ABOVE: NEW YORK, NEW YORK – NOVEMBER 15: In this photo illustration, packs of menthol cigarettes sits on a table, November 15, 2018 in New York City. The U.S.Food and Drug Administration is proposing a ban on the sale of menthol cigarettes and flavored cigars. Menthol cigarettes make up 35 percent of U.S. cigarette sales. (Photo Illustration by Drew Angerer/Getty Images)
Most recently, like others in the media, I have written about what we know about the potential deadly effects of smoking flavored e-cigarettes.
It seems that each day we hear news of yet another young person whose life is cut short following their “dabbling’ with vaping e-cigarettes. An outbreak of a vaping-related illness in the US has left hundreds sick and some dead.
The Surgeon General has reported that besides nicotine, e-cigarettes can contain harmful and potentially harmful ingredients, including: ultrafine particles that can be inhaled deep into the lungs; flavorings such as diacetyl, a chemical linked to serious lung disease; volatile organic compounds; heavy metals, such as nickel, tin, and lead.
But there are two related issues that go much farther than that and take this smoking thing to a different level.
One is the consistent, unrelenting targeting of young people to become smokers. A common misperception we often hear is that cigarette smoking is an adult choice. The reality is nearly all smokers started using the highly addictive product before they were adults. In fact, 9 out of 10 cigarette smokers start before they turn 18, and 98% first try smoking by age 26. Smoking is therefore very much a youth problem. This is no coincidence. Evidence shows that the tobacco industry has targeted young people for decades.
From using cartoons in advertisements in the past to candy-flavored tobacco products still today, the tobacco industry has multiple sketchy strategies to entice young people to get addicted to tobacco.
The second issue is the disproportionate marketing of tobacco and tobacco-related products to youth. Specifically, Menthol!
Make no mistake, vaping is clearly dangerous, and a health hazard. But we must keep in perspective the harm from cigarette smoking. This current crisis has led not only to (as of September 19) 530 cases of lung injury from vaping reported from 38 states and 1 US territory. Vaping has accounted for seven deaths in six states, according to the CDC.
Few of us neither understand, nor appreciate, the diabolical pathway that most black smokers followed to end up being the largest menthol smokers.
Candy and fruit flavors are appealing to teens and are a key ingredient in the tobacco industry’s plans to lure them into a lifetime of addiction. Flavors mask the bad taste of tobacco, making it easier for youth to start using. This eventually prompted the Food and Drug Administration (FDA) to ban flavored cigarettes – excluding menthol – in 2009 under the Family Smoking Prevention and Tobacco Control Act.
Now, let this sink in. We are currently in a climate where flavored e-cigarettes of all kind are either banned or proposed to be banned…except menthol.
Wondering what the big deal is about menthol?
Menthol reduces the harshness of smoke because of its cooling effects on the mouth and throat, making it more appealing and easier to smoke. There is no shortage of research that shows the deleterious impact of menthol smoking and tobacco use on the human body, yet for decades the tobacco industry has pumped copious amounts of dollars into advertising to influence the most susceptible users – young people.
Furthermore, a large number of studies show that menthol users have a higher nicotine addiction, and menthol users have a harder time quitting than non-menthol users. This is especially true for African American and other minority populations than it is for White smokers.
In fact, despite lower smoking rates among African American adolescents compared with other racial and ethnic groups, studies show that African American youths who do smoke use menthol cigarettes at a very high rate. About 70 percent of African American middle and high school students who smoke use menthol cigarettes, compared with 51 percent of their White counterparts. And while 29 percent of White smokers ages 12 and up smoke menthol cigarettes, almost 90% percent of African American smokers use menthol products
So, the problem is that with the growing use of e-cigarettes among youths raises serious concerns about early-age nicotine addiction, and the likelihood of these users transitioning to regular cigarettes and more African American youths to menthol cigarettes. According to findings from the Youth Against Menthol project from the NAACP, there are 10 times more menthol advertisements and retail promotions in Black communities than in other neighborhoods.
Not only is it still too early to determine exactly what it is about vaping that has led to the lung injuries and deaths in young people; but what we do know if that menthol cigarettes are killing young African American smokers, yet it is still legal, and allowed by the FDA!
From 2004 to 2014, as the use of non-menthol cigarettes by youth and young adults declined, the use of menthol cigarettes among these groups increased or remained constant. It’s clear that we must certainly continue the pressure for the proper regulation and/or outright restriction of e-cigarettes to protect young people from the greed of industry, but we must do something to save our children…
Remember, I’m not a doctor. I just sound like one. Take good care of yourself and live the best life possible!
The information included in this column is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her healthcare provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan. Glenn Ellis is a Research Bioethics Fellow at Harvard Medical School and author of Which Doctor?, and Information is the Best Medicine. Ellis is an active media contributor on Health Equity and Medical Ethics. For more good health information listen to Glenn, on radio in Philadelphia; Boston; Chicago; Shreveport; Los Angeles; and Birmingham, or visit: www.glennellis.com