CDC anti-smoking campaign takes aim at menthol cigarettes

By Mira Cheng, CNN

(CNN) — Tammy W. couldn’t breathe. She was on her daily 10-mile run when she felt a sudden constricting sensation in her chest. She went to see her doctor and learned that she needed open-heart surgery immediately.

The news came as a shock to Tammy, who took pride in living a healthy lifestyle. She had never thought that her “side hobby” of smoking menthol cigarettes – a common habit, she said, amongst members of the Little Travers Bay Bands of Odawa Indians tribe that she belonged to – could result in such dramatic health consequences.

Tammy underwent open-heart surgery at age 44. During the operation, she flatlined three times and had a stroke. She has recovered but can no longer run as far as she used to.

“I can’t forget my mom’s eyes,” Tammy says in a video interview, her voice breaking. “I said, ‘Mommy, I promise you I won’t make you bury me if I have a choice.’”

Tammy is one of 45 former smokers – who were not identified with their last names – sharing their stories as part of the US Centers for Disease Control and Prevention’s national Tips From Former Smokers campaign, which resumed Monday. The campaign is sharing stories like Tammy’s on television and radio, online and in print across the country to encourage people to quit smoking.

Tips From Former Smokers is the first federally funded national tobacco education campaign. The original version ran from 2012 to 2018 and resulted in 16.4 million smokers attempting to quit, 1 million of whom were successful, according to CDC surveys.

“While cigarette smoking among adults has declined, it remains the leading cause of preventable disease, disability and death in the United States, and some groups continue to be affected more than others,” Dr. Deirdre Lawrence Kittner, director of the CDC’s Office on Smoking and Health, said in a news release.

This new iteration of ads includes seven stories that place a special emphasis on the harms of menthol cigarettes, which have become particularly prevalent amongst historically marginalized communities and have contributed to worsening tobacco-related health disparities.

Although the number of people who smoke cigarettes in the US has fallen to one of the lowest levels in history, the proportion of those who smoke menthols has been increasing, according to the CDC. Young people, racial and ethnic minorities, LGBTQ+ people, women, people with low incomes and those with mental health conditions are more likely to smoke menthol cigarettes than other groups, the agency says.

Menthol masks the taste and smell of cigarettes and anesthetizes the throat, making it easier to inhale the smoke. It also enhances the effects of nicotine on the brain and can make cigarettes even more addictive, according to the CDC.

Tobacco companies have marketed menthols to first-time users and historically marginalized groups, such as Black Americans and individuals who identify as LGBTQ+.

“These tactics included event sponsorships, magazine advertisements, provision of free samples, and heightened point-of-sale marketing activities in certain neighborhoods,” Dr. Daniel Giovenco, an assistant professor of sociomedical sciences at the Columbia Mailman School of Public Health who was not involved in the new campaign, wrote in an email to CNN. “For example, menthol cigarette advertisements appeared disproportionately in magazines with high Black readership, and menthol cigarette companies once sponsored major music events such as the Kool Jazz Festival.”

Industry efforts to aggressively market menthols toward Black smokers have paid off. A 2020 study showed that although 43% of all adult smokers smoked menthols, more than 83% of Black smokers did.

“Tobacco companies target people like me with their menthol cigarette marketing. Realizing this made me angry enough to quit,” said Angie P., another former smoker featured in the CDC campaign. “This should make everyone angry.”

The federal government is now considering a ban on menthol cigarettes and flavored cigars.

In October, the US Food and Drug Administration took what anti-tobacco groups called a “momentous” step by sending final rules on banning menthol cigarettes to the White House for review. However, the issue has stalled since it was submitted to the White House’s Office of Management and Budget.

This delay has frustrated anti-tobacco groups who see it as an instance of politics getting in the way of public health.

“In an extremely disappointing end to 2023, the White House bowed to tobacco industry pressure and failed to move forward in 2023 with finalizing rules to eliminate menthol as a characterizing flavor in cigarettes and prohibit all characterizing flavors in cigars,” the American Lung Association wrote in its annual State of Tobacco Control report. “This lack of action prioritizes politics and tobacco industry profits over public health and if the White House fails to finalize the rules.”

Cigarette smoking kills more than 480,000 Americans every year, and 16 million Americans are living with at least one serious smoking-related disease, according to the CDC.

Banning menthol cigarettes would save up to 654,000 lives in the US within 40 years, including the lives of 255,000 members of the Black community, a 2022 study found.

Black people die at significantly higher rates than White people from smoking-related illnesses including stroke, heart disease and lung cancer; Black people make up 12% of the population in the US, but the community accounts for 41% of smoking-related premature deaths and 50% of the life-years lost associated with menthol tobacco product use between 1980 and 2018, one study found.

If menthols were banned, the gap between Black and White lung cancer deaths would close within five years, a Council on Foreign Relations study found.

The tobacco industry and other groups that are against the federal ban say that the rule will increase the potential for criminal charges in Black communities and create an underground market.

However, Giovenco noted that the regulations would not penalize the use or possession of menthol cigarettes, only companies that make or sell noncompliant products.

“Unsurprisingly, the industry fails to acknowledge how their own targeted and exploitative marketing practices are directly responsible for the deaths of hundreds of thousands of Black Americans,” he said. “The proposed ban has the support of virtually every major public health and medical association, as well as many prominent civil rights and social justice advocacy groups, who understand the devastating health toll caused by menthol cigarettes and flavored cigars.”

CNN’s Jen Christensen contributed to this report.

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