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Menthol and Flavored Tobacco Products

Researchers at UCSF and beyond are concerned about the health effects of menthol and other flavored tobaccos.
 

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Federal efforts to prohibit sales of menthol and flavored tobacco products

In 2009, Congress passed the Family Smoking Prevention and Tobacco Control Act, banning all flavorings from cigarettes except menthol, but granting the Food and Drug Administration (FDA) the authority to extend that ban to menthol. In 2011, the Tobacco Products Scientific Advisory Committee, which was tasked with investigating the issue of menthol and advising the FDA on how to regulate it, concluded that the removal of menthol cigarettes from the market would benefit the public health.  

On July 23, 2013, the FDA issued an Advance Notice of Proposed Rulemaking (ANPRM) to take public input on menthol in cigarettes. Specifically, the FDA requested information to inform its thinking about potential regulatory options. On March 20, 2018, FDA Commissioner Scott Gottlieb, MD, issued a statement on efforts to reduce tobacco use, especially among youth, by exploring options to address the role of flavors - including menthol - in tobacco products.

>read more from the FDA

UCSF Tobacco Research: FAQs

A closer look into research on menthol and flavored tobacco from Valerie Yerger, ND.  Dr. Yerger is an Associate Professor of Health Policy in the Department of Social & Behavioral Sciences and in the Center for Tobacco Control Research & Education.

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Valerie Yerger, ND  

Studies conducted separately by the U.S. Food and Drug Administration and its Tobacco Products Scientific Advisory Committee found that the removal of menthol from the marketplace would benefit public health. The SF CAN Menthol Task Force, a partnership of UCSF researchers, the City of San Francisco, and community advocates, is working to educate San Franciscans about the health effects of flavored tobacco products.

Regulating these products makes good public health sense and would be a major step forward in the fight against cancer. Engaging those San Francisco communities most disproportionately affected by menthol and other flavored tobacco products is vital to the development and implementation of meaningful policy that is successfully sustained.

>read more

 

Health Effects of Menthol and Other Flavored Tobacco Products (research links noted below)

  • Menthol and other flavors make it easier to start smoking. Flavors also make tobacco products taste good,(1-3) which is very appealing to new and inexperienced smokers.(3)
  • The cooling and anesthetic effects of menthol mask the harshness associated with cigarette smoke, allow deeper inhalation,(4) and make tobacco toxins go down easier.(5)
  • Flavors, especially menthol, make it harder to quit.(6, 7)
  • Menthol actually makes cigarettes more addictive than those cigarettes sold as non-menthol.(7)
  • Though many smokers may think flavors make tobacco and smoking safer, menthol cigarettes and other flavored tobacco products present the same disease risk as nonmenthol cigarettes.(8)
  • Menthol and other flavored tobacco products are disproportionately used by African Americans and other communities of color, as well as female, younger, and lesbian, gay, bisexual, or transgender (LGBT) smokers. All of these groups have been strategically targeted by tobacco industry to entice them to use menthol cigarettes.(9, 10)
  • Menthol cigarettes are predatorily marketed in marginalized communities, where one will find more advertisements and cheaper menthol cigarettes than in higher income neighborhoods.(11)

Uses of Menthol and Flavored Tobacco Products in California

  • 71.5% of Black, 51% of American Indian, 35% of Hispanic, 23% of Asian, and 18.5% of White adult smokers say that they usually smoke menthol cigarettes.(12)
  • 48% of high school cigarette smokers say they normally smoke menthol flavored cigarettes.(13)
  • 53% of lesbian, gay, and bisexual (LGB) adults who smoke usually smoke menthol cigarettes (compared to only 27% of straight adult smokers).(12)

More Young People Use Flavored Products

  • Most teens who use tobacco start with a flavored product.(14)
  • 54% of people between the ages of 18-24 who use other-tobacco products (OTP), report using a flavored OTP in the past month compared to 15% of 25-44 year old OTP users, 5% of 45-64 year old OTP users, and 1.7% of OTP users over 65 years of age.(12)
  • 38% of e-cigarette users between the ages of 18-24 have smoked a flavored e-cigarette in the past month compared to 17% of 25-44 year old e-cigarette smokers, 5% of 45-64 year old e-cigarette smokers, and 1.5% of e-cigarette smokers over 65.(12)

 

Research Citations:

  1. Flavored cigar smoking among U.S. adults: Findings from the 2009-2010 National Adult Tobacco Survey. Nicotine Tob Res. 2013
  2. Flavored-little-cigar and flavored-cigarette use among U.S. middle and high school students. The Journal of Adolescent Health: Official publication of the Society for Adolescent Medicine. 2014
  3. Tobacco industry control of menthol in cigarettes and targeting of adolescents and young adults. Am J Public Health. 2008
  4. Menthol's potential effects on nicotine dependence: A tobacco industry perspective. Tob Control. 2011
  5. Menthol sensory qualities and smoking topography: A review of tobacco industry documents. Tob Control. 2011
  6. Smoking cessation prevalence among U.S. smokers of menthol versus non-menthol cigarettes. Am J Prev Med. 2011
  7. Food and Drug Administration. Preliminary scientific evaluation of the possible public health effects of menthol versus nonmenthol cigarettes. Silver Springs, MD: Food and Drug Administration: July 23, 2013.
  8. Food and Drug Administration. Fact Sheet: Flavored Tobacco Products. 2011.
  9. Menthol Cigarette Smoking among Lesbian, Gay, Bisexual, and Transgender Adults. Am J Prev Med. 2015.
  10. Racialized geography, corporate activity, and health disparities: Tobacco industry targeting of inner cities. J Health Care Poor Underserved. 2007.
  11. Targeted advertising, promotion, and price for menthol cigarettes in California high school neighborhoods. Nicotine Tob Res. 2012.
  12. California Behavioral Risk Factor Surveilance System (BRFSS) 2012-2014 data; Age range: 18 years and older.
  13. California Department of Public Health, California Tobacco Control Program, California Student Tobacco Survey (CSTS) 2011-2012.
  14. Flavored Tobacco Product Use Among US Youth Aged 12-17 Years, 2013-2014. JAMA. 2015

Additional Tobacco Links and Resources

San Francisco Cancer Initiative
From SFCAN:  Coordinated action on tobacco control, especially in young adults, low income communities, the homeless and people with mental illness - where smoking rates are higher than the general population- can make the highest impact.