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Updated April 22, 2015.

Cigarettes stink. 

Cigarettes are the single most preventable cause of morbidity and mortality in the United States.  Each year, an estimated 443,000 Americans die of cigarette exposure, and 8.6 million people live with grim disease and disability secondary to cigarette use.  Cigarettes blight public health; they not only kill users but also put everyone breathing in secondhand smoke at risk, too.

Cigarettes should be an anachronism of a time when we knew little about how these little sticks of tobacco and additives caused cancer and COPD.


  Instead, Big Tobacco continues to thrive and peddle and push their product on everyone--most noticeably adolescents and minorities--with the hope that we all get hooked. 

When one person kills or maims another person, we expect the swift hand of American justice to mete out appropriate punishment.  However, when a big tobacco company kills untold millions, the company is rewarded with money.  We live in a world of blurred lines, where one person's murderer is another lobbyist's client or senator's PAC.

An important and symbolic first step in the eventual obliteration of cigarette sales could be banning the sale of menthol cigarettes--a move with limited precedent.  Specifically, in 2009 the feds banned flavored cigarette sales including fruit flavors and clove (kretek).  With this ban of flavored cigarettes, the FDA hoped to make cigarettes less palatable to youngsters.  However, menthol cigarettes, by and far the most popular flavored cigarette with a 25 percent market share, are still being sold to adolescents and others without hindrance.

  Moreover, menthol is more than mere flavoring; it's a drug with anesthetic properties.

In 2009, tobacco regulation was placed under the control of the Center for Tobacco Products at the Food and Drug Administration (FDA).  The center's flagship task was to figure out just how dangerous menthol cigarettes were as compared with nonmenthol cigarettes.  Specifically, the center focused on menthol cigarette use among adolescents, minorities and those who try to quit.  Despite their scary findings which were published in 2013, menthol cigarettes remain on the market.

 

The Seedy Underbelly of Cigarette Advertisement

 

It should come as no surprise that Big Tobacco plays dirty.  (For an, albeit fictional, crash course, watch Jason Reitman's tour-de-force film Thank You for Smoking.)  The marketing of menthol cigarettes is a prime example of how far cigarette companies go to perpetuate profit.

In a freely available article titled "Marketing of menthol cigarettes and consumer perceptions: a review of tobacco industry documents," researchers from UCSF do an excellent job at sampling how cigarette makers pushed menthol on cigarettes on the public.  Here are some of their findings:

• Menthol cigarettes were first created in 1920s by a young man named Lloyd "Spud" Hughes after he sprinkled menthol crystals in his tobacco tin.  His mother had given him the menthol for colds which he frequently experienced.  Spud cigarettes became the first commercially available menthol cigarette followed by Kool Menthol in 1933.
• Menthol has a cooling, soothing and anesthetic property which explains why it's used in lozenges, cold-sore preparations, gums, mouthwashes and so forth.  Riding on the coattails of menthol's perceived medical benefits, menthol cigarettes were first marketed with health messages.  Tobacco companies claimed that menthol cigarettes were safer and tastier than nonmenthol cigarettes.  Early advertisements cited the menthol in menthol cigarettes as "clean," "head clearing," and a remedy for coughs and throat irritation.
• By the early 1950s, the menthol-cigarettes-are-healthy jig was up, and Americans began to understand that cigarettes were unhealthy.  Consequently, annual per capita consumption of cigarettes actually decreased in 1953 and 1953 only to later continue its rise through the 1970s.  No doubt feeling threatened, Big Tobacco redoubled its advertisement efforts and toned down claims that menthol was healthy.  However, tobacco companies still contended that menthol cigarettes were safe and stressed how menthol cigarettes were "soothing" and "refreshing."  Unfortunately, to this day, many menthol smokers still believe menthol cigarettes are healthier, milder, easier to smoke and safer than nonmenthol cigarettes. 
• By the 1960s, advertisements for menthol cigarettes had become more sinister.  More specifically, cigarette makers started to target African Americans as an independent demographic and advertise in urban markets with an "urban image."  Furthermore, the message of such advertisement took on a more implicit and perverse tone which identified with the civil rights movement and focused on "Diversity/Community."  Once established, this "urban image" which identified with "urban lifestyle" was used to create an in-group and attract other minorities and whites to menthol brands.
• By the 1980s, cigarette makers started to advertise to adolescents--particularly young women--trying to convince them that menthol cigarettes were smoked by natural, unpretentious, humorous, affable, popular and witty people.  In other words, Big Tobacco knew that smoking was an important social behavior among young people and capitalized on this.  
• Currently, although the majority of menthol smokers are white, there's a disproportionate prevalence of menthol cigarette use among African Americans, some Hispanic populations, young people, women and "lighter" smokers.

