FDA must ban menthol cigarettes this time

Mass. set the standard for what is needed

AT THE END of April, the Food and Drug Administration announced it would move toward banning menthol flavored cigarettes and all flavored cigars. While encouraged by the announcement, we must remember that we have been at this stage before and have seen the FDA retreat. History should not repeat itself: the FDA must seize this opportunity to act more boldly and broadly to ban all flavored tobacco and nicotine products. Congress must listen to the voices of young people impacted by the industry, like students from the Holbrook Middle-High School in my district, and act in a bipartisan way, as done in Massachusetts, to ban all flavored tobacco products.

In 2009, Big Tobacco fiercely and successfully challenged the FDA’s effort to ban flavored tobacco products, resulting in the exemption of menthol flavored cigarettes from the flavor ban. Since then, the use of menthol products has increased. Now, according to the FDA, nearly 18.6 million people smoke menthol cigarettes, and youth smokers are more likely to smoke menthol cigarettes than older smokers, with almost half of 12- to 17-year-old smokers choosing menthol cigarettes.

These numbers and the FDA’s longstanding acknowledgement of the harmful effects of flavored tobacco products on our nation’s young people in 2017 prompted FDA Commissioner Scott Gottlieb to call the fight against tobacco the “most pressing mandate at the FDA,” with research showing nearly 90 percent of smokers begin using tobacco products before turning 18. Almost every day, 2,300 children smoke their first cigarette, and many turn to flavored electronic nicotine delivery systems. Flavors, including menthol, attract kids.

Meanwhile, the tobacco industry diversified, seeking to control the growing e-cigarette, vaping market. By 2019, the FDA found that of current youth e-cigarette users, approximately 1.6 million used such products frequently. Nearly 1 million used them daily.

With numbers like these, we know Big Tobacco will again fight back. This time, however, the FDA should heed its own numbers, listen as well to the young people targeted by the industry, and act more broadly and boldly.

Holbrook Middle-High School students realized Big Tobacco targeted their generation with flavored products. After seeing what nicotine addiction did to their grandparents and parents, they now saw the poison in the hallways of their school. They shared stories of classmates getting “nic-sick.” They called the bathroom the Juul room, and middle school students traded one flavored pod for another in the hallways between classes. One young student shared that he feared his younger brother would be targeted.

This generation knows they are being targeted with what the industry knows works, namely, flavors. And they counted menthol, in cigarettes and electronic nicotine delivery systems, among those appealing flavors. They testified at hearings, shared personal stories, and exclaimed that the flavored tobacco and nicotine ban was urgently needed.

In Massachusetts, we heard the young generation and worked with them to ban all vaping flavors—more than 8,000—from the shelves of local stores, as well as all flavored tobacco products, including menthol. Massachusetts remains the only state to have passed such comprehensive, bipartisan legislation.

Though focusing on youth generally, our campaign to pass this bill also recognized the deep inequities among communities of color relative to Big Tobacco’s marketing and lobbying efforts. These inequities result from deeply problematic, intentional marketing by the tobacco industry. Today, according to the FDA, almost 85 percent of African American smokers smoke menthol cigarettes, as do 47.7 percent of Hispanic smokers, and 41.1 percent of Asian smokers.

During our fight, Big Tobacco argued that banning flavored tobacco products would drive consumers out of the state, creating a negative fiscal impact in the Commonwealth. Early data show that while tobacco sales increased following the Massachusetts ban in surrounding states, (New Hampshire and Rhode Island), their tax revenue increases from the sale of tobacco products were less than the totality of decrease in such revenues in the Commonwealth. This analysis does not count healthcare cost savings in Massachusetts. A federal ban eliminates the likelihood of one state benefitting from another state’s potential revenue losses and would result in billions of dollars in healthcare savings nationwide.

The industry also argued that a ban on all flavored vaping products, including menthol, would negatively impact adults who may use these products to quit combusted tobacco products. That is precisely why the public health framework of this decision—centering on prevention—is critical. There are alternative methods adults can use to quit smoking, but there is no alternative for preventing our young people from becoming addicted.

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To finish its unfinished work from nearly 12 years ago and ban menthol and other flavored tobacco products, the FDA must follow the data, follow the young generation that has stood up against the industry, and follow Massachusetts’ lead by banning all flavored tobacco and vape products.

To stop likely industry regulatory challenges, Congress should act as well by passing comprehensive, bipartisan legislation like what we passed in Massachusetts. Our federal government can protect generations to come from the negative health impacts and early deaths caused by tobacco and nicotine use, while at the same time saving billions of dollars in healthcare costs. We must not allow this bit of sordid history to repeat itself.

John Keenan is a state senator from Quincy.