BLACK LUNGS MATTER TOO: BAN MENTHOLATED CIGARETTES

It claims almost half a million—480,000—lives per year.

Kills more people than alcohol, AIDS, car accidents, murders, illegal drugs, and suicides combined.

It’s the single leading preventable cost of death, jacks up health care costs up by almost a quarter of a trillion dollars per year, and generates a loss in the nation’s productivity to the tune of $364 billion per year.

Smoking ain’t no joke. We pay for it—and pay for it dearly—with our lives and our lungs.

And it exacts an especially devastating toll on Black lives and lungs:

• Tobacco use is the number one cause of preventable death amongst African Americans and claims 45,000 Black lives every year.

• Black men have the highest rate of death from lung cancer: There’s 50 deaths of Black men for every 100,000, compared to 44.4 for every 100,000 White males.

• Black men are 15% more likely to develop lung cancer compared to White men and have the highest cancer mortality rate of racial and ethnic groups.

• Almost one-third of heart disease deaths is attributable to tobacco use, with Blacks being 20% more likely than Whites to die from heart disease.

• Blacks are 50% more likely than Whites to experience a stroke, and 40% more likely to die from a stroke. The link between smoking and experiencing a stroke is well established: Smokes lead to strokes.

What’s more, Black smokers are much more likely than White ones to smoke mentholated cigarettes—85% and 30%, respectively. This racial disparity in the smoking of mentholated cigarettes has nothing to do with some supposed innate Black desire or preference for mentholated cigarettes. Blacks ain’t got a thing for Newports or a thing for Kools that’s got some kind of vise like grip on their souls. Rather, the relatively larger percentage of Black smokers who get down on them menthol cigarettes is the result of a decades long effort by Big Tobacco to target and nurture an “inner-city” market that could replace the potential loss of profit that they were bracing for in light of reports linking smoking to cancer, calls for federal regulation of the marketing and sales of cigarettes to youth, and the subsequent bans on cigarette advertising on television and billboards.

As one report notes:

Tobacco’s devastating impact on Black Americans is no accident, but rather the direct result of decades of targeted marketing by the tobacco industry, dating back to at least the 1950s. For more than 60 years, the tobacco industry has ruthlessly targeted the Black community, especially youth, with marketing for menthol cigarettes, profiting enormously while destroying Black lives and health

That same report continues:

Brown & Williamson first began targeting Black Americans with Kool cigarettes after a 1953 survey showed that 5% of Black Americans preferred Kool compared to 2% of White Americans. Brown & Williamson seized the opportunity to capitalize upon this small preference margin, recognizing the marketing advantage of appealing to a newly urbanized and more concentrated population. When other tobacco companies realized Kool’s growth stemmed from targeting Black Americans, they began competing for this market share with targeted marketing for Kool, Newport, Salem and Benson & Hedges. Newport’s aggressive marketing successfully doubled its share of the menthol market between 1981 and 1987, and in 1993 it became – and has remained – the market leader in sales of menthol cigarettes.

This strategy of targeting of poor and Black geographical spaces for profit entailed, among other things, the sponsoring of concerts featuring music rooted in Black culture (think: Kool Jazz Festival. Think: Newport Jazz Festival. Think: Kool Mixx, a hip-hop oriented event…), the heavy advertisements that found space in such Black themed magazines as Jet and Ebony), the lower pricing of mentholated cigarettes in areas with relatively large percentages of Black residents, and the contributing of much needed funds to major civil rights organizations (For one current example, think: Rev. Al Sharpton’s National Action Network (NAN)).

Menthols, which had long been portrayed as a “safer” cigarette with possible therapeutic benefits (think: soothing of smoker’s cough), masks the harsh taste of tobacco, thereby making it easier to start smoking. The scientific evidence also suggest that mentholated are more addictive than other cigarettes. In fact, it’s suspected that racial differences in the smoking of mentholated figures is one of the reasons that Black are less successful than White smokers in quitting smoking.

Here’s a recent statement by the Centers for Disease Control and Prevention (CDC):

People who smoke menthol cigarettes make more attempts to quit smoking than those who smoke non-menthol cigarettes. However, the proportion of people who tried and succeeded in quitting non-menthol cigarettes is greater than the proportion of people who have tried and succeeded in quitting menthol cigarettes. This could be due to a number of factors, including the way in which menthol enhances the effects of nicotine in the brain.22 African American people who smoke menthol cigarettes may be even less successful in quitting than other population groups.

THE FOOD AND DRUG ADMINISTRATION’S PROPOSAL TO BAN METHOLS

All of this is why public health groups—and those of us especially concerned with the ways in which mentholated cigarettes is doing a number on Black lungs— didn’t drop no tears when, finally, the Food and Drug Administration (FDA) proposed actions that would, among other things, ban the use of menthol as a “characterizing flavor” in cigarettes.

Tears weren’t dropped because, for one thing, the evidence suggest that a ban on mentholated cigarettes would result in almost an additional million persons seeking to quite within the first 13-17 months after the ban goes into effect.

Tears weren’t dropped because, for another thing, of that 923,000 people seeking to quit, 230,000 of them—25%— are projected to be Black.

Tears weren’t dropped because, finally, the ban on mentholated cigarettes could save between 324,000 to 654,000 lives over the next four decades, with 92,000-238,000 of those lives being Black ones.

For some of us, this ban was a victory for Black lives and Black lungs.

BIG TOBACCO STRIKES BACK

The thing, though, is this: Big Tobacco is known for going all out to protect its turf. They ain’t never been shy about expanding and protecting their market, about squaring up to defend their profitability and sustainability.

They muscled up and ensured that the Family Prevention and Tobacco Control Act of 2009 excluded menthols from the list of “characterizing flavors” banned from usage in cigarettes.

