The Food and Drug Administration on Thursday announced a plan to ban sales of menthol-flavored cigarettes in the United States, a measure many public health experts hailed as the government’s most meaningful action in more than a decade of tobacco control efforts.
The proposed ban is expected to have the deepest impact on Black smokers, nearly 85 percent of whom use menthol cigarettes, compared with a rate of 29 percent among white smokers, according to a government survey. If effective in reducing smoking, the ban could significantly diminish the burden of chronic disease and limit the number of lives cut short by one of the most hazardous legal products available.
The proposed ban “would, among other things, improve the health and reduce the mortality risk of current smokers of menthol cigarettes or flavored cigars by substantially decreasing their consumption and increasing the likelihood of cessation,” the F.D.A. commissioner, Dr. Robert Califf, told a Senate committee Thursday.
Menthol is a chemical derived from the mint plant that can also be made in a lab. It is included in cigarettes to make smoking less harsh, providing a cooling sensation in the throat. Public health experts say menthol cigarettes have been heavily marketed to Black people, to devastating effect: African American men have the highest rates of lung cancer in America, according to the Centers for Disease Control and Prevention.
Taking menthol cigarettes off the market is expected to further reduce smoking levels and reduce the number of young people taking up the habit. If the United States’ experience mirrors that of Canada after it banned menthol cigarettes, 1.3 million people would quit smoking and potentially hundreds of thousands of premature deaths could be averted, said Geoffrey Fong, principal investigator of the International Tobacco Control Policy Evaluation Project.
“This is potentially an extraordinary, landmark intervention to reduce the No. 1 preventable cause of death and disease,” Mr. Fong said.
The proposed ban was announced after a frenzy of lobbying by tobacco and retail interests. The proposed rule will be open for public comments for at least 60 days and then finalized with possible revisions. It is expected that it will take a least a year to go into effect.
The tobacco companies are likely to contest the rule in court, which could result in a long legal battle.
Erika Sward of the American Lung Association said that, once finalized, the menthol ban “will be the single most significant action taken by the F.D.A. in its almost 13-year history of regulating tobacco products.”
The proposed rule does not cover menthol e-cigarettes. The F.D.A. is currently reviewing all vaping products being sold in the United States to determine whether to allow them to stay on the market. (Sales of these products began before the F.D.A. had regulatory authority over them.) The agency has so far granted marketing approval to makers of some tobacco-flavored vapes. Some menthol products remain on the market as the agency mulls how to rule on some of the top-selling devices.
Public health advocates have long sought a menthol ban. When the landmark Tobacco Control Act passed in 2009, giving the F.D.A. the authority to regulate tobacco products, menthol was exempted from the tobacco flavors that would be banned.
The exception rankled public health groups and a cadre of former U.S. cabinet health secretaries, who noted the 47,000 Black lives lost each year to smoking-related disease. Allowing menthol cigarettes to remain on the market “caves to the financial interests of tobacco companies and discriminates against African Americans,” the health secretaries wrote in a letter to the Senate, when the tobacco control law was moving through Congress.
The law left the matter in the hands of the F.D.A. and its advisers, who took incremental steps forward. Agency advisers in 2011 said removing menthol cigarettes from the marketplace would benefit public health, but stopped short of calling for a ban. Two years later, the F.D.A. said menthol made it easier to start smoking and harder to quit, seeking comment on “potential regulation.”
A half decade passed before Dr. Scott Gottlieb, the F.D.A. commissioner at the time, announced his intent to seek a menthol cigarette ban in 2018. He left the agency before achieving that goal. Last year, the agency said it would pursue the ban again, as well as eliminating flavors in small, mass-produced cigars that are popular with Black and Latino teenagers.
White House records show recent meetings with supporters of a ban, including the American Heart Association and American Academy of Pediatrics. The Public Law Health Center and others left officials with a review of Canada’s experience with banning menthol cigarettes in 2017, which led to 59 percent of menthol smokers picking up unflavored cigarettes, 20 percent of the menthol smokers quitting and nearly the same proportion continuing to buy them on Native reservations, where they can still be sold.
Business groups including Americans for Tax Reform and the Tax Foundation warned White House officials of losing federal and state tax dollars — as much as $6.6 billion in the first year of a menthol cigarette ban.
Though supporters of the ban say it is an important step toward reducing disease inequities in the United States, the step has, to some degree, divided Black communities. The Rev. Al Sharpton has sharply criticized it, and recently secured a meeting with White House officials along with King & Spalding, a lobbying firm with an extensive record of advocating for RAI Services Company, the cigarette maker formerly known as R.J. Reynolds.
Mr. Sharpton, president of the National Action Network, wrote a letter to Susan Rice, the Domestic Policy Council director, saying the ban would lead Black smokers to tamper with cigarettes or use unregulated herbal menthol varieties, which would “promote criminal activity.” Mr. Sharpton has acknowledged that Reynolds has supported his organization for two decades but would not say how much it contributed.
Reynolds is one of the world’s largest cigarette companies and maker of Newport menthol cigarettes, which it calls “America’s No. 1-selling menthol cigarette brand.”
Reynolds raised similar concerns in a letter to White House officials, suggesting the F.D.A. extend the timeline on a ban to ensure local enforcement does not roll out “in a way that creates negative effects, such as disparate impacts on communities of color.”
“A menthol ban would impose serious risks,” Mr. Sharpton wrote, “including increasing the illegal sale of smuggled, black market menthol cigarettes as well as the street sales of individual menthol cigarettes — ‘loosies’ and in turn place menthol smokers at a significant risk of entering the criminal justice system.”
Carol McGruder, co-founder of the African American Tobacco Control Leadership Council, said it’s “shameful” that Mr. Sharpton and others take tobacco funding. She said that the need for police reform is real but that the lives taken early by menthol tobacco are far greater in number.
“To cynically use our pain, to say, ‘Oh, we want to protect you from that by leaving these products on the market that are killing you’ is crazy,” Ms. McGruder said.
The N.A.A.C.P. also supports the ban and says it has not taken funding from the tobacco industry in two decades. Portia Reddick White, legislative affairs vice president, said her organization rejected the notion that a menthol ban would exacerbate tensions with the police since enforcement would be focused at the manufacturing level.
“It’s really a smokescreen and it’s misleading and it’s not helpful,” she said, and distracts from the work of reducing health disparities and smoking-related chronic conditions. “We see it as discriminatory to have menthol allowed on the shelf.”
