“Three years after the FDA’s own findings that associated the use of menthol cigarettes with increased smoking, greater addiction, greater indications of nicotine dependence, decreased likelihood of smokers’ ability to quit smoking and confirmed significant racial, gender and socioeconomic disparities among those who used menthol cigarettes; and, despite mounting evidence of the grievous impact smoking menthol cigarettes has on the health and morbidity of Americans in general and Black Americans in particular—the FDA has failed to ban its use by the tobacco industry.”For years, scientific evidence has pointed to the disproportionate and deadly impact smoking menthol cigarettes has on African Americans.

In a bold move, last week a group of African American activists including a number of doctors and other health care professionals reignited discussion on this important and relevant issue when it penned a letter to the president and described the use of menthol in cigarettes as not only a growing health concern—but also a mounting social justice issue.

Why now? Well, while for years some in the Black community have pushed for a ban on menthol with no success. Many believe this failure was at least partly due to a split in the Black community between those concerned about the increasing health crisis and those who saw the good work that could be accomplished for the Black community on other issues of importance to Black Americans as a result of the large financial contributions from the tobacco industry—but, at what cost in Black lives.

Now, with issues of race at the forefront of the American political discussion; and with mounting scientific evidence related to the health implications of menthol in cigarettes—many believe now is the time to press for change on this issue.

Smoking related illnesses is the largest cause of preventable deaths among Blacks in America accounting for approximately 45,000 deaths each year—the greatest percentage of Blacks who smoke, smoke menthol cigarettes.

There is little doubt the tobacco industry has targeted the African American community.

At one time you could drive through any inner city community anywhere in the nation and you would see more billboard ads for cigarettes, particularly menthol cigarettes, than you see in any other community. The same held true for ad placements in Black print media and at recreational events, like concerts, etc. As a result, it was not surprising that federal surveys show nearly four out of every five African American smokers use menthol cigarettes.

There is little doubt the tobacco industry has targeted the African American community. University of California, San Francisco researcher Valerie Yerger has incorporated tobacco industry documents into community-based participatory research projects on tobacco cessation. Her research revealed tobacco industry documents that showed how cigarette companies purposely targeted low-income, African-American neighborhoods. In one example of such behavior during 1980’s Lorillard, the maker of Newport cigarettes, demanded sales representatives, “stay out of the suburbs and go into tough inner-city neighborhoods.”

A 2012 National Center for Biotechnology Information (NCIB) research document, African Americans’ Responses to Genetic Explanations of Lung Cancer Disparities . . ., reported when the smoking patterns of Black Americans is compared with Whites, historically, African Americans begin smoking at older ages and smoke fewer cigarettes per day than Whites; and yet, Blacks are more likely to be diagnosed with and die from lung cancer than Whites. (Black men have the highest lung cancer mortality rate than any other demographic group in the nation.) The report also noted that while cigarette smoking is the leading preventable cause of lung cancer, racial/ethnic disparities in lung cancer incidents cannot be explained by differences in smoking behavior alone.

There is some public misperception regarding the use of menthol by the tobacco industry. A 2011 study published by the NCBI, Menthol: Putting the pieces together, stated, “Menthol is not just a flavoring agent. Cigarette companies use menthol’s ability to mask irritation and provide sensory effects to make menthol cigarettes appeal to youth and health-concerned smokers, in part because menthol makes low-tar cigarettes more palatable. However, this report also stated there appears to be complex interactions with addictive effects of nicotine. The ubiquitous addition of menthol by tobacco companies to over 90 percent of all tobacco products, whether labelled ‘menthol’ or not, demonstrates that menthol is not simply a flavor or brand. Menthol imparts sensory characteristics to cigarettes and has a complex interaction with nicotine that affects smoking behavior whether it is perceived or not, or whether cigarettes containing menthol are marketed as ‘menthol’ or not.”

In 2009, Congress passed the Family Smoking Prevention and Tobacco Control Act that banned all flavors in tobacco products, with the exception of menthol; it remained on the market while the U.S. Food and Drug Administration (FDA) determined appropriate regulatory action. The Act gave the FDA the power to ban menthol if “appropriate for the public health.”

“…menthol may facilitate smoke inhalation and promote nicotine addiction and smoking-related morbidities.”

To ensure the FDA was advised about menthol and other smoking-related scientific issues, the Tobacco Products Scientific Advisory Committee (TPSAC) was established. In July, 2011, TPSAC released “Menthol Cigarettes and Public Health: Review of the Scientific Evidence and Recommendations.” This Review outlined TPSAC’s findings on menthol cigarettes. It concluded it is “biologically plausible” that menthol makes cigarette smoking more addictive. It also stated the removal of menthol cigarettes from the marketplace would benefit public health in the United States.

Also in 2011, a report by one of the world’s most cited biology journals, the FASEB, stated, “. . . menthol may facilitate smoke inhalation and promote nicotine addiction and smoking-related morbidities.”

Even though TPSAC provided convincing evidence of the dangers of menthol cigarettes—the FDA failed to take any action. Purportedly, because the report did not provide specific recommendations for follow‐up.

After nearly two years with no action by the FDA, in 2013 twenty national public health organizations filed a Citizen’s Petition that urged the FDA to protect American’s heath by banning menthol cigarettes. After all, the FDA possessed the regulatory power to do so.

In July, 2013, within two months of receipt of the citizen petition, the FDA released its own report, “Preliminary Scientific Evaluation of the Possible Public Health Effects of Menthol versus Non-Menthol Cigarettes.” The report validated TPSAC findings and concluded the use of menthol cigarettes was associated with increased smoking, greater addiction, greater indications of nicotine dependence, and decreased likelihood of smokers’ ability to quit smoking. The report also confirmed significant racial, gender and socioeconomic disparities among those who used menthol cigarettes.

The European Union has proposed to ban the use of menthol in cigarettes by 2020. Many believe it is passed time for America to do the same.

Reports indicate that between 2002 and 2010, the use of menthol cigarettes declined significantly among most users; however, use among African-American smokers increased dramatically to 85 percent during the same period—many believe advertising by the tobacco industry keenly focused on the African American community played a significant role in these results.

By 2013, menthol cigarettes accounted for 30 percent of the cigarette industry’s market share and was the most commonly used flavored tobacco product in the United States.

Three years after the FDA’s own findings regarding the impact of menthol cigarettes and despite mounting evidence of the grievous results smoking menthol cigarettes has on the health and morbidity of Americans in general and Black Americans in particular—the FDA has failed to ban its use by the tobacco industry.

The European Union has proposed to ban the use of menthol in cigarettes by 2020. Many believe it is passed time for America to do the same.