Chocolate flavored cigarettes bit the dust.

Candy flavored cigarettes came to an end.

Same for clover.

But not menthol. The industry was able to exempt this “characteristic flavoring” from meeting its demise.

Since then, however, public health experts and anti-smoking activists have upped the fight to ban mentholated cigarettes, protect public health, Black lives, and Black lungs.

In 2020, the African American Tobacco Control Leadership Council (AATCLC) filed suit against the FDA in the U.S. District Court of Northern California for engaging in an “unreasonable delay” in banning menthols. For the AATCLC, given the scientific evidence on mentholated cigarettes, the FDA’s failure to ban this “characterizing flavor” was downright inexcusable. The American Medical Association (AMA) later joined the suit and, after a couple of years of back and forth, the FDA got up off the dime and released a proposed rule that, if enacted, would “prohibit menthol as a characterizing flavor in cigarettes.”

But here we are—almost two years later— with mentholated cigarettes still being a thing, and considerable uncertainty surrounding exactly when the FDA’s proposed rule banning menthols will receive finalization.

What’s up with that?

Well, what’s up is this: Big Tobacco and its allies have leveled up critique of proposed efforts to ban mentholated cigarettes. And—sensitive subject, though it may be—those “allies” include representatives of Black organizations, many of whom have had some portion of their budget underwritten by financial contributions from Big Tobacco.

Indeed, in a seminal paper entitled “African American leadership groups: Smoking with the enemy,” authors V B Yerger and R E Malone painstakingly detail how the tobacco industry cultivated relationships with key Black organizations and leaders and attempted to use those relationships to ward off public health efforts to regulate tobacco. As Yerger and Malone puts it:

What this study illustrates is that the tobacco industry has for decades meticulously cultivated relationships with virtually every leader and leadership group within the African American community, and that this effort was expended not merely out of generosity, but for at least three specific business reasons: to develop and increase tobacco use among African Americans; to use African Americans as a frontline force to advance and defend industry policy positions; and to defuse or obstruct tobacco control efforts arising from both within and outside the community.

The current Black civil rights organizations and figures critical of the proposed menthol ban include Dr. Ben Chavis, President and CEO of the National Newspaper Publishers Association; Rev. Al Sharpton’s National Action Network (NAN); the National Organization of Black Law Enforcement Executives (NOBLE) and civil rights attorney Ben Crump.

These organizations and persons— which, again, have received cheddar from Big Tobacco— suggest that a ban on mentholated cigarettes could give rise to “unintended consequences,” including, for instance, increased police harassment of Black people whom they suspect of carrying or smoking a mentholated cigarette, the development of a black market in mentholated cigarettes, and increased anger amongst Black folks to such an extent that they’ll refrain from voting Democratic in the upcoming presidential election.

These arguments are the exact same ones that the Tobacco industry makes but the fact that they’re being made by persons largely revered amongst the Black public ends up giving the industry an additional layer of protection from critique and regulation.

By the way, there’s 130 jurisdictions that have fully banned the sale of all flavored tobacco products, including mentholated cigarettes. I know of not one example where the ban has resulted in an increase of police harassment of Black citizens or in the development of robust black market in the buying and selling of menthols.

What’s more, the proposed rule banning mentholated cigarettes explicitly states, “This regulation does not include a prohibition on individual consumer possession or use, and FDA cannot and will not enforce against individual consumers for possession or use of menthol cigarettes.”

Oh, and more thing: A recent poll finds that Black voters strongly support a ban on mentholated tobacco.

The industry’s allies, Black and otherwise, do exactly what it has always done when defending their product and market against regulation. They obfuscate and prevaricate like all get out.

This is why, for instance, commentator Roland Martin goes all the way in, and accuses those civil rights organizations and persons opposing the ban as peddling “bullshit.”

BUT THERE’S STILL SOME GOOD NEWS

But it’s not all doom and gloom. There are both Black organizations and individuals who have publicly and adamantly supported the ban on mentholated tobacco products. Of particular importance, Black public health entities and persons have long warned about the dangers of mentholated cigarettes and, accordingly, have insisted that a ban must be part of long-range strategy to promote and protect the health of Black folk. Also noteworthy is the support that Black Greek organizations, as well as clergy persons like Rev. William Barber and the nation’s oldest civil rights organization, the NAACP.

It is absolutely critical that we closely listen to and prioritize the voices of the Black public health and medical community. The National Medical Association (NMA), the organization whose mission is to protect and promote the health of well-being of people of African descent, makes it abundantly clear that the message being delivered by the Tobacco industry and its allies does not bode well for a people whose lives and lungs have long been dissed in this nation.

It’s worth quoting from the NMA’s letter released in support of the FDA’s proposed ban:

The National Medical Association (NMA) advocates for the FDA ban on menthol cigarettes as part of our crucial mission to eliminate health disparities that disproportionately affect Black communities. The CDC estimates that 40% of premature deaths due to menthol cigarette smoking in the U.S. from 1980 to 2018 were Black Americans. Black men have the highest rates of lung cancer fatalities.

The NMA goes on to state:

It is imperative to put this ban in place now. Otherwise, the potential delay would be needless and would only benefit tobacco companies. Banning menthol cigarettes would save 654,000 lives within 40 years, including the lives of 255,000 Black Americans. The ban also would help the Biden Administration accomplish its Cancer Moonshot initiative. The act to approve this ban is critical and necessary for the overall betterment of racial equity within public health policy.

We need to have this ban, and we need to ensure that all those who want to quit smoking have access to the best in the way of smoking cessation programs.

We need to this because both our lives and our lungs are precious.

Govern yourself accordingly, then.