It’s been one year since the U.S. Food and Drug Administration (FDA) released proposed rules to prohibit menthol cigarettes and flavored cigars. While the rules have been languishing on a shelf, tobacco companies have continued to aggressively market deadly products with flavors like menthol to recruit and retain Black youth and adults as users.

It’s time for this injustice to end. By reducing tobacco use, the FDA could address a key driver of cancer-related health disparities that impact people from racial and ethnic groups. The FDA has the power to save as many as 654,000 lives, including the lives of more than 238,000 African Americans, over the next 40 years.

As a leader in public health and as a Black woman, I know this predatory marketing has helped create an unequal burden of cancer in my community, with devastating impact. For example, menthol cigarette smoking caused approximately 1.5 million life-years lost among African Americans from 1980-2018. This amounts to 40 percent of the total excess deaths due to menthol cigarettes, despite African Americans making up only 12 percent of the US population.

Annually, about 25,000 Black people will be diagnosed with lung cancer and 14,000 will die of lung cancer. Black people have the highest death rates and shortest survival rates of any racial or ethnic group in the U.S. for most cancers, and lung cancer is no exception. Black individuals also experience more illness, worse outcomes, and premature death compared to White individuals. Systemic factors such as structural racism play a role in driving cancer disparities, but the direct actions of the tobacco industry are also to blame.

Eighty percent of Black people who smoke use menthol cigarettes, compared to about 30 percent of White people who smoke. It is no accident that the use of menthol cigarettes and flavored cigars is higher for Black individuals—it’s by industry design. For decades, tobacco companies have disproportionately marketed menthol cigarettes and flavored cigars in Black neighborhoods, in magazines popular with Black people, and at events widely attended by members of the Black community. 

And it’s not just adults being targeted. This concerns me, especially as a mother of a college student. Almost 40 percent of youth who currently smoke report smoking a menthol cigarette. Prevention is one of the most important tools we have in reducing health disparities and limiting the impact of tobacco-related diseases like cancer.

Prior to serving as the Chief Operating Officer of the D.C. Department of Health and as the Deputy Director of the U.S. Department of Health and Human Services’ Center for Substance Abuse Treatment at the Substance Abuse and Mental Health Services Administration, I worked directly with people who are struggling with addiction to tobacco and other substances. I know that quitting any kind of tobacco product is not easy.

However, science tells us that it’s even more difficult for people who use menthol or other flavored cigarettes or cigars, likely because Big Tobacco uses flavors like menthol to mask harsh effects. Data indicate that adults who smoke menthol cigarettes make more attempts to quit but have less success compared to adults who smoke non-menthol cigarettes. The FDA must work with all federal agencies to ensure that people who smoke cigarettes and cigars, especially Black people who smoke menthol cigarettes and flavored cigars, have adequate resources to quit as a response to the rules. There are many tools in our toolbox that we can explore as pathways to cessation.

Support for ending the sale of menthol cigarettes and flavors in cigars is gaining traction nationwide, as states including Maine, Minnesota, New York, Ohio, and Oregon are considering statewide and local action to end the sale of menthol cigarettes, all flavored cigars and all other flavored tobacco products. But without federal action, residents in the many states that don’t take action will remain vulnerable to the industry’s continued targeted marketing of these addictive and deadly flavored tobacco products.

Given the role of menthol and other flavors in driving cigarette and cigar-related health disparities, increasing youth initiation and use, and decreasing quitting success, there is no rationale for permitting the continued sale of these products. FDA must take quick action to finalize the proposed rules to end the sale of menthol cigarettes and all characterizing flavors in cigars. And the agency must do so without any exemptions.

Every delay means more lives lost to devastating tobacco-related diseases, which are inflicted upon Black people by an industry that aims to make a profit by any means possible. The FDA can stop Big Tobacco from marketing its deadly products to Black people. Please do so now.

Kimberly Jeffries Leonard, Ph.D., is Vice Chair, American Cancer Society Cancer Action
Network Board; 17th National President, The Links Incorporated; and Vice President of
Administration, The Black Women’s Agenda.