Debate Sharpens Over Menthol Cigarettes

Representatives from three major tobacco companies,
speaking before a committee tasked with advising the federal government on
tobacco regulation, defended menthol cigarettes against charges that they put
smokers' health at greater risk than regular cigarettes.

"Menthol does not make cigarettes more harmful," says William R. True,
senior vice president of Lorillard, the maker of the best-selling menthol
cigarette, Newport. Representatives from R.J. Reynolds and Altria, the parent
company of Philip Morris USA, also spoke.

Several public health experts, meanwhile, argued for a total ban of the
additive, referring to its role in cigarettes as "sweetening the poison."

So began the second and final day of the Tobacco Products Scientific
Advisory Committee's inaugural meeting in Washington, D.C. The committee,
formed following the passage of the Family Smoking Prevention and Tobacco
Control Act in June 2009, has a year to review available research -- both
publicly available studies as well as unpublished tobacco industry documents --
in order to determine where the balance should lie.

"We need to review all the evidence and get insight into the scope of the
research that has not been published," says committee chairman Jonathan M.
Samet, MD, of the Keck School of Medicine at the University of Southern
California.

The committee spent the afternoon hashing out the types of information it
would require in order to make its recommendations. Much of what they hope to
review concerns industry marketing practices, the chemical makeup of menthol
and what effects it has on human physiology, as well as any role it might play
in a person's decision to start smoking or their efforts to quit.

A decision to ban menthol outright would have a huge impact on the tobacco
industry, as menthol cigarettes account for approximately a quarter of the
market. But, argue advocates of such a ban, the FDA has already banned all
other flavored cigarettes.

"There's no distinction, no logic" to allowing menthol cigarettes to remain
on the market while other flavors are banned, says Philip Gardiner, PhD, of the
University of California's Tobacco Related Disease Research Program.

Who Smokes Menthol Cigarettes?

Much of the day's discussion focused on a few key issues. Foremost among
them was the appeal of menthol cigarettes for different ethnic groups,
including African-Americans, and also for young smokers, who many believe favor
menthols because they mask the harshness of regular tobacco.

African-Americans account for more than three-quarters of the market for
menthol cigarettes. Gardiner, who says this a social justice issue, calls the
opportunity for the FDA to ban menthol "a historic opportunity. ... At a
minimum they should rein in [tobacco companies'] predatory marketing campaigns
that have bombarded the African-American community."

Cheryl Healton, PhD, professor of public health at Columbia University and
president and CEO of the American Legacy Foundation, also supports a ban, in
particular because of menthol's appeal to young and new smokers.

"If you want [young people] to start smoking, give them something that
tastes like candy," she says. "And guess what? Young smokers smoke more
menthols."

The tobacco companies disagree. "Youths smoke what is accessible to them,"
True says.

Pediatrician Dana Best, MD, MPH, director of the Smoke Free Project at
Children's National Medical Center in Washington, D.C., who was not involved
with the meeting, says kids often don't have much of a choice when it comes to
what they smoke. After all, they can't legally buy cigarettes, so they take
what they can get, where they can get it. It makes studying their habits very
difficult.

In fact, researchers trying to study kids' smoking behavior are often
confronted with a real catch-22. "You have to get their parents' permission to
study them, but kids don't want thir parents to know they smoke."

In her practice, she sees patients who fall into the two categories of most
concern to the panel: youths and minorities, particularly African-Americans. So
what would be the result of a ban on menthol?

"It would be another step along the path toward making cigarettes more
unpalatable," says Best, who acknowledges that little is known about the health
risks of menthol in cigarettes.

In fact, much of the publicly available data regarding menthol cigarettes is
inconclusive or contradictory, and the issue before the committee will likely
remain quite contentious over the next 12 months. However, says committee
member and Harvard professor of public health Greg Connolly, "I hope everything
we do shows respect and dignity to smokers. We are here to help smokers."

By Matt McMillen
Reviewed by Laura Martin
©2005-2008 WebMD, LLC. All rights reserved