Clearing the Smoke: FDA Working Toward Tobacco Flavor Ban to Save Lives, Promote Health Equity

April 29, 2021
Leah Kuntz

Looking to reduce youth initiation into tobacco products, the FDA takes steps against menthol cigarettes and flavored cigars.

The US Food and Drug Administration (FDA) announced its commitment to advance tobacco product standards banning menthol cigarettes and all characterizing flavors in cigars. The decision to advance these proposed standards is based on evidence establishing the addictiveness and harm of these products, as well as previous actions banning other flavored cigarettes in 2009.1

“Banning menthol—the last allowable flavor—in cigarettes and banning all flavors in cigars will help save lives, particularly among those disproportionately affected by these deadly products. With these actions, the FDA will help significantly reduce youth initiation, increase the chances of smoking cessation among current smokers, and address health disparities experienced by communities of color, low-income populations, and LGBTQ+ individuals, all of whom are far more likely to use these tobacco products,” Acting FDA Commissioner Janet Woodcock, MD, said in a press release. “Together, these actions represent powerful, science-based approaches that will have an extraordinary public health impact. Armed with strong scientific evidence, and with full support from the Administration, we believe these actions will launch us on a trajectory toward ending tobacco-related disease and death in the US.”2

Strong evidence suggests that a menthol ban will help people quit. According to studies, menthol increases the appeal and likelihood of regular smoking, particularly with youth. Menthol makes tobacco more palatable by masking potentially unpleasant flavors, thus making them easier to start using.

A study by Chung et al suggested that a menthol cigarette ban in the US would lead to an additional 923,000 people who stopped smoking. Included in that number are 230,000 African Americans who would likely quit in the first 13 to 17 months after a ban goes into effect.3 Levy et al estimated that about 633,000 deaths would be averted with a menthol cigarette ban.4

“For far too long, certain populations, including African Americans, have been targeted, and disproportionately impacted by tobacco use. Despite the tremendous progress we’ve made in getting people to stop smoking over the past 55 years, that progress hasn’t been experienced by everyone equally,” said Mitch Zeller, JD, director of the FDA’s Center for Tobacco Products. “These flavor standards would reduce cigarette and cigar initiation and use, reduce health disparities, and promote health equity by addressing a significant and disparate source of harm. Taken together, these policies will help save lives and improve the public health of our country as we confront the leading cause of preventable disease and death.”2

If these actions are implemented, the FDA’s ban on menthol cigarettes and all flavored cigars will only affect manufacturers, distributors, wholesalers, importers, and retailers. Individual consumer usage of menthol cigarettes and tobacco products cannot be enforced by the FDA, but the FDA will work to ensure unlawful tobacco products are kept off the market.

References

1. US Food and Drug Administration. Menthol and other flavors in tobacco products. Accessed April 29, 2021. https://www.fda.gov/tobacco-products/products-ingredients-components/menthol-and-other-flavors-tobacco-products

2. US Food and Drug Administration. FDA commits to evidence-based actions aimed at saving lives and preventing future generations of smokers. News release. April 29, 2021. https://content.govdelivery.com/accounts/USFDA/bulletins/2d6d785

3. Chung-Hall J, Fong GT, Meng G, et al. Evaluating the impact of menthol cigarette bans on cessation and smoking behaviours in Canada: longitudinal findings from the Canadian arm of the 2016–2018 ITC Four Country Smoking and Vaping Surveys. Tob Control. April 5, 2021. https://tobaccocontrol.bmj.com/content/early/2021/03/31/tobaccocontrol-2020-056259?utm_medium=email&utm_source=govdelivery

4. Levy DT, Pearson JL, Villanti AC, et al. Modeling the future effects of a menthol ban on smoking prevalence and smoking-attributable deaths in the United States. Am J Public Health. 2011;101(7):1236-40.