Menthol: 10 million additional smokers in the United States

A recent study published in the journal Tobacco Control[1] indicates that menthol cigarettes have slowed the decline in smoking prevalence in the United States. These cigarettes led to the consumption of 10.1 million additional smokers and 378,000 premature deaths between 1980 and 2018.

The researchers attempted to assess the health impact of menthol cigarettes. They used a simulation model of smoking prevalence and health effects to reproduce smoking rates and associated deaths from 1980 to 2018, drawing on data from national health surveys The researchers found that "menthol cigarettes were responsible for initiating 10.1 million smokers (266,000 per year), 3 million cumulative years of life lost, and 378,000 premature deaths (9,900 per year) between 1980 and 2018."

According to the study, in the absence of menthol cigarettes, the overall prevalence of smoking in the United States would have fallen from 33.2% in 1980 to 11.1%, compared to 13.7% observed in 2018. Menthol cigarettes have therefore had significant health consequences, and these consequences could continue if menthol cigarettes continue to be marketed. The authors believe that their research can help the Food and Drug Administration (FDA) evaluate potential regulatory measures for menthol cigarettes.

Tobacco industry's targeted marketing called into question

Menthol causes a cooling sensation in the throat and airways, reducing the irritation and pungency of cigarette smoke. This characteristic encourages young people to start smoking and makes it more difficult to quit. These characteristics also explain the advertising tactics deployed by the tobacco industry, which has particularly targeted specific social and demographic groups, including young people, African-Americans, women and the LGBT community.

The American NGO Campaign for Tobacco-Free Kids has just published a new report[2] titled Stopping Menthol, Saving Lives, which documents the tobacco industry's marketing to African-American communities, particularly youth, for more than 60 years and the health consequences it causes. Smoking is the leading cause of preventable death among African-Americans, killing 45,000 people each year. The report comes amid broader federal, state and local efforts to ban menthol cigarettes and other flavored nicotine products in an effort to end the industry's targeted marketing.

FDA failures highlighted

In 2009, Congress granted the United States Food and Drug Administration (FDA) the authority to regulate tobacco products (Family Smoking Prevention and Tobacco Control Act). However, despite the conclusions of its reports and those of its Scientific Advisory Committee that banning menthol cigarettes would benefit public health in the United States, the FDA has failed to take action on this issue. In April 2013, several medical and public health organizations filed a petition with the FDA calling on it to ban menthol as a distinctive flavor in cigarettes. In June 2020, the organizations filed suit against the FDA to compel it to respond to the petition. The plaintiffs claim that the FDA’s failure to take action on menthol cigarettes constitutes an “unreasonable delay” that is contrary to its mission to regulate tobacco products. In a January 21, 2021 filing with the U.S. District Court for the Northern District of California, the FDA committed to issuing a final response to the petition by April 29, 2021.

Keywords: United States, menthol, marketing, tobacco industry, FDA

Photo credit: Truth Initiative

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