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Health & Wellness

FDA proposes a ban on menthol in cigarettes after decades of use

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Cartons of cigarettes in the window of a grocery store in New York - March 8, 2013

The Food and Drug Administration has begun a 60-day public comment period on its proposal to stop using menthol in cigarettes and cigars. Dr. David Balis, director of the nicotine cessation program at UT Southwestern Medical Center, tells KERA’s Sam Baker why he thinks the ban is important.

INTERVIEW HIGHLIGHTS:

What menthol does:

Adding a flavoring like menthol makes it easier to smoke by cutting the edge of the cigarettes. And we need to do everything we can to make it harder for patients to smoke, not make it easier. 

What's behind the high rate of use among Blacks and other racial and ethnic groups?

The tobacco industry really has targeted the African American population with the cigarette brands is cruel, and 85% of African Americans (who smoke) smoke menthols. We know that smoking is not distributed equally in a population that's lower socioeconomic or underserved.

The complications of smoking and menthol just worsened these health disparities that we see in our population by increasing the prevalence of smoking in African American communities and others and has worsened all the poor health outcomes associated with smoking by increasing the smoking in these populations. 

Does targeted marketing lead to the high rate or is there some reason African Americans and other groups of color tend to use menthol more?

I don't think we know the answer to that. But regardless, it has made it easier for that population to smoke. They have been targeted in aform of racism, and it's well past time for us to stop this marketing and taking advantage of this population when we know that this is harmful and is an easy thing that we can do to reduce the smoking and the complications. 

Could the absence of menthol reduce the number of people who smoke now or prevent more people from taking up the habit?

Both. There was a study in Canada where they banned menthol. Hopefully, we will, too. And they found that 20% of their menthol smokers quit smoking just by banning menthol. And so since 18 and a half million Americans smoke menthols, 40% of them quit. We could have 4 million Americans quit smoking just by using this ban, which would be a huge benefit. 

The rate of smoking is still that high?

Well, the rate has been consistently coming down since the surgeon general's report in 1964, and it's currently down to around 13% of our population. But again, it's not evenly distributed, with much higher smoking rates in minorities, LGBTQ, those with comorbid psychiatric disease, substance abuse, etc. 

Menthol has been used in cigarettes for decades. Why is the FDA trying to ban it now?

Well, they had the opportunity and the power to do this many years ago, but unfortunately did not take advantage of that. Not sure why - was it the lobbying of this very strong tobacco industry? But hopefully, now they will take advantage of this opportunity to make our country a much healthier place. 

So we're all clear, why is smoking cigarettes bad for you? 

We know they dramatically increase the risk of heart disease, lung disease, and all types of cancer. Strokes, infections, amputations. The data is very clear that on average, smokers lose about a decade of life.

The problem is, is that it's very hard to quit. We give patients counseling and medications to help them quit on an individual basis. But we need the FDA to help us out and ban menthol.  We've had a lot of other public health efforts that have been very effective. Bans on cigarettes, increasing age to 21, increasing taxes, making it less cool. But this will be yet another thing that the FDA can do in our fight against tobacco.

RESOURCES:

FDA Proposes Menthol Ban

New York Times: F.D.A. Moves to Ban Sales of Menthol Cigarettes

Time: The FDA Is Moving Forward with a Menthol Cigarette Ban. Here's What the Science Says

UTSW/Nicotine Cessation Program

CDC: Health Effects

Interview highlights were lightly edited for clarity.

Got a tip? Email Sam Baker at sbaker@kera.org. You can follow Sam on Twitter @srbkera.

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