Encouraging a final rule to ban menthol products by 2024
December 12, 2023
In a formal letter to the Office of Information and Regulatory Affairs
(OIRA), the American College of Chest Physicians (CHEST) stresses the
need to complete its review of the Tobacco Product Standard for Menthol
in Cigarettes (menthol cigarette rule) and to allow it to be issued in
final form without delay.
“For decades, menthol has been disproportionately targeted to
communities of color, the LGBTQ+ community and the youth population,”
says Frank Leone, MD, MS, FCCP, Chair of the CHEST Tobacco/Vaping Work
Group. “The evidence clearly shows the negative impact of menthol and
other flavored tobacco products, and it’s time for the government to
enact laws to prohibit the sale of these life-threatening products.”
The formal letter substantiates three key arguments supporting the
ban of menthol products:
- Prohibiting menthol cigarettes will reduce youth smoking
- Prohibiting menthol cigarettes will increase smoking
cessation and save lives
- Prohibiting menthol cigarettes would decrease
tobacco-related health disparities and advance health
equity, especially among Black Americans
Read the full letter below.
Hon. Shalanda Young
Director
Office of Management and Budget
1650 Pennsylvania Ave. NW
Washington, D.C. 20502
Hon. Richard L. Revesz
Administrator
Office of Information and Regulatory Affairs
Office of Management and Budget
262 Old Executive Office Building
Washington, D.C. 20503
Pending EO 12866 Regulatory Review, Tobacco Product Standard for Menthol
in Cigarettes, RIN 0910-A160
Dear Director Young and Administrator Revesz:
The American College of Chest Physicians (CHEST) writes to urge the Office
of Information and Management Affairs (OIRA) to complete its review of the
Tobacco Product Standard for Menthol in Cigarettes (menthol cigarette rule)
and to allow it to be issued in final form without delay. The proposed
product standard prohibiting menthol as a characterizing flavor in
cigarettes will reduce youth smoking, save lives, and advance health equity.
The proposed rule will have an enormous public health impact both in the
short and long term. It is imperative that the rule be finalized without
delay.
CHEST represents over 21,000 physician and clinician members who serve
patients around the globe suffering from respiratory disease. Since 1960,
CHEST has been a tireless advocate against tobacco and has fought for key
milestones, including recognition that tobacco, cigarette smoking, and now
vaping causes harmful and preventable disease and often leading to
mortality. Our members work with their patients toward smoking cessation
goals and in the treatment of the diseases caused by cigarettes. We develop
tools and programs and advocate to support them in these efforts. We hope
you will help us make this job more tractable by issuing the proposed
standard.
Prohibiting menthol cigarettes will reduce youth smoking. Menthol cools and numbs the throat, reduces the harshness of tobacco smoke, and makes cigarettes more appealing to new smokers, particularly young people. As is well-documented in the proposed rule, menthol facilitates experimentation, progression to regular smoking of menthol cigarettes and contributes to greater nicotine dependence. Half of youth who have ever tried smoking started with menthol cigarettes, and menthol cigarettes were responsible for 10.1 million additional new smokers between 1980 and 2018. Early menthol use has been significantly associated with progression to established, frequent smoking. Further delay in regulation will ensure CHEST members and their patients will continue to face the prospect of preventable lung disease by delaying continued progress in youth smoking reduction.
Prohibiting menthol cigarettes will increase smoking cessation and save lives.
Smoking remains the leading cause of preventable disease and death in the
United States. Prohibiting menthol cigarettes, which are more difficult to
quit than non-menthol cigarettes, will reduce this burden by increasing
smoking cessation. Research estimates that prohibiting menthol cigarettes
would prevent 654,000 smoking attributable deaths, including 255,000 deaths
in the Black community, by the year 2060. That means that for every year
menthol cigarettes remain on the market, there will be approximately 16,000
more smoking-caused premature deaths, including over 6,500 more deaths in
the Black community. Menthol is a powerfully reinforcing component of
tobacco smoke, making it more difficult for our patients to quit in response
to treatment. Examination of industry documents has confirmed prior
awareness of menthol’s cooling and sensory effects and the resulting change
in smoking behaviors that result in increased overall exposure to the toxic
effects of tobacco use. It is CHEST’s position that this abuse should not be
allowed to stand.
Prohibiting menthol cigarettes would decrease tobacco-related health
disparities and advance health equity, especially among Black Americans. Menthol cigarettes have caused substantial harm to public health, and
particularly to Black Americans. For more than 60 years, the tobacco
industry has targeted Black Americans with marketing and price
promotions for menthol cigarettes,
and as a result, 85% of Black smokers smoke menthol cigarettes compared to
29% of White smokers. Consequently, Black Americans are less likely to
successfully quit smoking and suffer disproportionately from tobacco-related
disease and death. Despite accounting for 12% of the population, Black
Americans represented 41% of premature deaths caused by menthol cigarettes
between 1980 and 2018. In addition to youth and Black smokers, preference
for menthol is also disproportionately high among Hispanic and Asian
smokers, lesbian, gay, and bisexual smokers, smokers with mental health
problems, socioeconomically disadvantaged populations, and pregnant women.
Importantly, the proposed product standard is expected to substantially
decrease tobacco-related health disparities and to advance health equity
across population groups. A recent analysis by researchers at the Council on
Foreign Relations found that a ban on menthol cigarettes would eliminate the
disparity in lung cancer death rates between Black Americans and other U.S.
racial and ethnic groups within 5 years – 25 years sooner than it would
otherwise happen.
On behalf of CHEST members and the patients they directly serve every
day, we urge this lifesaving rule be issued in final form by the end of
the year.
Respectfully submitted,
Doreen J. Addrizzo-Harris, MD, FCCP
President
American College of Chest Physicians