An article released today by the American Journal of Public Health concludes that tobacco companies use menthol to enhance addiction of smokers, especially adolescents and young adults. The study, which reviewed tobacco industry documents, examined data on menthol cigarette advertising and use, and tested cigarettes directly, was conducted by researchers at the Harvard School of Public Health (see: Kreslake JM, Wayne GF, Alpert HR, Koh HK, Connolly GN. Tobacco industry control of menthol in cigarettes and targeting of adolescents and young adults. American Journal of Public Health 2008).
The researchers found that tobacco companies use menthol to aid the addiction process of new, adolescent smokers. The menthol works through its anesthetic effects on the respiratory tract, which reduce the harshness of the initial smoking experience. Cigarette company research revealed that a low level of menthol can reduce the initial negative reaction to cigarette smoking. Since the initial negative reaction turns many adolescents off of cigarettes permanently, reducing this reaction can be the key to successfully addicting a youth.
For example, an R.J. Reynolds document notes that: "First-time smoker reaction is generally negative. . . . Initial negatives can be alleviated with a low level of menthol."
The memo also notes that: "Once a smoker adapts to smoking a menthol product, the desire for menthol increases over time. A brand which has a strategy of maximizing franchise acceptance will invariably increase its menthol level."
Thus, manipulation of menthol levels in cigarettes plays a substantial role in sustaining addiction to cigarettes as smokers become older and more experienced.
The article concludes: "Cigarettes are nicotine delivery devices. They are engineered to promote initiation and transition to addiction through design features that make the products more attractive and palatable. Although menthol is not addictive, it may contribute to tobacco addiction by promoting initiation and facilitating inhalation of smoke."
The Rest of the Story
First and foremost, this research exposes the hypocrisy of the Campaign for Tobacco-Free Kids, the American Medical Association, and other groups which are supporting the FDA tobacco legislation and actively opposing the Congressional effort to remove the menthol exemption.
These groups are arguing that we need to ban cigarette flavorings because these flavorings help induce young people to start smoking. They are supporting a ban on a wide range of flavors, including cherry, chocolate, strawberry, banana, mint, clove, raspberry, and even snozberry. Yet there is no scientific evidence that any of these flavorings are actually used to recruit and addict young smokers.
On the other hand, we now have solid evidence that menthol is actually being used by cigarette companies to recruit and support addiction among literally millions of young smokers. So what does the Campaign for Tobacco-Free Kids want to do with this flavoring? Ensure that it can remain in cigarettes, because smokers are actually using it!
This hypocrisy is just too absurd to be true. How can a public health group argue, on the one hand, that tons of flavorings that are not being used to any substantial extent to recruit young smokers need to be banned, but that the one flavoring that has now been conclusively shown to be contributing toward the addiction of millions of smokers needs to remain on the market?
I'm not arguing here that menthol products need to be removed from the market. I'm arguing that it is complete and utter hypocrisy to argue that chocolate needs to be banned from cigarettes, but that menthol needs to remain.
Second, I find it ironic that here we now have evidence of the one thing that the FDA legislation could potentially do that would actually make a dent in youth smoking, but the Campaign for Tobacco-Free Kids opposes it. All of the other measures in the legislation are not going to do a thing to prevent youth smoking. Now we have an evidence-base to support an action that we know will make a substantial difference, and the Campaign for Tobacco-Free Kids and its partners are opposing it!
Third, this story reveals just how apparent the lack of an evidence-base is in the national tobacco control movement. Where there is no evidence to support action, the health groups are demanding regulation. Where there is solid evidence to support action, the health groups are demanding that Congress not intervene. This is insanity!
Once again, I'm not calling on the regulation of the constituents of tobacco products. It should be well known to my readers that I am opposed to that concept and I don't think it is appropriate for the FDA to be entrusted with such a mission. However, it is ludicrous for those who are calling on the FDA to regulate cigarettes to give the Agency numerous tasks for which there is no evidence to suggest there will be any positive effect on the public's health, but to ban the Agency from taking the few actions for which there is evidence that there would be a positive effect on the public's health.
The loopholes in the bill, which preclude it from taking exactly those actions for which there is evidence that a dent in cigarette use would occur -- including the menthol exemption -- represent sellouts that occurred at the negotiating table with Philip Morris. To be holding on to these sellouts even after Congressional leaders themselves have demanded that the loopholes be removed and after research has been presented demonstrating why the loopholes are critical to the protection of cigarette sales is unconscionable.