With their enticing cool and minty flavour, menthol cigarettes have emerged as one of the most controversial products made by the tobacco industry.
Kids are particularly drawn to them, with nearly 45% of smokers aged 12 to 17 using menthol cigarettes, according to a 2009 National Survey on Drug Use and Health. Most black teenaged smokers - and 82.7% of black adult smokers - favour menthols, the same survey found.
"The manufacturers would have you believe there is not a scintilla of evidence that menthol is no more dangerous than other cigarettes to the individual smoker, but we do not agree," said Ellen Vargyas, general counsel for the American Legacy Foundation, a smoking prevention and cessation organisation in Washington, D.C., founded with funding from the landmark Master Settlement Agreement between the tobacco industry and state governments.
"Over 80% of African-American smokers smoke menthol, and African-America smokers have the highest rates of lung cancer. We also know African-Americans with lung cancer are more likely to die from lung cancer."
Minty taste encourages people to start
In addition, the popularity of menthols among younger, newer smokers suggests that maybe the minty taste does encourage people to start, perhaps by masking the harsh taste of regular cigarettes, she added.
"We know the younger you are and the newer the smoker you are, the more likely you are to smoke menthol," said Vargyas. "There is a very strong correlation between being a teenaged smoker and menthol cigarettes."
That's no coincidence, say smoking opponents: The tobacco industry has long targeted youth and minorities for menthol cigarette marketing, even manipulating menthol content in different brands in an effort to recruit new smokers among youth, according to the National Cancer Institute and the Harvard School of Public Health.
The debate over how menthols should be regulated lit up again last month, during the second round of hearings held by the US Food and Drug Administration's Tobacco Products Scientific Advisory Committee.
Fruit flavours banned
The advisory committee was established by the Family Smoking Prevention and Tobacco Control Act, signed into law by President Barack Obama in June 2009. The legislation gave the FDA unprecedented power to restrict the marketing of tobacco products.
While the law bans cigarette makers from adding candy or fruit-like flavours such as clove, cinnamon, vanilla, cocoa or strawberry to cigarettes, legislators hedged when it came to menthols, the most popular flavouring by far.
Although menthol was not banned from cigarettes, the law stressed that nothing prevented it from regulating menthol as well. In fact, the act required the FDA advisory committee to consider menthol cigarettes impact on public health - including its use among children and minorities - as its first order of business.
During the first round of hearings in March, the advisory committee sought answers about the addictive nature of menthol cigarettes, whether they are more harmful than regular cigarettes and whether the flavour encourages kids in particular to take up smoking.
Anti-smoking advocates say there is no evidence that menthols - which account for an estimated 33.9% of the US cigarette market - are less deadly than any other cigarette. Research from the University of Medicine and Dentistry of New Jersey, in fact, suggests that they are more addictive, making it harder for smokers to quit, particularly blacks and Latinos.
Industry defends menthol
During the hearings, tobacco industry representatives defended their products, saying menthols are no more harmful than other cigarettes and should not be singled out for a ban.
"We don't think there is any evidence or even any suggestion that youth would choose not to smoke if menthol products weren't available," said Bill True, senior vice president of research and development for Lorillard Tobacco Co., the makers of Newport's. "Kids don't smoke because there are menthol cigarettes. Kids smoke for a variety of reasons which are probably quite complex."
"Cigarettes do pose significant dangers to an individual's health," True added. "In dealing with regulating the product, we believe the FDA should be looking at those things that are the most significant."
On that point, anti-smoking advocates agree. Cigarettes are by their very nature a deadly product, and legislation to sharply regulate their manufacture, sale and marketing can't come a moment too soon, said Vargyas.
Some limitations to prevention laws
Mitch Zeller, vice president for policy and strategic communications at Pinney Associates in Washington, DC and the director of the FDA's Office of Tobacco Programs during the Clinton Administration, noted that there were some limitations to the family smoking prevention laws reach. While the FDA has far more power over the industry than before, it cannot ban all cigarettes outright, nor can it force cigarette companies to reduce nicotine levels to zero, he said.
However, he said, the legislation requires tobacco companies to disclose comprehensive information about the contents and manufacturing process for tobacco products. The tobacco companies, he added, have been less than forthcoming with their data about the marketing and manufacture of menthols.
"The industry presentation on the issues that matter the most - those related to marketing that influences kids and any issue related to the initiation of smoking - was non-responsive," Zeller said. "The advisory committee is in need of more information to do its job."
The FDA advisory committee has nine members and includes physicians, scientists and public health experts; the tobacco industry is represented by three non-voting members. The committee has until March 2011 to report its menthol findings to the US Secretary of Health and Human Services. (August 2010)
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