CHESTCHEST NewsKey Points From White House Meeting on Banning Menthol Cigarettes and Flavored Cigars

Key Points From White House Meeting on Banning Menthol Cigarettes and Flavored Cigars

On December 4, 2023, the American College of Chest Physicians (CHEST) joined the American Thoracic Society (ATS) and other medical societies to meet with the Office of Management and Budget (OMB) for the White House to discuss banning the sale of menthol cigarettes and flavored cigars.

The medical society representatives shared statistics and notable points surrounding general health impacts of tobacco and the specific impact of menthol cigarettes and flavored cigars on youth and Black Americans.

The full list of talking points can be found below.

  1. General health impacts of tobacco
    • Tobacco is the leading cause of preventable death in the US, amounting to more than 480,000 deaths annually.
    • Approximately 16 million Americans suffer from smoking-related illnesses.
    • Annual smoking-related costs are $241.4 billion, including $72.7 billion in Medicaid, $61.1 billion in Medicare, and $21.8 billion in other federal health programs (mostly the US Department of Veterans Affairs).
    • There is an additional $6.5 billion in annual health costs from secondhand smoke exposure.
  2. Impact of menthol cigarettes and flavored cigars
    • Menthol cigarettes increase the number of children who experiment with cigarettes and the number of children who begin smoking regularly, increasing overall youth smoking.
    • Young people who initiate using menthol cigarettes are more likely to become addicted and begin long-term daily smoking.
    • Half of the youth population ages 12 to 17 who had ever tried smoking initiated with menthol cigarettes.
    • In 2023, 42.3% of high school students who smoke reported using menthol cigarettes.
    • The popularity of menthol-flavored cigarettes is also evidenced by brand preference among youth. According to data from the 2015 National Survey on Drug Use and Health, 1 in 5 people ages 12 to 17 who smoke prefer Newport cigarettes, a heavily marketed menthol cigarette brand.
    • Preference for Newport is even higher among the Black youth population who smokes (69.1%) because of targeted marketing by the tobacco industry.
    • Data from Truth Initiative’s Young Adult Cohort Study, a national study of 18- to 34-year-olds, showed that 52% of new young adults who smoke initiated with menthol cigarettes.
  3. Impact of tobacco on pregnant women and infants
    • According to the US Surgeon General, a pregnant woman who smokes is 1.5 to 3.5 times more likely than someone who doesn’t smoke to have a baby with a low birth weight.
    • According to a meta-analysis of published studies, tobacco use is responsible each year for 19,000 to 141,000 spontaneous abortions; 1,900 to 4,800 infant deaths caused by perinatal or prebirth disorders; and 1,200 to 2,200 deaths from sudden infant death syndrome (SIDS).
    • Almost one quarter of all SIDS deaths have been attributed to prenatal maternal smoking. Fetal mortality rates are 35% higher among pregnant women who smoke than among those who don’t smoke.
    • Of the top 15 causes of infant mortality identified by the National Center for Health Statistics for 2005 (the most recent data available), smoking during pregnancy contributes to five of those conditions.
  4. Impact of flavors on youth initiation
    • Each day an estimated 1,400 kids try their first tobacco product.
    • 2.8 million high school and middle school students use tobacco.
    • 1.9% of high school students smoke cigarettes.
    • 2.3% of high school boys smoke cigars.
    • In recent years, there has been an explosion of sweet-flavored tobacco products, especially e-cigarettes and cigars. These sweet products have fueled the popularity of e-cigarettes and cigars among youth.
    • Studies show that flavors play a major role in youth use of tobacco products such as e-cigarettes and cigars.
    • Tobacco companies have a long history of developing and marketing flavored tobacco products as "starter" products that attract kids.
  5. History of tobacco marketing toward Black Americans
    • For decades, the tobacco industry has targeted Black Americans, especially youth, with marketing for menthol cigarettes  and other tobacco products like flavored cigars.
    • Tobacco use is the No. 1 cause of preventable death among Black Americans, claiming 45,000 Black lives each year.
    • Black Americans are disproportionately impacted by tobacco use and die at higher rates than other groups from tobacco-related diseases such as cancer, heart disease, and stroke.
    • Lung cancer is the leading cause of cancer deaths in the Black community.
    • Initiation with menthol cigarettes was higher among Black Americans who smoke (93.1%) compared with White Americans who smoke (43.9%).
    • The tobacco industry spends $8.6 billion annually in tobacco advertising, which equates to $23.5 million each day.
  6. The need for tobacco cessation support
    • According to the Centers for Disease Control and Prevention, nearly 70% of people who smoke cigarettes want to quit.
    • The US Food and Drug Administration’s (FDA) action to ban menthol cigarettes and flavored cigars presents a teachable moment to help people who smoke quit.
    • Medical societies are ready NOW to help patients and use the menthol cigarette and flavored cigar ban as a teachable moment.
  7. Refuting industry claims
    • We reject industry claims that a menthol ban will lead to excessive policing. The FDA rule will be enforced against Big Tobacco and retailers, not individuals.
    • We reject the industry insinuation that a menthol cigarette and flavored cigar ban will hurt the Black community. The ban is strongly supported by the National Association for the Advancement of Colored People and National Medical Association (NMA). In fact, the NMA sued the FDA to force action on a menthol ban.
    • We reject industry claims of illicit trade. Other countries who have banned menthol (ie, Canada) have not seen spikes in black market tobacco products. “Illicit trade” is the bogeyman argument Big Tobacco makes on any policy it opposes (warning labels, increased excise taxes).
    • We reject industry calls for a delayed implementation. Swift implementation will prevent youth initiation, prevent addiction, save lives, and reduce health care spending. Delaying or weakening the menthol cigarette and flavored cigar ban will make achieving the Biden Cancer Moonshot goals impossible to achieve.
    • President Biden has made health equity a central theme of his administration; banning menthol cigarettes and flavored cigars IS a health equity issue.
  8. Concluding remarks
    • The science is clear and compelling: Menthol cigarettes and flavored cigars increase youth initiation of tobacco use and lead to addiction.
    • The evidence is undeniable: Menthol cigarettes and flavored cigars are a unique danger to minority communities, particularly Black Americans.
    • Banning menthol cigarettes and flavored cigars is essential to meet President Biden’s health equity goals.