Civil rights groups and public health organizations, incensed over what they see as foot-dragging by the Biden administration on a potential ban on menthol cigarettes, met with White House officials this week to push for what they consider to be a life-saving measure.
The groups said the administration might be dragging its feet to avoid possibly alienating Black voters, who are disproportionately more likely to smoke menthols.
“This is their rule,” she said. “One would hope that they had felt the science was sufficient.”
She said she left Tuesday’s meeting feeling “fairly positive” that the groups’ concerns been heard, but she also said there is still a feeling that they need to continue to press the administration to act.
Concerns about delays
Although the FDA has been considering a ban on menthol cigarettes for nearly a decade, it wasn’t until October that the FDA finally took what anti-tobacco groups called a “momentous” step forward by sending final rules on the issue to the White House for review.
In the federal government’s extensive rulemaking process, the agency that regulates tobacco can’t just finalize a rule and have a ban go into effect. The White House Office of Management and Budget has to sign off on proposed language from the FDA.
But when the federal government published its regulatory to-do list, called the Unified Agenda of Regulatory and Deregulatory Actions, in early December, it indicated that the final menthol rule wasn’t expected until March.
With concerns swirling, a coalition of more than a dozen high-profile civil rights and public health groups said they met with Health and Human Services Secretary Xavier Becerra and leaders from the White House on Tuesday to encourage them to enact a ban now.
“This is a public health issue that did have nothing to do with politics, but it now has everything to do with politics,” said Carol McGruder, a founding member and co-chair of the African American Tobacco Control Leadership Council, who attended the White House meeting.
“This is a product that’s killed a million Black people in the past 20 years. It is the number one killer, and so it has to be in the top five political priorities at all times,” McGruder said.
The virtual meeting included the American Heart Association, the American Lung Association, the Truth Initiative, the African American Tobacco Control Leadership Council, the National Council of Negro Women, the NAACP, the National Coalition on Black Civic Participation and others who want immediate action on flavored tobacco.
“As is standard practice for all rules, OIRA works to schedule meetings with all requesters while the rule is under review. OIRA does not approve attendees,” an administration official said, referring to the Office of Information and Regulatory Affairs, a part of the Office of Management and Budget.
The potential to save lives
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. Smoking is still the No. 1 cause of preventable death in the US.
The issue is particularly important to the Black community because for decades, the tobacco industry has aggressively marketed menthols toward them, a move that’s paid off. A 2020 study showed that although 43% of all adult smokers smoked menthols, more than 83% of Black smokers did.
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.
It would also eliminate some of the significant health disparities in the US between Black and White people, according to a study from the Council on Foreign Relations.
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, the Council on Foreign Relations study found.
A menthol ban could also keep kids from picking up the habit. Menthol cigarettes are attractive to new smokers, studies show, because the flavoring masks the harsh taste and smell that put some new smokers off. The menthol also anesthetizes the throat, making it easier to inhale the dangerous smoke deeply.
More than half of kids who smoke choose menthol cigarettes, according to the CDC. Studies have found that children who smoked menthols were more likely to become regular smokers than occasional smokers.
The coalition went over many of these statistics in this week’s meeting, and McGruder said she came away hopeful. Administration officials seemed “engaged and were paying attention,” she said. It also helped that among the attendees were powerful organizations “who have the esteem of our people,” she said, and who represent Black voters, whom the administration will need in next year’s elections.
Dr. Kimberly Jefferies Leonard, vice chair of the American Cancer Society Cancer Action Network, also felt optimistic after the meeting.
“I think that because of the number of people that showed up and who showed up, I think the administration heard us and heard our plea and our cry,” she said.
The American Heart Association, which was also represented in the meeting, said it appreciated the opportunity to speak with the White House.
Facing opposition from other groups
The coalition hoped that the meeting would counter the narrative put forward by groups that receive funding from the tobacco industry, like the Rev. Al Sharpton’s National Action Network, that also met recently with the White House in a bid to resist regulation.
As of early December, the public calendar of Biden administration’s meetings showed a recent full-court press from the tobacco industry. Of the 41 meetings on the menthol rule in the past month, 38 were with tobacco industry groups and their allies.
One argument from these groups is that a ban would criminalize menthol smokers and encourage more deadly interactions with police. The FDA and anti-tobacco advocates say that’s not true.
“It’s not about the individual person in the street,” McGruder said. “Smoking a menthol cigarette is not illegal. If you get one or if you make one, that’s your business. This is about the tobacco industry, and they’re doing everything that they can to keep their hooks in our community.”
Justin Bibb, mayor of Cleveland, a key city in a key state in any presidential election, was also in Tuesday’s meeting with the White House. A menthol ban is important to him on a personal level and a political level.
“I lost my father way too early because he was addicted to cigarettes – Newports, to be specific – and my grandfather actually died of lung cancer as well, so I’ve seen so many instances as a kid growing up in the city and as mayor where tobacco companies are preying on the Black community,” Bibb said.
Cleveland, which is more than 46% Black, leads the nation with a smoking rate of 35%, more than three times the national average.
This year, Bibb introduced a plan to ban flavored tobacco product sales in his city, but Republicans in the Ohio statehouse say they would like to prevent local governments from enacting such bans. With limited authority, Bibb said, federal action is absolutely necessary.
“It’s past time that we get some real leadership from this President and Congress to see some real change in this issue,” he said.
A ban would make an important statement, Jefferies Leonard said.
“It makes a statement that the administration is concerned with Black lives, and it will send the message to our communities that the administration feels that Black lives do actually matter,” she said.
“Reynolds has been clear on where it stands on banning menthol – we strongly believe there are more effective ways to deliver tobacco harm reduction than banning products. A ban on menthol cigarettes would harm, not benefit, public health,” the statement said.
McGruder bristles at tobacco companies’ talk about how a ban will hurt the community. “It’s just so cynical that they’re flipping their racist, pernicious targeting of our community,” she said.
The ban cannot be left up states, she said. Two, Massachusetts and California, banned menthol cigarettes with some success, but not without pushback.
When California passed its ban on menthol, the industry put a referendum on the ballot to keep the products on shelves. Voters rejected that push, but the companies came up with new products that are “non-menthol menthol” chemicals, McGruder says, to mimic menthol. The industry also sued the state.
“It’s neverending. That’s why we need to take action on the federal level,” McGruder said. “We need protection from this industry that’s rabid and will not stop.”
Her group and the others say they plan to keep the pressure up. On January 18, there will be a “menthol funeral” in Washington to recognize the 45,000 Black people who die each year from tobacco-related illness and to encourage the White House to act now.
If a ban is put in place, then the “real work begins,” McGruder said. There will need to be additional resources, culturally appropriate smoking cessation programs, and efforts to eliminate systemic racism and better address social determinants of health.
“We need the same vigor and attention that the industry gave us in seeding our community with addiction,” McGruder said. “We need that same attention and love from our country, from our government, from the FDA, from the CDC, to help people get off these addictive products.”