Posted: May 12, 2022, University of Kentucky
The news of the U.S. Food and Drug Administration (FDA)’s proposal to ban mentholated cigarettes and flavored cigars will save lives. Every two and a half minutes, someone in the U.S. is diagnosed with lung cancer. Every day in the U.S., 400 lives are lost to lung cancer. If the FDA’s proposal is approved, researchers expect a 15 percent decline in tobacco smoking. Over the next 40 years, that decline in smokers could result in saving up to 654,000 lives. Nearly one-third of those deaths avoided will be among non-Hispanic Black smokers, who are more likely to use menthol cigarettes than non-Hispanic White smokers.
Why ban menthol in cigarettes and flavored cigars?
Menthol is a chemical compound that the tobacco industry intentionally adds to cigarettes to market as “smoother” and “less harsh”. However, menthol’s flavor and sensory effects make menthol-flavored tobacco products highly addictive and appealing, especially to new users such as youth and young adults. Despite the marketing that suggests otherwise, mentholated cigarettes are not less harmful than non-mentholated and are likely a greater public health risk, especially among Black and urban communities. There are over 18.5 million menthol cigarette smokers ages 12 and older in the U.S.
Historically, the tobacco industry targeted marketing of mentholated products to young and Black Americans through culturally tailored advertising. As such, compared to other racial/ethnic groups, Black Americans have the highest proportion of menthol cigarette use and seven out of 10 Black youth who smoke use mentholated cigarettes. Although Black Americans begin smoking at later ages than White youth, they are disproportionately affected by heart disease, stroke and lung cancer.
For the second consecutive year, the American Lung Association “State of Lung Cancer” annual report lists Kentucky as the number one state for lung cancer incidence. Specifically, among Black Kentuckians, the lung cancer incidence is 84 per 100,000 – a significantly higher rate than the national rate of 60 per 100,000 Black Americans. Despite the significant advances in lung cancer screening and treatment, the survival rate of Black Kentuckians lags that of White Kentuckians at 21 percent and 19 percent respectively. Menthol cigarette smoking also disproportionately affects women, LGBTQ+, individuals with lower levels of education and income, and those with mental health diagnoses. These striking disparities warrant the FDA’s proposal to ban menthol and flavored cigars.
The FDA proposal is historic and long overdue. If approved, it will protect Kentuckians, advance health equity, save lives, and reduce the enormous economic toll from tobacco use in our state and in the U.S. The proposed ban has the potential to significantly impact Kentuckians, given the state’s high adult prevalence rate which continues to be among the highest in the country, 21.4 percent compared to 15.5 percent. Furthermore, it will protect Kentucky’s youth who smoke flavored cigars at higher rates than the nation, 7.9 percent and 5.7 percent respectively.
As established tobacco control policy advocates, clinicians, and researchers, we know the powerful public health impact when regulatory bodies, such as the FDA, disrupt tobacco industry practices of putting profit over health. Advancing Kentucky’s health and reducing the mortality risk among menthol cigarette users is more critical than ever, especially for populations that suffer disproportionately from the harmful effects of tobacco. Join us in providing public comment today to support one of the most aggressive and historic actions by the FDA to save lives and money.
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The opinion piece was authored by Janie Heath, PhD, APRN-BC, FAANP, FAAN, Dean and Warwick Professor of Nursing, University of Kentucky College of Nursing; Ellen J. Hahn, PhD, RN, FAAN, Professor and Director, BREATHE, UK College of Nursing; Audrey Darville, PhD, RN, FAANP, Clinical Associate Professor and Tobacco Cessation Specialist, UK College of Nursing; and Lovoria Williams, PhD, APRN-BC, FAAN, Associate Professor and Associate Director & Endowed Research Professor Cancer Health Equity, Markey Cancer Center, UK College of Nursing