Thursday, January 07, 2016

City of St. Paul Takes Cowardly Political Move that is a Public Health Sham; Anti-Smoking Groups Supporting Law Should be Ashamed

Last night, the St. Paul City Council voted to enact an ordinance which bans the sale of flavored tobacco products and flavored electronic cigarettes, unless the retail store is purely a tobacco outlet and access is restricted to adults only.

City Council members and health groups put themselves up on a pedestal, claiming that they were taking on Big Tobacco and protecting youth from being seduced by flavorings into using hazardous tobacco products and e-cigarettes.

For example, ClearWay Minnesota stated: "With this measure, St. Paul is protecting the health of its young citizens. Not only does this action make the city healthier, it can encourage other communities and the state to act as well."

Another ordinance supporter (a high school student) boasted that: "Flavored products are just as deadly and addictive as the stuff that isn't flavored. They are all appealing to young people. You have the chance to make sure that kids in the future won't lose loved ones too soon or struggle with years of addiction."

One City Council member proudly stated about the ordinance: "It’s going to send a strong message to the tobacco industry that their intent to appeal to kids is not going to be tolerated."

The Rest of the Story

There's just one thing that the proud members of the St. Paul City Council and the praising health groups and ordinance supporters aren't telling you.

The rest of the story is that this ordinance is a complete sham. Its enactment is an act of political cowardice, revealing policy makers and health groups that are actually afraid of taking on Big Tobacco. Moreover, they are afraid of taking the one policy action that truly would save the lives of our children, make sure that kids in the future won't lose loved ones too soon or struggle with years of addiction, make the city healthier, send a strong message to the tobacco industry that their intent to appeal to kids is not going to be tolerated, and set an example for other cities to follow.


Because hidden in the ordinance is the critical fine print that the City Council members, policy makers, and ordinance supporters are hiding from the public.

The fine print is that the ordinance exempts menthol cigarettes. However, menthol cigarettes are the #1 threat to the health of the youth in St. Paul. A full 50% of youth smokers use menthol cigarettes, and there is abundant evidence that the tobacco companies use menthol to appeal to youth. Rather than standing up to Big Tobacco, the council members and public health groups are actually bowing down to Big Tobacco. They are cowards who are afraid to actually take on the industry. They are unwilling to put their actions where their mouths are by restricting the sale of the one flavoring that is having the greatest impact in terms of addicting youth to nicotine and causing them to lose loved ones too soon. They are afraid to take an action that might actually put a dent in cigarette sales.

The ordinance also exempts mint and wintergreen flavors, meaning that it exempts most smokeless tobacco products. The policy makers and health groups are also caving in to the smokeless tobacco industry. They are afraid to take an action that might actually put a dent in smokeless tobacco sales.

Thus, the St. Paul City Council is taking the easy way out. They are taking the politically easy step of restricting the sale of flavored cigars and cigarillos, but they are not willing to take an action that might actually threaten the sale of the main products that are causing long-term youth addiction and eventually disease and death: cigarettes.

In boasting that this ordinance is going to send a strong message to the tobacco industry that enticement of youth via flavored tobacco products will not be tolerated by the city of St. Paul, the City Council members are full of crap. The message they are actually sending is that where it really counts - where the rubber meets the road - they are not willing to take on the industry, change the status quo, or make a real dent in the sale of tobacco products.

And it is disturbing that the health groups supporting the ordinance have used youth, such as the high school student who was enticed by the groups to unknowingly make a fool out of himself, to do their dirty work. Was this youth informed that the ordinance bans menthol cigarettes? Was it explained to him that menthol cigarettes are the preferred product of youth smokers and that among African American youth smokers, nearly 80% were enticed by menthol cigarettes? Was it explained to him that mint and wintergreen are the main flavors of smokeless tobacco, so that the ordinance does almost nothing to prevent smokeless tobacco companies from enticing youth via flavored products?

To make matters worse, the ordinance bans the sale of most electronic cigarettes by convenience stores, making it likely that hundreds of former smokers will return to smoking because of the unavailability of the products that are keeping them off of tobacco.

But to me, the worst part of this story is that the health groups supported the ordinance. And even worse, in their letters of support, not a single one of the health groups even pointed out that the ordinance exempts menthol, mint, and wintergreen flavors. Furthermore, not a single one of these health groups even suggests that the ordinance be strengthened by restricting the sale of the flavored tobacco products which are actually responsible for the bulk of youth addiction to nicotine and for the overwhelming majority of disease and death caused by tobacco (cigarettes and smokeless tobacco).

Each of the following health groups submitted letters of support to the City Council, and not a single one so much as mentioned the menthol exemption or even mildly suggested that the ordinance be strengthened by removing the menthol, mint, and wintergreen exemptions:
  • Campaign for Tobacco-Free Kids 
  • ClearWay Minnesota
  • Model Cities of St. Paul
  • Rainbow Health Initiative
  • Association for Nonsmokers' Rights - Minnesota
  • Minnesota Medical Association
  • American Cancer Society
  • Twin Cities Medical Society
  • St. Paul - Ramsey County Public Health Department
  • American Heart Association
  • Minnesota Cancer Alliance
  • American Academy of Pediatrics - Minnesota Chapter
  • Minnesota Department of Health
  • Minnesota Academy of Family Physicians

Unlike the political cowards in St. Paul (and in Minneapolis, which recently enacted a similar ordinance), the city of Chicago actually stood up to Big Tobacco and restricted the sale of menthol cigarettes, producing a cogent argument for why this is actually a meaningful public health measure, unlike the token actions taken in Minnesota:

"Menthol contributes to the appeal and addiction potential of smoking in youth. Derived from the peppermint plant, menthol provides a minty flavor and cooling sensation in cigarettes, covering up the tobacco taste and reducing the throat irritation associated with smoking, particularly among first-time users. The anesthetic cooling effect of menthol facilitates initiation and early persistence of smoking by youth. The National Survey on Drug Use and Health found that 47.7% of all adolescent smokers smoke menthol. The prevalence use of menthol-flavored cigarettes among kids (ages 12-17) is staggering, with disproportionate rates being evident across the community: 72% of African Americans, 51% of Asians , 47% of Hispanics and 41% of Whites; as well as 71% among young LGBT smokers. The trend continues into young adulthood, with 85% of African American smokers, 38.2% of Hispanics, and 35.8% of Asians using a mentholated brand compared to 28.8% of Whites. At the Federal level, a menthol ban could prevent up to 600,000 smoking-related deaths by 2050, a third of these from the African American community."

The fact is that St. Paul's exemption of menthol means that the city is differentially providing less public health protection for African American youth. Though unintentional, this meets the definition of institutional racism because it is the systematic under-protection of the health of racial/ethnic minorities, with no public health rationale. The only rationale for exempting menthol is either political (we're too scared to take on Big Tobacco) or economic (we don't want to actually see a real decline in cigarette sales and tax revenues).

Yes, it's a wonderful day in the city of St. Paul because kids will no longer be able to easily access flavored cigars. But they can still walk into any gas station or convenience store and pick up a Marlboro menthol, Camel menthol, or Newport cigarette. And they can also easily pick up Skoal or Copenhagen smokeless tobacco, whose most popular flavors are tobacco, wintergreen, and mint (all exempt from the law).

And as Paul Harvey would say, now you know the rest of the story.

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