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Mint-flavored, but more addictive

Our view: Having found that menthol cigarettes pose an increased risk to public health, the FDA should move to ban them

6:00 AM EDT, July 29, 2013

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A report last week by the federal Food and Drug Administration that menthol-flavored cigarettes pose a greater risk to public health than ordinary cigarettes signals that the agency may finally be prepared to regulate their sale or perhaps ban them altogether. It's long been known that smoking in general is a significant public health risk. Having concluded that menthol cigarettes can add to that risk even further, the agency should move quickly to protect the public from these dangerous products.

Congress gave the FDA the power to regulate cigarettes and other tobacco products in 2009, the same year it passed a law banning candy-, fruit- and spice-flavored cigarettes on the grounds that manufacturers had used them to lure young smokers into addiction. But the law specifically exempted menthol flavoring from the ban on other flavored tobacco products until such time as the FDA could determine whether regulating menthol cigarettes would provide any public health benefit.

Last month the agency, for the first time in its history, rejected a bid by the tobacco industry to put four new products on the market based on the fact that they posed a serious risk to public health. Though the FDA declined to name the products or the companies that manufactured them, news reports suggested that all four banned items contained menthol.

In its report last week, the FDA said there is still little evidence that adding menthol to cigarettes by itself makes them more toxic than cigarettes without it. People who smoke menthol cigarettes do not appear to light up more often or inhale more deeply than other smokers. But the FDA also noted that because mint flavoring serves to cut the harsh taste of tobacco, cigarettes made with the additive tend to make it easier for people to start smoking and harder for them to quit.

For that reason, the agency said, it was more likely than not that those who began smoking menthol cigarettes as young people would continue the habit throughout adulthood and that their addiction to nicotine and other toxic chemicals contained in cigarettes would be harder to break.

The agency also said that teenagers were particularly vulnerable to the addictive properties of menthol-flavored cigarettes, as were African-Americans, Hispanics and other minority young adults, who generally start smoking at a later age but who often live in communities where menthol cigarette brands are heavily marketed. Studies have found that while menthol-flavored brands make up a quarter of the market for cigarettes, for example, 80 percent of African-American smokers use menthol brands.

Moreover, while the percentage of Americans who smoke cigarettes has been declining overall in recent years, rates among those who smoke menthol brands have actually increased. Clearly, that rise is related to the difficulty people who smoke menthols experience in trying to kick the habit even when they recognize the increased health risks of smoking and want to quit.

Last week's report echoed the findings of an earlier advisory panel, which issued a report in 2011 concluding that menthol cigarettes were more addictive than ordinary cigarettes because they made it easier to get hooked and were harder to quit. The panel wrote that "removal of menthol cigarettes from the marketplace would benefit the public health in the United States."

The FDA has been moving cautiously in that direction since then, despite the tobacco industry's loud insistence that menthol cigarettes are inherently no more dangerous than cigarettes without the additive and should be treated no differently. Nevertheless, the agency said it would invite public comment over the next two months on what it for the first time called "potential regulation" of menthol brands before proceeding further.

That's progress if it means the FDA intends to stick to its intention to base its policy on science rather than the influence of powerful industry lobbyists. It's long been known that smokers are more likely to develop cancer, heart disease and other illnesses that kill more than 400,000 Americans every year. If taking menthol brands off the market results in saving just a fraction of that number, the government should do it without further delay.