Menthol Cigarette Ban and Marginalized Groups

Menthol Cigarette Ban

Perhaps emboldened by the onerous regulations dropped on vaping by the PACT Act, now menthol cigarettes that are in the crosshairs of the federal government. They have been a target of health groups for years but this time the federal government is vowing to act. The appeal of menthol cigarettes is that the minty finish makes them less harsh on the throat. The demographics of menthol customers is why they are viewed as low hanging fruit and an easier victory over the big tobacco lobby. Regardless of the vulnerability to an outright ban in the US, the federal governments resolve will be tested by the lawsuits that are sure to follow. 

Disparate Impact

What makes menthol cigarettes the target instead of full-flavored and light cigarettes? It is more than just the addition of a minty flavors. It is time to address the elephant in the room. African American smokers prefer menthol cigarettes. Fully 85 percent smoke menthols as opposed to 30 percent of white smokers. Hispanic is a census designated linguistic identity rather than a race, 65 percent self-identify as white, but 35 percent of this cohort also prefer menthol cigarettes.

There are two ways to view a menthol cigarette ban. The argument by menthol ban advocates and their water carriers in the media is that menthol cigarettes, an exceedingly unhealthy consumer item, are disproportionately smoked by African Americans. Banning menthol cigarettes would help with smoking cessation and promote healthier lifestyles. The problem would be solved through an outright ban. After dealing with prohibition and the war on drugs in the last century, what could possibly go wrong? What is also lacking is compelling evidence that menthol smokers would quit outright after being stripped of their preferred cigarette flavor. Then there is the failure to acknowledge smoking alternatives other than the nicotine replacement therapies which were destroyed by vaping in a New England Journal of Medicine study in 2019.

A less common argument questions the ban. It is anchored by the reality that menthol cigarettes and nicotine are a legal for an adult to consume. A menthol cigarette ban would place African American menthol smokers on the wrong side of the law unless they embrace total nicotine abstinence. With federal and state governments working to eviscerate the vaping industry, options other than regular cigarettes are harder to come by. In an area without vape shops, this would usually be other flavors of cigarettes or one of the brands of ecigarettes sold by big tobacco. And this is assuming the ban works and does not simply create a black market for menthol cigarettes. This is argument that Eugene Robinson of the Washington Post made.  

 

Parallels to Vape Bans

Unlike vaping, which such wide ranging sources as former FDA chief Scott Gottlieb and the UK’s National Health Service have argued is preferable to combustible cigarettes, no one is arguing that menthol cigarettes proffer any sort of benefit over unflavored cigarettes. The UK’s NHS actually has dedicated resources and website that promotes vaping: Using Ecigarettes to Stop Smoking. The NHS and UK tax payers have skin in the game as their health care system is not run for profit. If ecigarettes did not work and were not cost effective, they would join homeopathy, herbal medicine and other health modalities that have been discarded as ineffectual. 

Any notion that vaping is anything other than bad is alien in the United States. Matters were not helped when nicotine vaping was falsely blamed for the mysterious vaping lung illness of 2019. When it turned out black market THC carts were responsible for vaping lung disease, suddenly the media became a whole lot less interested. The connection between vitamin E, THC carts and the lung ailment were known by Labor Day 2019 but the CDC waited until Christmas Eve to verify this information.The CDC failed to find a single nicotine eliquid sample that had any trace of vitamin E in it. 

 

Nicotine Bans Punish Marginalized

No one is under the impression that menthol cigarettes are somehow less harmful but there is a common thread running between these parallel efforts at nicotine prohibition. Vape bans punish marginalized groups and a menthol cigarette ban would have much the same impact. In both cases, they make an easy target because the wealthy have largely ceased smoking and view vaping as a disreputable activity. It is much easier to ban something that you and no one that you personally know uses. Soda pop made an easy target for the same reason. This is not to say that nicotine is harmless or should be championed, any more than any other high risk behavior should be endorsed. But it is a legal substance and the efforts at denying access continue to fall most heavily on smokers and vapers who do not have access to the levers of power. 

The puritanical embrace of zero nicotine is undermined by an underlying hypocrisy. Marijuana is being decriminalized on a wide scale. The beacon of LGBTQ+ culture, San Francisco did not hesitate to ban vaping and lay the ground work for safe injection sites for IV drug users in the same calendar year. Not surprisingly, the San Francisco vape ban also punished marginalized groups and the LGBTQ+ community was most harshly impacted. Smoking and vaping at a higher rate than their heterosexual peers, San Francisco working to create humane spaces for drug addicts in the name of harm reduction and at the same time worked to funnel nicotine users back onto combustible cigarettes.  

It is unclear where freedom ends and state hell bent on regulating any risky behavior begins. But the easy to ignore unless it is your preferred vice being criminalized.

Menthol smoking is a scourge. So is alcohol. The impact of alcohol on teens is exponentially more severe than vaping. Alcohol, which according to the CDC kills 4,300 minors annually and sends over 100,000 to the emergency certainly isn’t under this level of scrutiny.

The difference lies in the fact that the wealthy imbibe more frequently than any other group. Marijuana is also viewed through rose colored glasses at this time. Whether it is regrets over the war on drugs, nostalgia for youthful carousing or the lobbying efforts of the hemp lobby, weed’s treatment looks awfully strange when juxtaposed with cigarettes. Youth smoking rates are at near all-time lows. The menthol ban largely impacts adults engaged in legal activity. 

This does not mean that no effort should be made to improve public health. But it does call into question why the items being banned and regulated out of existence are invariably those enjoyed almost exclusively by marginalized groups.