The FDA could ban menthol cigarettes. It was time, especially for black America.

In 2009, Congress made the important decision to ban flavored cigarettes that entice young people to start smoking. However, this landmark legislation contained a significant loophole: a loophole that allowed tobacco companies to continue selling menthol cigarettes.

For decades, tobacco companies have relied heavily on menthol flavor — a naturally occurring chemical additive that can also be created in the lab — because menthol makes it easier to start smoking and harder to quit. When added to cigarettes, menthol produces a cooling effect that masks the harshness of cigarette smoke and allows the user to inhale more deeply while enhancing the effects of nicotine, the addictive element of cigarettes.

The Food and Drug Administration is finally planning to act to close this loophole for good, proposing rules earlier this year to end the sale of menthol cigarettes as well as all flavored cigars. The public comment period, during which the agency seeks comments to inform the potential implementation of the proposed rules, ends on Tuesday. It’s crucial that we talk about ending menthol sales now, especially with so many black lives at stake.

No doubt thanks to the predatory marketing tactics of the past four generations – including billboards, point-of-sale promotions, corporate sponsorships, coupons and free samples concentrated in black communities – around 85% black people who smoke use menthols.

While rates of menthol cigarette use in other communities are also too high, including 48% of Hispanics who smoke and 30% of whites who smoke, tobacco companies have clearly and disproportionately targeted black people. with menthols.

The results are devastating: Tobacco use claims an estimated 45,000 black lives a year, a disproportionately high burden of tobacco-related deaths in America. Black adults are 30% more likely to die from heart disease and 47% more likely to die from stroke, two of the most serious smoking-related conditions, compared to white adults.

In line with these statistics, tobacco companies have long ruthlessly targeted black people and communities with menthol products. In the 1950s, less than 10% of black smokers used menthol cigarettes, according to a study commissioned by Philip Morris, but surveys from the time found that black Americans had slightly higher preferences than white Americans for these products.

Additionally, post-World War II migration patterns of Black Americans leaving the Deep South created concentrated population centers across the United States, which opened up new marketing advantages for companies with the means to capitalize on them. left. The tobacco industry has identified and exploited these factors to its advantage.

I experienced this firsthand growing up in East Nashville, Tennessee, a predominantly African-American area in my youth. I remember seeing billboards and signs in neighborhood grocery stores and pharmacies for menthol cigarettes that made them “cool”.

Turns out, those ads were just the tip of the iceberg. Tobacco companies have a long history of recruiting black celebrities and athletes as spokespersons and heavily advertising in black publications and newsmagazines, among other ways to attract black youth. An article published in the National Institutes of Health’s National Library of Medicine called it “a ‘masterful manipulation’ campaign targeting menthols for African Americans” beginning in the 1960s.

When I became a doctor, I saw the devastating impact of this persuasive effort almost daily. During my clinical career as a cardiologist in Nashville and Atlanta, I have cared for thousands of patients. I don’t remember a single person with severe atherosclerotic cardiovascular disease who didn’t smoke.

Since Congress first banned flavored cigarettes, the case for stopping the sale of menthol cigarettes has only grown stronger. In 2011, an FDA advisory committee concluded that ending the sale of menthols would benefit public health. Research modeling a ban has shown that it would have put our country on track to save more than 633,000 total lives by 2050, more than a third of them African Americans.

We cannot afford any further delays. Tobacco companies still spend huge amounts of money marketing their menthol brands to keep their highly addictive cigarettes cheap and visible in black communities. Young people are targeted very early. Research in two cities in Ohio found that in areas with large populations of black children, menthol tobacco products are often advertised near candy displays.

As usual, tobacco companies responded to the FDA’s proposed rules by positioning themselves as community advocates. This is a continuation of a phenomenon from the 2009 legislative struggle described in the National Library of Medicine article: “Tobacco industry spokespersons have insisted that making menthol available has put them on the side of African Americans’ fight for justice and has enlisted civil rights groups to help push the case.

Today, RJ Reynolds Tobacco Company, maker of one of America’s most widely used menthol cigarettes, says it wants to preserve “access and choice,” while saying it’s “committed to reducing tobacco harm” and in promoting “reduced risk products. Altria, parent company of Philip Morris, says the proposal would create “unregulated criminal markets”.

These claims illustrate how tobacco companies oppose public health measures by trying to stoke fear. It’s a cruel irony, given that tobacco companies target these communities — the communities of my youth and the communities I serve today — with products that kill tens of thousands of people each year. None of my patients who suffered a heart attack, stroke, or had their legs amputated from smoking ever expressed their gratitude to the tobacco companies for taking care of them.

It is high time to say “enough”. With the public comment period on the FDA proposal ending on Tuesday, the agency must act quickly to remove menthol cigarettes and flavored cigars from the market. It will save lives and prevent untold disease and suffering.

For too long, black people in America have been the victims of tobacco company tactics that put their sales before people’s health. The FDA’s proposed rules finally give our nation the chance to be on the right side of history and show that we truly care about the health of all of our communities.