13 June 2022
By: The Times Editorial Board Source: Los Angeles Times
Take a deep breath, America. We’ve made serious progress against cigarette smoking. According to the U.S. Centers for Disease Control and Prevention, 23% of adults were smokers in 2000. By 2020, the rate had fallen to 12.5%. Teen use of traditional cigarettes has plummeted from 22.5% in 2002 to 6% in 2019, according to the American Lung Assn.
And yet we have a long way to go, in part because the popularity of vaping has led to an overall increase in use of tobacco products. A 2021 survey found that 11.3% of high school students said they currently used e-cigarettes; of those, more than a quarter vaped daily. And yes, e-cigarettes don’t have the smoke associated with lung cancer, but they contain a batch of harmful chemicals that can cause breathing problems and other health issues. Not to mention that they hook young people on nicotine, which then opens the door to cigarettes.
It’s probably not a coincidence that in 2009, the U.S. Food and Drug Administration banned most kinds of flavored cigarettes, those that taste of candy or fruit and lured teens into smoking. It would take 12 more years for the FDA to announce a similar but partial ban on flavored e-cigarettes while it continues to consider whether vaping products should be banned altogether.
But there’s one flavor that has remained untouched, at least until now. After more than a decade of consideration, the FDA is proposing to ban menthol cigarettes and cigars (and is taking public comments on this plan until July 5). Menthol has long been the most common and popular flavoring for tobacco products.
Menthol has a minty taste that softens the harshness of cigarette smoke, making it easier to start — and, some studies indicate, harder to quit. It also is especially marketed to communities of color, so it should be no surprise that 48% of adult Latino smokers and 85% of Black smokers use menthol tobacco products, compared with 30% for white smokers, according to the CDC.
Of course, adults are entitled to make their own decisions — even very bad decisions — about whether to smoke. Banning menthol, considering its effect on the Black community, is a double-edged sword. Tobacco companies have targeted vulnerable populations with marketing, causing disproportionate harm. Black people smoke at somewhat higher rates than white people. But banning menthol could be seen as biased and patronizing, with the government telling Black adults that they no longer have access to the kind of smokes they like, while most white people get to continue with their chosen form of cigarettes. Nor is menthol’s effect on smoking rates entirely clear. Despite the higher levels of menthol use among Latinos, they are significantly less likely to smoke than white people.
But the debate ends with the irrefutable fact that menthol is a gateway to smoking and it worsens the rate of smoking overall. According to the anti-tobacco group Truth Initiative, the percentage of smokers who choose menthol rose steadily from 2008 to 2018. And young smokers — teens and young adults — are significantly more likely to choose menthol than regular cigarettes.
Our society does have the right and duty to take steps to protect kids and young adults from tremendous harm, as the federal government did in 2019 when it raised the smoking age from 18 to 21. Considering how difficult it is to stop smoking — fewer than one in 10 who try to quit are successful — prevention is the best way to bring down this deadly addiction.
Menthol’s popularity has already been waning among some young people. A 2020 study found that from 2011 to 2018, use of menthol among young cigarette smokers dropped from 57.3% to 45.7%. But the numbers didn’t change at all for young Black and Latino smokers, the ones most likely to choose menthol in the first place. And even at the lower rate, it’s still higher than for adults.
The menthol ban is the right way to go — except that it doesn’t go nearly far enough. Menthol e-cigarettes are not included, even though the FDA banned cartridge-based vaping with candy and fruit flavors in 2020.
This month, the Los Angeles City Council tackled this in a stronger way: It banned flavored and menthol e-cigarettes as well as cigars and cigarettes. This isn’t the first city to do this, but it’s the largest. Of course, without a statewide ban — a similar California law is on hold pending a referendum on the November ballot — many smokers are likely to buy their flavored tobacco products outside the city. But bold moves by a few cities create a trend. That’s what happened with California’s single-use plastic bag ban.
The tobacco industry has argued that a ban on menthol products would only cause menthol smokers to turn to regular cigarettes. But a 2020 meta-study that included examinations of places where such bans were already in place found that while some smokers switched products, fewer people started smoking altogether. And surveys of menthol smokers cited in the meta-study found that a significant number said they’d quit smoking rather than try another tobacco product if there were a ban.
To paraphrase an old cigarette advertising slogan, they’d rather quit than switch.