FDA Finding May Curb Mentholated Cigarette Availability

Abstract

T he availability of menthol cigarettes increases the likelihood that youths and African Americans will become habitual smokers, making menthols a greater public-health hazard than regular brands, the U.S. Food and Drug Administration’s Tobacco Products Scientific Advisory Committee (TPSAC) said at its mid-March meeting. “The availability of menthol cigarettes has an adverse impact on public health by increasing the number of smokers and increasing the number of avoidable deaths and premature mortality,” said committee member Mark Stuart Clanton, M.D., chief medical officer of the American Cancer Society’s High Plains Division. However, the committee found insuffi cient evidence to conclude that smoking menthols increases the likelihood of addiction among all adults. Nor did evidence indicate that mentholated brands are more dangerous than regular cigarettes, which increase lung and other cancers, heart disease, emphysema, and other chronic conditions. The TPSAC’s conclusions came after a year-long review of epidemiological and physiological studies of menthol smokers in the past decade. The committee’s fi ndings could lead to stepped-up FDA regulation of mentholated brands, which could go as far as a ban. The FDA has until mid-June to issue its fi nal review of the evidence. Agency officials were noncommittal about what actions they might take in response to the TPSAC report. “We do recognize the strong interest in this issue,” said Lawrence Deyton, M.D., director of the Center for Tobacco Products at FDA. “Now it’s up to us to do our job.” The 2009 Tobacco Control Act, which created TPSAC and gave the FDA the authority to regulate tobacco, targeted menthol cigarettes as the fi rst product for heightened scrutiny because of mounting evidence that mentholated brands ultimately lead to lifelong smoking by youths and minorities. The consensus statement of the eight-member panel (three industry representatives on the committee were not allowed to vote on the fi nal recommendations) said the evidence was suffi cient to reach that conclusion. The committee found that menthol brands increase experimentation and regular smoking, as well as increase the likelihood of addiction in young smokers and African-Americans, 80% of whom prefer menthols. It also found that smoking menthols makes the success of smokingcessation programs less likely. “Youths who initiate with menthol cigarettes are more likely to become daily, regular smokers than those who initiate with nonmenthol cigarettes, [and] adolescent menthol smokers have a higher prevalence of addiction than those who smoke nonmenthol cigarettes,” Clanton said. Also, “the availability of menthol cigarettes results in lower likelihood of smoking cessation in AfricanAmericans [than that for] nonmenthol cigarettes.”