Letter by Lempert et al Regarding Article, “Menthol and Nonmenthol Cigarette Smoking: All-Cause Deaths, Cardiovascular Disease Deaths, and Other Causes of Death Among Blacks and Whites”
To the Editor:
The 2009 Family Smoking Prevention and Tobacco Control Act exempted menthol from the list of “characterizing flavors” prohibited in tobacco products, but gave the Food and Drug Administration authority to act on menthol. Munro et al1 reported that 84% of black smokers used menthol cigarettes in comparison with 27% of white smokers, and that, controlling for race and smoking intensity, menthol cigarettes were not associated with a different risk of death from cardiovascular disease than nonmenthol cigarettes. Although menthol per se was not associated with higher cardiovascular disease risk, tobacco companies have targeted black communities effectively with specialized marketing to promote menthol cigarettes, which contributes to tobacco-related disparities.2 In 2011 the Food and Drug Administration’s Tobacco Products Scientific Advisory Committee concluded that “removal of menthol cigarettes from the marketplace would benefit public health in the United States,”3 and a 2012 study found that 44% of black menthol smokers said they would try to quit smoking if menthol were banned.4
In May 2016, the Food and Drug Administration published its “deeming rule” extending its jurisdiction over cigarettes and smokeless tobacco to all tobacco products. The rule, as submitted to the White House,5 included 17 pages of substantial evidence demonstrating menthol’s impact on public health, including the fact that “[m]enthol in cigarettes also is likely associated with increased dependence, with consistent findings showing that menthol smokers are more likely to smoke their first cigarette within five minutes of waking (a well-established measure of dependence), and are less likely to successfully quit smoking.”
The rule, as submitted to the White House, would have resulted in all newly deemed menthol products to have been ordered off of the market by November 6, 2016, and would remain off the market unless the manufacturers could demonstrate these products protect public health.
The White House, however, deleted these 17 pages, leaving menthol and other flavored products to remain on the market, missing an important opportunity to protect the public health of all Americans, especially blacks.
Lauren K. Lempert, JD, MPH
Valerie Yerger, ND
Stanton A. Glantz, PhD
Circulation is available at http://circ.ahajournals.org.
- © 2016 American Heart Association, Inc.
- Munro HM,
- Tarone RE,
- Wang TJ,
- Blot WJ
- 3.↵FDA Tobacco Products Scientific Advisory Committee. Menthol Cigarettes and Public Health: Review of the Scientific Evidence and Recommendations. 2011. http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/TobaccoProductsScientificAdvisoryCommittee/UCM247689.pdf. Accessed June 20, 2016.
- 5.↵Department of Health and Human Services and Food and Drug Administration. TAB B 2014-850 Deeming Final Rule Redline Changes. Deeming Tobacco Products To Be Subject to the Federal Food, Drug, and Cosmetic Act, as Amended by the Family Smoking Prevention and Tobacco Control Act; Restrictions on the Sale and Distribution of Tobacco Products and Required Warning Statements for Tobacco Products. 21 CFR Parts 1100, 1140, and 1143 [Docket No. FDA-2014-N-0189]. 2016. https://www.regulations.gov/#!documentDetail;D=FDA-2014-N-0189-83193. Accessed June 20, 2016.