What science says about the Menthol tobacco ban

BILLIONThe US Food and Drug Administration (FDA) is moving forward plan to ban menthol cigarettes and all flavored cigars — policies that agency officials say could help prevent some of the roughly 500,000 tobacco-related deaths in the United States each year.

“The actions we are proposing could significantly reduce youth initiation and increase the likelihood that current smokers will quit,” said FDA Commissioner Dr. Robert Califf said in a statement. “It’s clear that these efforts will help save lives.”

But whether the proposed menthol ban will work as intended is a matter of active debate.

Many influential public health groups advocate the policy. Menthol adds a minty flavor and a cooling sensation to cigarettes, masking their sharpness. As a result, menthol cigarettes are believed to be both more appealing to new smokers and harder to quit for current smokers, which justifies their prohibition, according to the report. many public health professionals. (A new studyThe question, however, raises the question of whether menthols are actually harder to quit than regular cigarettes.)

Black Americans have a disproportionate ability to smoke menthols, in large part due to decades of targeted marketing from tobacco companies. Supporters of the menthol ban, including NAACP, argued that the move would improve the health of black Americans, while critics argued it was a matter of racial equity and could lead to discriminatory policies by criminalizing a product that is disproportionately used by people of color. In a joint letter sent to the secretary of the U.S. Department of Health and Human Services last year, the ACLU and other signatories wrote that a ban on menthol would “prioritize public health and reduce harmful” and could create an illegal market for menthol products. (The FDA says it will enforce penalties against retailers and manufacturers that violate the ban, not individuals.)

Others who do not support the ban argue that it will simply spur menthol smokers to use unflavored tobacco products.

After San Francisco in 2018 banned all flavored tobacco products, including menthols and e-cigarettes, fewer young people used vaping products but more cigarettes smoked, a small 2020 study found. While other social factors may explain that change — including Outbreak of vaping-related lung disease begins a few months after San Francisco’s policy goes into full effect — the authors conclude that flavor bans could lead to more traditional smoking.

However, some recent empirical studies show that banning menthol has a positive impact on public health.

In 2020, menthol cigarettes are banned in the UK A piece of paper published year Open JAMA Network on May 3 examined how the regulation affects menthol smoking among adolescents, using national surveys conducted before and after the regulation went into effect. Before the policy came into force, around 12 per cent of youth smokers in the UK said they had used menthol-flavored products. Once it went into effect, that number dropped to 3% — a clear indication that the ban has led to a reduction in menthol use among young people, the authors write. (3% said they continue to smoke menthol that may have been illegally purchased or used products such as menthol-flavored sprays and filters).

That finding, though intuitive, could bolster support for menthol bans, as public health authorities include the US Centers for Disease Control and Prevention. argues that the use of flavored tobacco products may appeal to young people lifelong addiction. However, Open JAMA Network The study did not look at whether previous menthol users had quit smoking altogether or had simply switched to a different type of tobacco product.

“The UK ban seems to have eased [teenage] Katherine East, co-author at the Institute of Neuroscience, Psychology and Neuroscience at King’s College London, says smoke with menthol. Cigarette smoking is rare among U.S. teenagers, with only about 2% of high school students using them regularly, according to Latest federal data. But among that subgroup, menthols are common: around 38% of teenagers smoke in the US using them, compared with about 12% in the UK before the ban.

Geoffrey Fong, principal investigator of the International Tobacco Control Policy Review Project, has studied the ban on menthol in Canadawhere provinces started banning menthol cigarettes in 2015 and a national ban was introduced in 2017. In an article published in AprilFong and his colleagues found that Canadian regulations have actually led many menthol users to quit smoking altogether.

By comparing national surveys of tobacco use before and after it was banned, they found that 22% of Canadian adults who used menthol had quit, compared with about 15 % of non-smokers with menthol. Of course, that means almost 80% of people use menthol did not quit, and have instead switched to a different tobacco product or sought to continue smoking, such as by purchasing them through a First Nations order that is exempt from the ban. (Pre-booking in the US is also free from many federal tobacco regulations.) But Fong calls the seven percentage point difference in quit rates between menthol smokers and non-menthol smokers ““ huge,” especially considering how difficult it is to quit nicotine addiction of any kind.

Relatively few Canadians smoked before the ban. But Fong and his co-authors wanted to know how similar policies might affect population health in the US, where more people use these products. Using their results in Canada, they estimate that more than 1.3 million smokers in the US will quit following the menthol ban, including more than 380,000 black smokers.

“There are extremely strong public health benefits from this,” says Fong. “From our study, we can expect significant positive effects and commensurately greater benefits to the public health of the Black community.”

Another research review, published in 2020, found that up to 30% of menthol smokers in the US would consider switching to e-cigarettes if menthol were banned. While E-cigarettes are not harmlessExperts widely consider them to be less dangerous than traditional cigarettes – so even without completely stopping nicotine intake, most experts would consider it a positive for public health.

Ultimately, however, researchers won’t know what effect the menthol ban might have on US smokers until years after the ban is implemented. As the rule faces a long bureaucratic road and probably won’t come into force until at least 2024, that means the conclusions are certainly a shortcut.

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