Medical studies show that menthol cigarettes are harmful and, at the same addicting, making it challenging to quit. Its impact on youth and high-school students is devastating, and its number is increasing. Their addiction comes from the flavors of mint and others, which attract the youth to get enmeshed and seek more cigarettes. Due to that, the law approved for the Food and Drug Administrator to take actions concerning prohibiting and banning cigarette products with menthol after a long debate with opponents. By finalizing this step, they aim to reduce the number of smokers and save souls and prevent thousands of smoking deaths over 40 years. Even though the discussion took a long time, later, during the reign of Biden, the law came true.
Menthol cigarettes increase the likelihood of becoming addicted and its degree too. However, menthol is one of the medications that you can buy over the counter sale. Menthol cigarette smoking increased among individuals, especially those with substance use disorder. However, even smokers who get addicted to it have fewer chances to quit, which encourages smoking initiation and contributes to cigarette dependence. About 30% of the United States smoke menthol cigarettes. Menthol intensifies tobacco use and facilitates its addition due to its flavor, reduces the harshness of cigarettes, and serves as a sensory cue. Scientists and advocates know that manufacturers add menthol to cigarettes, which makes them concerned about the influence of menthol cigarettes for decades. Food and Drug Administration prohibits the sale of menthol cigarettes due to reports that cited more than 18.5 million current menthol smokers ages 12 and older. For the FDA, it is an alarming issue that needs urgent action, especially after the spread of menthol-flavored products used by youth, adults, Black Americans, and ethnic minority groups. However, the FDA took action against menthol after knowing about the lawsuit by several public health, medical, and health justice organizations. According to the Centers for Disease Control, in 2021, 50% of middle and high school students smoked menthol or its flavored products.
On the other hand, prohibiting the sale of menthol cigarettes will encourage smokers to quit and reduce the widespread use of tobacco products. According to modeling studies, removing menthol from the market saves 324,000 to 654,000 lives for 40 years. Also, these models ensure that 15.1% decrease in smoking prevalence within 40 years. These models’ statistics came from the success of The Tobacco Control Act of 2009, which prohibited flavored cigarettes except those including menthol. So, the FDA partnered with several government agencies, including the National Institute of Health, to understand and learn more about menthol’s impacts and side effects. Then, they started a close study through scientific research, pieces of evidence, and complex policy issues related to menthol cigarettes. After getting the scientific results they needed about menthol, Food and Drug Administration proposed to end the sale of menthol to protect public health.
Menthol is a chemical compound that has cooling effects on the mouth and throat, and manufacturers use it in more significant quantities by adding its flavor to some brands. For this, current law prohibits using products with a menthol flavor except for menthol cigarettes. So, public health groups obliged FDA to ban menthol cigarettes for a decade by a lawsuit; the Food and Drug Administration decided to take action to remove menthol from cigarettes, cigars, and all flavors. Even though they did this action, menthol remained an exemption to the policy in e-cigarettes. Remember, statistics show that individuals who smoke menthol cigarettes are 50% between 12-17, 49% between ages 18-25, 48% between ages 26-34, 39%ages 35-49, 33% between ages 50-64, and 29% aged 65 and above. In addition, the 2009 Family Smoking Prevention and Tobacco Control Act prohibited characterizing cigarette flavors. FDA claimed that they are on track to issue rules based on citizens’ petitions and a lawsuit and product standards to remove menthol within one year from the announcement in spring 2022. Later, FDA, which has the authority to regulate e-cigarettes, issued an enforcement policy to ban flavored e-cigarettes other than menthol. Also, it allowed other e-cigarette products, such as e-liquids, refillable tanks, disposable e-cigarettes, and all menthol e-cigarette products, to remain on the market. In addition, FDA reviews applications from e-cigarette manufacturers that their products are suitable for public health. But the FDA refused their marketing applications for more than a million e-cigarette products except for keeping the applications for menthol-flavored e-cigarettes pending.
The FDA’s activities on menthol include:
- Regarding the Tobacco Control Act, they required the Tobacco Products Scientific Advisory Committee to review the effects of menthol cigarettes on youth and other vulnerable populations. In March 2011, the TPSAC concluded that taking off menthol cigarettes from the market benefits public health in the United States.
- Lorillard Tobacco Company challenged the fairness of the suitcase against the FDA because the experts they appointed to the committee had different opinions. For this, they had to remove them, which led the judge to take a side with Lorillard and prevented the FDA from using the TPSAC menthol report. When the Food and Drug Administration agreed to the judge’s decision in January 2016, the D.C. Circuit reversed the court’s decision. Hence, the agency continued to rely on the TPSAC menthol report to take action and regulate menthol tobacco products.
- The FDA announced in April 2021 plans to remove menthol cigarettes, cigars, and all flavors. While in July 2013, the FDA concluded that removing menthol cigarettes from the market could save and improves public health. Besides, it seeks more information to help the agency make informed decisions about cigarette menthol.
