ACP Expresses Support for FDA Proposal to Ban Menthol Cigarettes, Flavored Cigars

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Members are encouraged to express support for the proposed ban at the FDA listening sessions in June

June 3, 2022 (ACP) — In its commitment to improving public health, the American College of Physicians fully supports the new U.S. Food & Drug Administration proposal to outlaw menthol cigarettes and flavored cigars.

“It's clear that menthol cigarettes pose a unique threat to public health,” said Ryan Crowley, ACP senior associate for health policy. “ACP has long supported a ban on flavors, including menthol, in all tobacco products because they increase youth initiation to smoking and make it harder for established smokers to quit.”

At issue are menthol, a minty-tasting additive, and flavorings for cigars, such as strawberry, grape, cocoa and fruit punch. According to the FDA, “more than a half million youth in the U.S. use flavored cigars, and in recent years more young people tried a cigar every day than tried a cigarette.”

All these additives make it easier to tolerate tobacco smoking.

“Tobacco companies exploit this by marketing menthol cigarettes as smoother alternatives to nonmenthol products,” Crowley said. “In 2011, the FDA concluded that menthol cigarettes are more addictive and harder to quit than nonmenthol products, especially among Black smokers. The evidence on menthol's negative impact on cessation has grown since then, including a 2019 study concluding that a menthol ban would improve cessation rates among Black Americans. Recent surveys of smokers show that most would quit smoking if menthol cigarettes were removed from the market.”

ACP has already been a major player in the fight to outlaw these products. Last year, ACP signed onto a friend-of-the-court brief supporting a lawsuit by the African American Tobacco Control Leadership Council, the National Medical Association, and the American Medical Association to force the agency to take action. More recently, ACP and several other groups placed an ad in several newspapers calling for swift action to ban menthol cigarettes and flavored cigars.

On April 28, 2022, the FDA announced its proposal to ban menthol cigarettes and flavored cigars and target manufacturers, distributors, wholesalers, importers and retailers who violate the rules. Individual smokers can continue to own and use the products.

“The authority to adopt tobacco product standards is one of the most powerful tools Congress gave the FDA, and the actions we are proposing can help significantly reduce youth initiation and increase the chances that current smokers quit. It is clear that these efforts will help save lives,” FDA Commissioner Dr. Robert M. Califf said in a statement.

According to the FDA, more than 18.5 million people older than 12 years in the United States smoked menthol cigarettes in 2019, with especially high usage among young people, African-Americans and other racial/ethnic groups. “Published modeling studies have estimated a 15 percent reduction in smoking within 40 years if menthol cigarettes were no longer available in the United States,” the FDA said in a statement. “These studies also estimate that 324,000 to 654,000 smoking-attributable deaths overall (92,000 to 238,000 among African-Americans) would be avoided over the course of 40 years.”

The tobacco industry is not likely to accept the proposed rules without a fight because menthol cigarettes are a big source of profit, Crowley said. But ACP and its allies have a major weapon on their side: They have gathered grim evidence about the cynical motivations of the tobacco industry and the toll of menthol cigarettes and flavored cigars.

“Tobacco companies have been targeting menthol products to Black communities for decades,” Crowley explained. “A 2020 Surgeon General report on tobacco cessation showed ‘predatory marketing by the tobacco industry is common in geographic areas with large numbers of Black residents, which may negatively influence cessation.’”

The FDA will accept comments on the proposed ban through July 5, 2022, and the agency will hold public listening sessions on June 13 and 15, 2022. “ACP members can weigh in on how a ban on menthol cigarettes and flavored cigars will benefit their patients,” Crowley said.

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