Would menthol cigarettes be banned if the typical consumer was young, white and upper-middle class?

Menthol could be exacerbating deep social inequities according to a paper just published in Nicotine & Tobacco Research. Researchers at Columbia University Mailman School of Public Health and colleagues at CUNY and Rutgers School of Public Health suggest that a ban on menthol cigarettes could have monumental implications for both the short- and long-term physical and mental health of communities of color.

"Assessing menthol smoking status should be a priority in all substance use research and smoking cessation interventions," observed Renee Goodwin, Ph.D., an epidemiologist at Columbia Mailman School, and senior author. "A decade after Congress exempted menthol from the flavored cigarette ban, preference for menthol remains more popular among young smokers and extremely high among Black smokers."

Overall estimates indicate that over 630,000 deaths would be averted and that one of three of these would be a Black life if menthol was included in the flavored cigarette ban.

Using data from the most recent National Survey on Drug Use and Health (NSDUH), the analysis showed that 10 years after the exemption of menthol from the ban, its preference among cigarette smokers remains inversely correlated with age and race. Among black smokers, 85 percent had a preference for menthol cigarettes while only 29 percent of Non-Hispanic Whites expressed the same penchant.

According to Goodwin, in the context of inaction on menthol, young people and Black smokers are not the only vulnerable populations that warrant attention with respect to menthol smoking. Preference for menthol among cigarette smokers was also disproportionately high among lesbian and gay smokers (51 percent), bisexual smokers (46 percent), and smokers with mental health problems (45 percent). The analyses also highlighted disproportionately high percentages among socioeconomically disadvantaged populations and pregnant women.

"The menthol loophole and subsequent inaction on menthol comes down to policy makers, political influence, and power," noted Cristine Delnevo of Rutgers and the first author. "For decades, tobacco companies have been targeting marginalized populations with advertising for menthol cigarettes. It's clear that a ban on menthol is not only necessary for the protection of public health, but also to achieve health equity in the U.S."