The American Society of Clinical Oncology sent joint letters with the American Association for Cancer Research and the Campaign for Tobacco-Free Kids to the Food and Drug Administration urging that the agency establish regulations that would eliminate menthol in cigarettes in November.
“Additive flavors like menthol have a cooling effect that makes the inhaled cigarette smoke less harsh, and can lead to an increase in smoking, especially with young people,” Frank L. Meyskens, Jr., MD, FACP, Chair of ASCO's Cancer Prevention Committee, explained in a news release. “Flavors that help aid addiction to tobacco products should be prohibited—period.”
In July, the FDA issued an Advanced Notice of Proposed Rulemaking (ANPRM) to seek additional information related to potential regulatory options, such as establishing standards for tobacco products. The notice was available for public comment for a period that was eventually extended to be open until last November.
“Menthol cigarettes raise critical public health questions,” FDA Commissioner Margaret A. Hamburg, MD, said in a statement at the time the ANPRM was issued. “The FDA is committed to a science-based approach that addresses the public health issues raised by menthol cigarettes, and public input will help us make more informed decisions about how best to tackle this important issue moving forward.”
Both the ASCO/AACR and ASCO/Tobacco-Free Kids letters call for establishing a uniform standard that sets a maximum menthol level that all cigarette manufacturers will need to comply to. The ASCO/AACR letter strongly recommended that the FDA ban the addition of menthol to cigarettes and other combustible tobacco products as a characterizing flavor, a recommendation that is also supported by ASCO's tobacco-cessation policy statement, which noted, “Removal of menthol cigarettes from the market place would benefit public health in the United States.”
Other key points from the letters:
- Multiple lines of investigation support a role for menthol cigarettes in increasing experimentation and progression to regular smoking;
- Youth who initiated smoking with menthol cigarettes are more likely to become daily, regular, or established smokers than are those who initiated with non-menthol cigarettes;
- Adolescent menthol cigarette smokers have a higher prevalence of nicotine dependence and more severe nicotine addiction than those who smoke non-menthol cigarettes;
- The danger of menthol-flavored cigarettes fall disproportionately on African Americans—they are more likely to smoke menthol cigarettes, and African-American menthol smokers are less likely to quit smoking successfully than are non-menthol smokers; and
- Banning menthol flavoring would be an important step toward reducing tobacco-associated harm to this population and would curtail a longstanding tobacco industry marketing approach targeting African Americans, including youth.
The letters come after ASCO issued a policy statement last year, published in the Journal of Clinical Oncology, launching the Society's latest hard-hitting initiative on tobacco control (OT 8/25/13 issue). The ASCO/AACR letter is available online at http://bit.ly/19EdJoc.