pair high rates of smoking with systemic racism in health-care programs, you have a huge health gap,” said Erika Sward, national assistant vice president for advocacy at the American Lung Association.
The Centers for Disease Control and Prevention and the National Institutes of Health have unveiled efforts to counter racial racism in health care recently. The FDA faces a court-ordered deadline on Thursday to refer to a citizen petition submitted to the department in 2013 asking it to prohibit the use of menthol as a flavoring in cigarettes. When the FDA declined to respond at the time, two organizations – the African American Tobacco Control Leadership Council and Action on Smoking and Health – filed a lawsuit.
It’s likely that a decision will be made before Thursday. Since the case just addresses standard cigarettes, it’s unknown if electronic cigarettes and other menthol-containing nicotine products will be impacted.
Under the leadership of then-Commissioner Dr. Scott Gottlieb, the FDA was poised to ban menthol flavoring in 2018 but did not follow through. Gottlieb did not respond to a comment message. Any adherents of a menthol ban argue that a nationwide emphasis on the Black Lives Matter movement may prompt the department to act now.
“Covid-19, as well as the racial awakening we witnessed last summer, exposed the inequities in our system,” Jefferson said. “Menthol one of the health disparities that have been linked to lung cancer in African Americans for decades,” says one expert.
It is likely that the department will postpone its response by requesting further time from the judge.
Even if a decision to begin the banning process is made this week, Fagan is suspicious that it would be motivated by “social problems that surfaced in 2020.”
If the FDA decides to implement a ban, menthol will not vanish immediately. In essence, such a statement will actually inform the public and the tobacco industry that the FDA plans to prohibit the flavoring in cigarettes.
The rule-making process will most likely take years to complete and execute. This will provide time to expand nicotine prevention services aimed at menthol smokers.
“Any smoker who uses menthol cigarettes requires assistance in quitting,” Sward said. Evidence suggests that a ban like this could benefit public health. An analysis released this month in the journal Tobacco Control looked at how menthol cigarette bans in Canada from 2016 to 2017 influenced smokers.
Although almost 60% of surveyed menthol smokers turned to standard cigarettes, those who used menthol prior to the ban were slightly more likely to choose to quit smoking multiple times. More than 20% are willing to leave. There was also proof of lower relapse rates by ex-smokers.
“The enormous popularity of Canada’s menthol ban makes it much easier now that the United States should eventually ban menthol,” study author Geoffrey Fong said in a news release announcing the report on April 6.