Not Mint to Be

I remember my first cigarette. My neighborhood friend Victoria looked at me and held up one flimsy and misshapen Camel Crush Blue—menthol flavored. We crouched behind her mother’s mini-van one May day in 2009. It tasted minty and terrible. We felt cooler than ever. Like many other youths, we started our smoking journey on menthols; we were the target demographic for tobacco companies. Menthol cigarettes remain the primary cigarette younger people start smoking and have been marketed particularly at Black communities.

There are over 18 million menthol smokers in the United States, meaning close to half of all smokers nationwide prefer a minty cigarette. Every year 480,000 people die from smoking-related causes. To try to lower the number of smokers, the U.S. Food and Drug Administration in April 2022 proposed a ban on menthol cigarettes and cigars.

David Levy and colleagues conducted a simulation study to measure the potential impact a ban on both menthol cigarettes and vaping products would have on smoking rates. Using recent smoking trends, the researchers simulated the American smoking prevalence from 2022 through 2060. They measured the differences in smoking rates with the ban in place (orange line) against current smoking trends without the ban (blue line).

The model predicted that the overall prevalence of menthol cigarette smoking would decrease immediately following the ban (Graph A). For non-menthol smoking, the study predicted a 2% increase in 2022 followed by a steady decline from 2023 to 2060 (Graph B). Overall, the study modeled a 2% decrease in smoking for both menthol and non-menthol cigarettes and cigars starting with the ban in 2022 and steadily decreasing through 2060 (Graph C). Therefore, with the proposed ban, smoking rates in the U.S. would decrease at a faster rate and be lower overall than without the ban.

I remember a Marlboro Menthol poster I saw back in my teen years. It had a pack of menthols sitting on this lush green background and suggested that menthols were like breathing clean air (a clean cigarette—imagine that). When I could legally purchase cigarettes, I started buying packs of Marlboro Menthols. They were cheaper than the Camel Crush Blue I choked down with Victoria all those years before. Would I have turned away if menthol had been banned?

Databyte via David T Levy, Rafael Meza, Zhe Yuan, et al. Public health impact of a US ban on menthol in cigarettes and cigars: a simulation study. BMJ Tobacco Control, 2021.