 

Results on FDA Study Examining Menthol versus Nonmenthol Cigarettes

 

In 2013, the FDA released results of its large study titled "Preliminary Scientific Evaluation of the Possible Public Health Effects of Menthol versus Nonmenthol Cigarettes."  Here are 4 conclusions from this study.  First, menthol cigarettes are equally unhealthy as nonmenthol cigarettes.  Second, menthol cigarette use is associated with increased smoking initiation by young folks.  Third, menthol cigarettes are positively associated with greater addiction, greater dependence and greater difficulty with cessation.  In other words, menthol cigarettes are harder to quit than nonmenthol cigarettes.  Fourth, because of the anesthetic and soothing qualities of menthol, menthol cigarettes pose a unique threat to public health.  On a related note, in March 2011, even before this study was published, the FDA recommended that the "removal of menthol cigarettes from the marketplace would benefit public health in the United States."

Ultimately, based on modelling, some experts suggest that during the next 40 years, 300,000 to 600,000 deaths could be avoided by placing a ban on the sale of menthol cigarettes.

 

So why haven't the feds banned menthol cigarettes?  That's the $64,000-dollar question.  It's now 2015, and all the sources I present are dated 2013 and earlier. 

I have some ideas as to why menthol cigarettes are still going strong.  First, none of these research findings or recommendations are binding--essentially making all this information as weighty as political rhetoric.  Second, with all its lobbyists and campaign contributions, Big Tobacco has an iron grip on the U.S. government and would fight tooth and nail against having a quarter of its sales dry up by banning the sale of menthol cigarettes.  Third, maybe the FDA thought we forgot about the ban on menthol--after all, they stopped soliciting feedback from the public way back in 2013.  Well, the medical community still remembers and so should you.

The United States is a country of greatness.  Our government has gained Independence from the British, abolished slavery, fought off Axis powers and waged a Global War on Terrorism.  However, our most deadly threat, tobacco, is grown in Virginia not far from our nation's capital.

Although menthol cigarettes suck, getting rid of them is going to be extremely difficult.  Sure, there have been some cosmetic changes made to the sale of cigarettes including restrictions on advertising, but menthol cigarettes are alive and well.   In contrast, the European Parliament voted to ban menthol cigarettes in 2022. 

If you or a loved one, smoke menthol (or regular) cigarettes, it's high time to quit.  Keep in mind that successful cessation is a battle that usually takes multiple attempts.  Moreover, although wonderful, individual cessation is just one piece of the pie.  You, your friends and your family should send a letter to the FDA demanding a ban on menthol cigarettes, and for more impact, send a letter to  your congressperson and the White House, too. 

Please remember that the government is supposed to work for us and not the combined interests of various cigarette makers.  After all, prevention is always better than cure--not that we even have a cure for lung cancer, COPD and a host of other problems attributable to cigarette smoke.

I'm going to end by expanding a conceit that I presented earlier.  If Big Tobacco were human, it would be more than just a mass murderer.  By targeting specific races like African Americans, Big Tobacco is perpetrating genocide.

 

Selected Sources  

Article titled "Marketing of menthol cigarettes and consumer perceptions: a review of tobacco industry documents" by SJ Anderson published in Tobacco Control (BMJ Journals) in 2011.

Article titled "Smoking Cessation Prevalence Among U.S. Smokers of Menthol Versus Nonmenthol Cigarettes" by CD Delnevo and co-authors published in the American Journal of Preventive Medicine in 2011.

Document titled "Preliminary Scientific Evaluation of the Possible Public Health Effects of Menthol Versus Nonmenthol Cigarettes" Food and Drug Administration