This article was first published in The Montreal Gazette.
Back to basics. Smoking is bad for you and menthol cigarettes are no safer than regular cigarettes.
Flavourings, like menthol, make smoking more appealing to young smokers, which is why Canada banned menthol cigarettes years ago. In the U.S., the Food and Drug Administration (FDA) has been working toward a ban since 2022. On Jan. 21, President Donald Trump’s second day in office, the proposed ban was withdrawn quietly without fanfare or explanation. I don’t expect it will be put forward again.
If any smoker or ex-smoker remembers their first cigarette, it was probably disgusting. Tobacco companies have long used flavourings to overcome this drawback and make their product more palatable to prospective clients. Many tobacco flavourings were designed to mimic the taste of candy and provide an obvious enticement to young people, whom tobacco company executives famously termed “replacement smokers.” Flavoured cigarettes were banned in the United States in 2009, but with one glaring exception: Menthol cigarettes were still allowed.
One of the great public health achievements of the 20th century was the introduction of anti-smoking laws. Yet while overall smoking rates have decreased, the market share of menthol cigarettes has gone up. In 2020, over 40 per cent of active smokers smoked menthol cigarettes. They are most likely to be young, African-American, Hispanic or part of some other minority. That’s because tobacco companies have been aggressively marketing menthol cigarettes to key demographics for years. The move was a strategic pivot after the industry was barred from advertising to children and had to abandon ads like the infamous Flintstones commercial where Fred and Barney took a smoking break.
In Canada, provinces started banning menthol cigarettes in 2015, with Health Canada finalizing a national ban in 2017. Two studies — the Ontario Menthol Ban Study and the International Tobacco Control Policy Evaluation (ITC) Canada Survey — evaluated the impact of this ban on Canadian smokers. One analysis that combined the data from these two studies found that the menthol ban led to an eight percentage point bump in quit rates among daily smokers.
If these numbers were applied to a U.S. population, a similar menthol ban there would see nearly 800,000 daily smokers quit the habit. That number would jump to 1.4 million if you included occasional smokers. Modelling studies from the U.S. estimate the menthol ban would prevent 255,000 deaths over a 40-year period.
The FDA has been contemplating a ban on menthol cigarettes for years. They proposed one in 2022 and sent it to the White House’s Office of Management and Budget in October 2023 for approval. The Biden administration delayed that approval to hold public consultations with groups opposed to the ban, and multiple delays eventually meant the proposal was overtaken by the US election.
Opponents of the ban claimed that making menthol cigarettes illegal would simply lead to more black market sales. While that sounds convincing in theory, we don’t have to speculate on what might happen in the event of a ban. After banning menthol cigarettes in Canada, there was no observed increase in illicit cigarette purchases, which puts the lie to this particular talking point.
No explanation was given for why the proposed menthol ban was withdrawn because health agencies like the FDA have received a directive to halt external communications. So we can only speculate on why this administration felt menthol cigarettes should still be sold to the public. In the absence of any official statement, the more cynical among us will think industry lobbying swayed the decision makers.
What is clear is that leaving menthol out of the 2009 ban on flavoured cigarettes was a mistake and a loophole that should have been closed long ago. We’ve banned menthol cigarettes in Canada, and the current U.S. administration should do the same. Because menthol cigarettes aren’t going to make America healthy again.
