The war on smokers is hurtling toward one of its logical conclusions. The U.S. Food and Drug Administration recently announced a plan to ban menthol cigarettes. But, the move raises a variety of public policy questions. For example, with menthol cigarettes accounting for only around one-third of U.S. cigarette sales, why is the FDA banning menthol products while leaving most of the rest of the cigarette market untouched? And what consequences could follow such a prohibition of menthol products?
The FDA makes three claims as to why menthol is uniquely dangerous. First, FDA contends menthols are especially attractive to kids. Second, the agency suggests menthol prohibition will increase the rate of people quitting smoking among current menthol smokers, who it says are more addicted than regular smokers. Third, FDA asserts the menthol ban will narrow health disparities, particularly among communities of color since 85 percent of black smokers use menthol products.
Unfortunately, none of these claims about the proposed menthol ban hold up. The latest data from the Centers for Disease Control and Prevention’s National Youth Tobacco Survey survey of U.S. middle school (grades 6–8) and high school (grades 9–12) students show only 1.5 percent of young people smoked at least once in the past month and the majority of these youth, 61.2 percent, used a non-menthol cigarette. The percentage of American youth who smoke regularly is just 0.28 percent. Essentially, youth smoking in the United States has nearly entirely been eliminated.
Thus, the FDA’s claims that hundreds of thousands of lives will be saved by cutting off the next generation of smokers are decades out of date. It is also difficult to justify the FDA’s assertion that menthol is more addictive and harder to quit than non-flavored cigarettes. One week before the FDA’s announcement, research from Vanderbilt University Medical Center showed quit rates for menthol and non-menthol smokers were indistinguishable, with no significant difference between black and white smokers.
If the ban is supposed to get adult menthol smokers to quit, the results from similar prohibitions are not encouraging. From 2015 to 2018, menthols were banned across Canada, where menthol sales were just five percent of the market. One study on the ban found that 78.6 percent of menthol smokers still smoked after the ban, with 19.5 percent continuing to use menthol. Worse still, compared to regular smokers, the study found that “menthol smokers did not differ significantly from non-menthol in quit success” between the study’s baseline and follow-up.
Before the European Union banned menthol cigarettes, Poland had the largest menthol market of all member states, at 28 percent. A preprint evaluation of the Polish experience finds there has been no statistically significant reduction in cigarette sales in Poland after the menthol ban.
The only U.S. state to have banned menthols is Massachusetts. Menthol trafficking in bordering states exploded after the ban, with Massachusetts and its bordering states experiencing an increase in cigarette sales of 1.28 percent. There was also a significant uptick in non-menthol cigarette purchases.
The most common response to menthol bans is switching to equally dangerous regular cigarettes, buying illicit menthol, or using devices to give non-menthol cigarettes a menthol taste. Because of these substitution effects, the alleged health benefits of prohibition are unlikely to materialize. According to the American Cancer Society, disparities amongst smokers have already narrowed significantly because young black people have been less likely to start smoking than their white peers in.
The FDA insists it will not be involved in any enforcement of a menthol ban when it comes to individual consumers, but federal agencies will need to be used to stop the flow of menthol cigarettes from abroad. Every state penalizes the sale of untaxed cigarettes with punishments ranging from hefty fines to significant jail time. With around 18 million consumers of menthol cigarettes in America and billions of dollars in revenue at stake, believing criminal networks will not look to make money by filling customer demand for menthol products is naive at best.
There is an alternative that would cut smoking rates without the costs of prohibition. The Biden administration has committed itself to a policy of harm reduction when it comes to tackling the opioid epidemic. Extending this logic to smokers who want to quit would avoid the specter of cops hassling people selling Newports or loose cigarettes, which tragically led to the death of Eric Garner in 2014.
Most Americans are unaware or misinformed about safer nicotine alternatives like vapes, nicotine pouches, and heat-not-burn products. According to the Health Information National Trends Survey, just 2.6 percent of adults correctly believe e-cigarettes are much less harmful than traditional cigarettes. E-cigarettes are more effective than nicotine replacement therapies at helping smokers quit and because there is no burning tobacco in these products, they are also substantially safer than traditional cigarettes.
Promoting innovation and harm reduction would likely be more effective in achieving public health goals without increasing the carceral state or the unnecessary targeting of minority communities that the FDA’s proposed menthol cigarette ban will likely deliver.