Addressing menthol cigarette usage, vaping, highlights policy inequities

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According to the U.S. Food and Drug Administration, tobacco is the leading preventable cause for death and disease in the United States. It causes more than 480,000 deaths per year.

The most dangerous tobacco product is menthol cigarettes. Black Americans also smoke menthol cigarettes at a higher rate than other tobacco products. This is due to its targeting in the early years. This is evident: 85% of Black and African American smokers of cigarette use menthol cigarettes, compared to 29% for white smokers.

Recent research by Dana Mowls Carroll, University of Minnesota, highlighted inequalities between e-cigarettes versus menthol cigarettes. They wanted to stress the importance of involving people of color, particularly Black and Indigenous communities in menthol cigarettes research, so that the FDA can make policies that will positively impact those communities.

“Twenty-one per cent of the research done to inform Food and Drug Administration is among Black and African American populations or indigenous peoples. Carroll stated that this is “problematic”. “The efforts of the Food and Drug Administration should be directed at those populations most affected by smoking.”


The effects of menthol

Menthol, a flavoring agent with a minty flavour that enhances nicotine’s addictive properties and reduces irritation, harshness, and harshness of smoking, is also a flavor additive. It is likely that youth who smoke regular menthol cigarettes will use them again and find it harder to quit. According to the FDA, there were 18.5 million menthol cigarettes smokers aged 12 and over in the United States in 2019.

“Cigarettes, the most dangerous product that is legally sold in the United States, are cigarettes.” Carroll stated that cigarette smoke is nothing like a cigarette. It combusts and burns. It releases thousands of chemicals because of this. More than 70 chemicals are known to be carcinogenic.

Commercial tobacco used a government policy that prohibited the use of tobacco products from traditional Native communities in the late 1800s to target Indigenous communities using various marketing strategies. This policy was in effect until 1978. According to the Minnesota Department of Health, 59% of Minnesota’s Native American adults use commercial tobacco. This compares to 14.5% of Minnesota’s adult population.

Carroll stated that it is important to look at the history of targeting when examining the smoking rates.

Carroll stated that he cringes when I see studies saying that “Fifty percent” of American Indians smoke cigarettes. He left it at that, as though people have made these unhealthy choices, but it’s actually historical structural issues that have led to high smoking prevalence.

According to Eugene Nichols (a board member of The Association For Non-Smokers In Minnesota), Menthol targeting began in the 1950s.

“I can recall as a child looking through magazines that targeted the Black community like Jet Magazine and Ebony. Nichols stated that the ads were focused on Black smokers, and how happy they would feel.

Nichol’s recalls that the Harlem tobacco industry would offer free menthol cigarettes.

He said that his brother, who was 15 years old, started smoking because vans were strategically parked on 125th Street. “The children would be able to tell their parents where they could get them. My brother, who was addicted to smoking, started to smoke. He later died from COPD (chronic obstruction pulmonary disease).

Source: Stanford School of Medicine
Newport Ad, 1976

Nichols stated that the impact of this targeting continues to be felt today.

He said, “If you look at the health statistics for African Americans nationwide, COPD, high blood Pressure, certain cancers and especially lung cancer that’s specifically linked to the use nicotine smoking,”

The menthol also helps to reduce the amount of nicotine, making it a popular choice for many who have smoked it. According to ANSR’s 2017 survey, menthol cigarettes require five to six times more quit attempts than regular cigarettes.

“The numbers are clear and the history is clear. The health data is available. Nichols stated that black people have more health issues than other races, which is why there is a disparity in Minnesota’s health.


Federal response to inequities?

In June, the Cedrick Frazier (DFL–New Hope) sponsored the bill. It aims to ban all flavors in the state, including menthol.

Although it has bipartisan support in Congress, it did not receive a hearing in the Senate. Anderson is hopeful that it will be brought up again next legislative session depending on the Senate leadership.

Minneapolis and St. Paul banned fruit-flavored tobacco products from adult-only shops in 2015 and 2016. They also established a minimum price limit for cheap, flavored cigars.

With the support of the Minnesota Menthol Coalition in 2017, Minneapolis and St. Paul included menthol to their flavored-tobacco restriction. This means that menthol-flavored tobacco products cannot be sold in adult-only stores or liquor stores.

It was a stair-step approach from both a political and a community organizing standpoint. Anderson stated that the latter is where Anderson put sweat, blood and tears. He knew how important it was for everyone to buy-in.

Nichols recalls the reaction of a St. Paul storeowner during a meeting about the menthol restriction.

“He was testifying. He pulled out the keys from his pocket and threw them up on top of the podium. Nichols stated that if you limit the sale of menthol, then you might as well take my home and my life.

However, the policy does not prohibit the sale of these items. It restricts their availability to adult-only shops that sell tobacco products, as 90% of their revenues must come from tobacco-related products. The policy was implemented in 2018 by both cities.

Many other cities have also passed the menthol restrictions, such as Edina and Bloomington, Arden Hillss, Mendota Heightss, Golden Valley, and others.

Association for Nonsmokers Minnesota
Minnesota municipalities address the issue of selling flavored commercial tobacco products

Nichols believes that advocacy starts with local legislation. This can be done by educating local governments. It is also helpful to find someone in your community to advocate for you.

Anderson stated that people fear being perceived as racist because they are opposed to restricting menthol.

“The industry is responsible for creating this problem. We are now trying to fix the mess they have created. This is why it’s important that these policies are formulated by Black leaders, Black organizations, and Black coalitions. Anderson stated that it must be those who are directly impacted that lead.

NorthPoint Health & Wellness Center, North Minneapolis has a team that supports local policies to limit the sale of tobacco products including menthol.

Bethlehem Yewhalawork is the NorthPoint program manager for Health Policy & Advocacy. She stated that the policies she supported in the past were focused on the African American Community and education around it through presentations and just meeting community members about how marketed targeted menthol tobacco has really impacted that community.

NorthPoint conducts education about vaping and menthol cigarettes. This outreach is primarily done at Minneapolis schools. Because menthol masks the harshness and makes it easier for youth to smoke, the organization makes it a priority to educate them about the dangers of vaping.

“We can see that vaping is affecting a lot of these children, but what about other communities that have been affected by menthol for many years?” Yewhalawork stated that menthol is a key component of all flavor tobacco restrictions, as we are aware of the disparities caused by it.

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