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By Dr. Martha A. Dawson, DNP, RN, CNS, FACHE, President of the National Black Nurse’s Association
The Food and Drug Administration’s proposed ban on menthol cigarettes and flavored cigars is a game changer for public health, one that builds on decades of progress in fighting the tobacco industry’s deadly products and predatory marketing practices.
The health benefits of eliminating these products would be enormous, especially for the Black community that has been targeted by the tobacco industry for far too long, and the FDA has an obligation to move forward without delay.
For more than six decades, the tobacco industry has heavily targeted Black Americans with pervasive advertising, free samples and cheap products, particularly for menthol cigarettes. Worse, this deceitful marketing has worked. Today, 85% of Black smokers use menthol cigarettes compared with just 10% in the 1950s, and we are paying the price with chronic diseases and premature deaths.
Reversing a deadly trend of menthol cigarette consumption in Black communities
As president of the National Black Nurses Association and as a nurse with more than 45 years of experience, I have been on the frontlines of the fight against the tobacco industry’s racist race-based marketing schemes and have seen firsthand the devastating health consequences.
My association represents more than 300,000 Black nurses across 111 chapters in 33 states and Washington, D.C. Since I joined more than 30 years ago, we have become vocal advocates in the fight against tobacco use and menthol cigarettes in particular.
There are more tobacco retailers, more advertising for menthol cigarettes and more price discounts for menthols in Black neighborhoods. Tobacco companies have sponsored community and music events and associated themselves with popular Black artists. They also use young, healthy and vibrant models to portray smoking — particularly menthol cigarettes— as a good time.
It is anything but.
The deadly cost
Menthol cools and numbs the throat, which masks the harshness of tobacco smoke and makes it easier for kids to start smoking. Research shows that menthol cigarettes are also more addictive and harder to quit. Big Tobacco’s targeted marketing has harmed the health of Black communities across the country, destroying lives and creating significant health disparities for Black Americans compared with other racial groups.
Black Americans smoke at about the same rate as white smokers. However, largely because of menthol cigarettes, Black smokers die at far higher rates from tobacco-related diseases such as cancer, heart disease and stroke. The data clearly reflect the disproportionate toll of menthol cigarettes on Black Americans. Tobacco kills 45,000 Black people each year in the United States.
A 2021 study found that menthol cigarettes were responsible for 378,000 additional premature deaths in the U.S. between 1980 and 2018. A shocking 41% of those premature deaths were Black Americans. This gap in health outcomes could be swiftly narrowed with the implementation of the FDA’s
FDA’s proposed ban should proceed
In a recent analysis, the Council on Foreign Relations found the elimination of menthol would close the gap for lung cancer deaths among Black Americans and other racial groups within just five years. Without the ban, the organization found that the gap would not close for another 25 years. What’s more, studies estimate that banning menthol cigarettes would save up to 650,000 lives over the next 40 years, including over 250,000 Black lives.
As part of our efforts at the National Black Nurses Association, we have spoken to young people to urge them not to fall victim to Big Tobacco’s tricks, and we have worked to help older adults finally quit after decades of tobacco use. We have also partnered with federally qualified clinics to make sure information on the harmful health impacts from smoking — and how to quit —are readily available, and our Substance Misuse Committee remains highly active in this space.
All this work is important, but it is not enough. If Big Tobacco’s pervasive marketing were truthful, it would show Black men and women suffering from the many diseases caused by smoking, from cancer and heart disease to emphysema and diabetes.
It would show Black lives cut short and generation after generation getting hooked on these addictive products. It would show the harm of secondhand smoke to our children and families. It would show what those young, vibrant models look like 15-30 years later after decades of tobacco use. We know, of course, that this will never happen.
But what can happen is just as powerful. The FDA can once and for all stop the spiral of harm that started with Big Tobacco’s racist marketing tactics. Prohibiting menthol cigarettes and flavored cigars will quickly drive down tobacco use, reduce deeply rooted racial health disparities, safeguard the next generation from addiction, and ultimately save hundreds of thousands of lives.
There’s no reason to wait a moment longer to start realizing these benefits.
Dr. Martha A. Dawson, DNP, RN, CNS, FACHE, is President of the National Black Nurses Association and Associate Professor of Nursing at the University of Alabama at Birmingham School of Nursing.