What’s the problem with menthol? According to government statistics, menthol cigarettes top of the list for 75 percent of Black smokers compared to fewer than 25 percent of White smokers. Like other additives, menthol, which is derived from mint and also is available in synthetic form, can help mask the bitter taste of tobacco.

“If we’re banning things such as clove and peppermint, then we should ban menthol,” said Dr. Louis Sullivan, who served as the health secretary under George H.W. Bush. “If it doesn’t happen, this bill will be discriminatory against African-Americans.” Mr. Sullivan is one of five former health secretaries that recently sent a letter to Congress urging lawmakers to ban menthol flavoring in all tobacco products.

Despite a history of opposing such bills in the past, AMA’s leadership and many representatives support the menthol exemption pushed by cigarette industry heavyweights. The AMA’s board was given the power to decide on the group’s stance which in turn silenced many doctors who wanted to challenge the exemption.

AMA President Ron Davis said the bill would give the FDA authority to decrease dangerous ingredients in cigarettes, improve health alerts and bar misleading labels such as “mild” and “light.” “Removing the menthol exemption from the bill might derail the legislation,” said Mr. Davis. “While other flavor additives are aimed at luring young smokers, menthol is different. Banning it would merely drive mature Black smokers to other brands.” It would also change the political dynamic, he added.

According to the African American Tobacco Prevention Network, menthol cigarette brands like Kool were marketed during 1960s advertising campaigns aimed at Black consumers. A 1987 survey conducted by the city of St. Louis found twice as many billboards in Black neighborhoods as White. Almost 60 percent of the billboards in Black neighborhoods advertised cigarettes and alcoholic beverages.

In another study of 73 billboards along 19 blocks in a Black neighborhood in Philadelphia and 60 advertised cigarettes or alcohol. In a 1989 survey by the Abel Foundation, 70 percent of the 2,015 billboards documented in the city of Baltimore advertised alcohol or tobacco products. Three-fourths of the billboards were in predominately poor Black areas.

The Centers for Disease Control estimates billboards advertising tobacco products are placed in Black communities four to five times more often than in White communities.

“The (menthol) exemption harms the Black community,” said Robert McCaffree of the American College of Chest Physicians. He believes cigarette maker Philip Morris USA’s support for the bill and the exemption could be a major influence.

William S. Robinson, director of the African American Tobacco Prevention Network, said his group firmly believes a better tobacco control bill could be drafted without the support of Philip Morris, which produces a high number of menthol brand cigarettes.

“We understand from an industry perspective why menthol is off the table,” Mr. Robinson said. “We think part of it is because menthol represents almost 30 percent of the $70 billion U.S. cigarette market.”

Philip Morris spokesman Bill Phelps said the bill would give the FDA authority to remove ingredients that are determined harmful to health. “Based on our scientific judgment, menthol does not increase the inherent hazards of smoking,” Mr. Phelps said.

Related links:

Tobacco will kill 650 million smokers worldwide (FCN, 07-03-2008)

Anti-Tobacco campaigns escalating in the Black community (FCN, 04-16-2007)