On December 31, 2021, a hundred jurisdictions took policies to ban the sale of all flavors across all products, including menthol, mint, and wintergreen tobacco products. According to Truth Initiative research, local policies helped eliminate the marketing and sales of products besides the immediate results of the legislation. For example, Massachusetts banned the sale of flavored menthol tobacco products except for smoking in smoking bars. At the same time, 76 localities in California, Bangor, Maine, and Colorado prohibited flavored tobacco products except for menthol. For example, Minnesota, Manheim, New York, and Chicago, Illinois, forbid the sale of all flavored menthol tobacco products. So, even if states took these actions, they should pay fines and bills if they violated the law (August 2020) in selling flavored menthol tobacco cigarettes. The law created opposition from the tobacco industry in California, and they did a media blitz television costing $21 million to the campaign to gather signatures to seek a referendum accusing the law would increase racial profiling by law enforcement
Truth Initiative supports some policies regarding menthol in tobacco products. FDA should issue product standards with removing menthol and eliminating menthol as characterizing flavor from all tobacco products. Also, the FOOD and Drug Administration should regulate menthol in e-cigarettes because the FDA authorization of menthol e-cigarettes is unsuitable for the agency’s handling of another e-cigarette flavor. Besides restricting the marketing of all flavored tobacco products. Opponents of the law considered that banning menthol cigarettes and mint smoking products would lead customers to go across the border of New Hampshire, and this would affect the shop and store owners (Massachusetts) to lose their business. Due to this procedure, Massachusetts lost $250 million in sales and taxes. Michael Siegel, an anti-smoking advocate and a BU School of Public Health professor of community health sciences, criticized the proposed legislation prohibiting the sale of menthol cigarettes, except at 21-and-over smoking bars and combustible cigarettes. Due to that exemption, kids will get cigarettes from gas stations or nearby stores.
On the other hand, menthol addiction will decrease among youth due to the law and prevent them from becoming the next generation of smokers and help others to quit smoking. Also, it represents an important step in advancing health equity. FDA took the authority to adopt tobacco product standards, which will help reduce youth initiation and increase smokers’ chances to quit. FDA can’t force individuals to possess or use menthol cigarettes or flavored cigars. But, when they finish the rules and their implementations, FDA will only deal with manufacturers, distributors, wholesalers, retailers, and even those who import them within the United States. Besides, State and Local law enforcement agencies can’t impose their opinion on the Federal Food, Drug, and Cosmetic Act to take action against any violation of the FDA’s tobacco authorities. However, the agency fears applying the state and local law enforcement, which may affect equity and community safety for deprived and underrepresented communities. The FDA makes it clear that the roles of the agency and state and local law enforcement and policy considerations will respect racial and social justice implications. The public can make comments regarding these rules, and FDA will review them to take action later. So, with federal partners, the FDA and HHS will do their best to help those who want to quit smoking, including insurance plans that cover tobacco cessation services(medication and counseling) for free. According to federal law, tobacco manufacturers don’t have the right to market cigarette products except for menthol or tobacco-flavored cigarettes.
Menthol is addictive because menthol flavoring contributes to greater nicotine dependence and to have higher levels of nicotine receptors in the brain. Then, menthol increases the number of these receptors to make the brain more dependent on the repeated use of tobacco, specifically menthol. Mentholated tobacco has psychoactive effects, leading to nicotine addiction or withdrawal. Mixing menthol and nicotine increases the communication between the brain and memory (known to be involved in nicotine addiction or withdrawal). The minty taste and odor are behind the symptoms of respiratory problems. A Survey conducted by FDA and the Centers for Disease Control and Prevention reported a 78% increase in the number of high school students using e-cigarettes between 2017 and 2018. The survey says that 27% of high school and 10.5% of middle-school students used e-cigarettes and cited the availability of flavors like fruit, mint, and menthol as their reason for vaping. So, e-cigarettes increased among high school students, with menthol and mint ranking as the second flavor after fruit.
Moreover, the Family Smoking Prevention and Tobacco Control Act was signed into law and enacted by the 11th United States Congress, which gives the power for FDA to regulate the tobacco industry. A signature element of the law adds warning labels on tobacco packaging and advertisements to prevent individuals from smoking. The Act, which bans flavored cigarettes, limits the advertising of tobacco products to minors. In addition, any new tobacco products need the approval of the FDA when it changes the tobacco product content. First, banning flavors applies to any product related to cigarettes according to section 3(1) of the Federal Cigarette Labeling and Advertising Act. Second, it calls for new rules for selling except for face-to-face exchanges between a retailer and a customer. Third, limit advertising to avoid attracting customers and put a warning (capitalized) on the package covering 60% of the front and rear of each pack. Finally, they need FDA approval for using expressions such as “light,” “mild,” or “low.” On August 31, 2009, Commonwealth Brands filed suit against the United States and the Food and Drug Administration because of their restrictions on tobacco products. As a result, in June 2011, the FDA added nine warning signs as graphic text and images for cigarette packaging and advertisement.
For example, most people addicted to menthol cigarettes are Black, and the tobacco industry devastates their community apart among youth. So, when the Food and Drug Administration banned menthol cigarettes, they considered the law “racial.” As a result, millions of Black people died from tobacco-induced diseases. Other opponents of the law were Family members of Eric Garner, George Floyd, and Trayvon Martin, where all victims of the police force signed a letter for the Biden Administration regarding the decision. They fear that banning smoking menthol cigarettes will not stop their selling, production, or purchase but will open the door for smuggling. So, the FDA’s enforcement of the rule decreases the comments and reviews of the opponents, and new actions prevail.
Finally, the FDA declared the harmful effects of smoking menthol cigarettes, where its flavor enhances the addictive effects of nicotine. Due to that, in 2009, congress enacted a law to ban flavored cigarettes that enticed youth to start smoking. Even though it took a long time and that landmark legislation contained a significant flaw because some companies continued selling menthol, the FDA made that come true. So, passing legislation is on board, and public health is on the right track after considering action to close this loophole, proposing rules to fight the widespread selling and trading of menthol cigarettes and all flavored cigars.
