Three generations of LaTrisha Vetaw's family have smoked menthol cigarettes. It might even be four, since Vetaw knows that her great-grandfather smoked but isn't sure what brand he lit up.
It is a family tradition that Vetaw has long lamented. Before her 2021 election to the Minneapolis City Council, she worked as the director of health policy and advocacy for NorthPoint Health and Wellness, a medical center in the city's North Side neighborhoods. There, she was an outspoken advocate against tobacco use, particularly menthol cigarettes whose green packages she saw far too often growing up in her family and community.
Thanks to advocates like Vetaw, a few states and a growing number of communities in Minnesota and elsewhere have taken steps to ban menthol cigarette sales, with objections including the minty flavor's appeal to new users and its enhancement of nicotine's addictive powers. Now, the U.S. Food and Drug Administration (FDA) is poised to build on that work by taking a strong and necessary step:
Prohibiting menthol flavor in cigarettes nationally.
A stunningly large part of the total market may go up in a puff of smoke if the regulatory agency follows through. Menthol-flavored products totaled 37% of all U.S. cigarette sales in 2019 and 2020, according to the U.S. Centers for Disease Control and Prevention (CDC).
The FDA should have moved to ban menthol cigarettes over the past decade, but late remains better than never. In 2009, Congress passed the Tobacco Control Act, a public health milestone that banned cigarette flavorings but left the decision on menthol up to the regulatory agency.
The agency sounded the alarm on menthol in the years afterward. Finally, in 2018 the agency's leadership announced its intentions to ban menthol cigarettes. Dr. Scott Gottlieb, a Trump appointee, merits praise for making this move. While he departed before completing the vital work, Gottlieb nevertheless created some lasting momentum that the Biden administration is now building on.
In addition to banning menthol-flavored cigarettes, the FDA has announced a move to prohibit flavored cigars, which could reduce their appeal to new or young smokers. Both of these measures are now going through the rule-making process. Two "listening" sessions are scheduled on Monday and Wednesday for public input, with participation information at this link: tinyurl.com/2rx38b2e.
The new restrictions will save lives. A 2011 modeling study published in the American Journal of Public Health evaluated a menthol ban's benefits and concluded: "In a scenario in which 30% of menthol smokers quit and 30% of those who would have initiated as menthol smokers do not initiate, by 2050 the relative reduction in smoking prevalence would be 9.7% overall and 24.8% for Blacks; deaths averted would be 633,252 overall and 237,317 for Blacks."
The focus on a menthol ban's impact on the Black community is important. Close to 85% of Black smokers use menthol products vs. 30% of white smokers. In addition, Black Americans are "more likely to die from smoking-related diseases than Whites," according to the CDC.
Those statistics mirror what Vetaw saw growing up. Ads for menthol cigarettes abounded at the stores her family shopped in and in the magazines in their home. Free samples and branded merchandise were often available at events and gathering places. Along with other advocates, she has sounded the alarm that menthol marketing campaigns "targeted" Black consumers.
"We were just bombarded with it," Vetaw said.
Banning menthol cigarettes isn't just a public health advancement. It's also would take an important step toward addressing stubborn health care disparities affecting minority communities.
Said Vetaw: "We need this."
