Menthol cigarettes may be harder to quit, particularly for some teens and African-Americans, who have the highest menthol cigarette use, according to a study by a team of researchers. Recent studies have consistently found that racial/ethnic minority smokers of menthol cigarettes have a lower quit rate than comparable smokers of regular cigarettes, particularly among younger smokers.

One possible reason suggested in the report is that the menthol effect is influenced by economic factors — less affluent smokers are more affected by price increases, forcing them to consume fewer cigarettes per day.
“This pattern of results is consistent with an effect that relies on menthol to facilitate increased nicotine intake from fewer cigarettes where economic pressures restrict the number of cigarettes smokers can afford to purchase,” said Jonathan Foulds, Ph.D., professor, Public Health Sciences, Penn State College of Medicine, and an author of the report.
Menthol is a compound extracted from mint oils or produced synthetically that activates cold-sensitive neurons in the nervous system. Menthol cigarettes make up about 25 percent of the market but are preferred by certain subgroups of smokers, including about half of teenage smokers and 80 percent of African-American smokers.
Research has shown that menthol cigarettes may provide higher levels of carbon monoxide, nicotine and cotinine per cigarette smoked than regular cigarettes.
“Menthol stimulates cold receptors, so it produces a cooling sensation,” Foulds said. “This effect may help smokers inhale more nicotine per cigarette and so become more addicted. In effect it helps the poison go down easier.
“The smoker who has reduced their cigarette consumption typically compensates by increasing inhalation per cigarette. Menthol in cigarettes makes the smoke less harsh, enabling these smokers to obtain a larger and more reinforcing nicotine hit.”
The researchers, who published their results in a special issue of the journal Nicotine and Tobacco Research, reviewed the evidence from 10 published studies that compared smoking cessation rates or proportions between mentholated and regular cigarette smokers.
Not all of the studies included in the report found an effect of menthol on quitting, and no studies to date have been specifically designed to look at menthol and cessation, but the effects of menthol on quitting were larger in more recent studies, in younger smokers and largely restricted to African-American and Latino smokers.
Other members of the research team are Monica Webb Hooper, Ph.D., Department of Psychology and Biobehavioral Oncology, University of Miami; Mark J. Pletcher, M.D., M.P.H., Department of Epidemiology and Biostatistics, University of California at San Francisco; and Kolawole S. Okuyemi, M.D., M.P.H., Program in Health Disparities Research, University of Minnesota Medical School.

That cool, throat-numbing sensation some smokers find in their cigarettes could go the way of other products the federal government has deemed dangerous. Menthol, a natural compound found in the mint plant, soothes throats and helps tame an achy tummy. But in cigarettes, some health experts argue, it makes the poison that is tobacco go down more smoothly, tricking the youngest and most foolhardy smokers. Last year, Congress passed far-reaching tobacco regulations that, among other things, banned chocolate- or strawberry-flavored cigarettes, saying they lured kids to smoke by dressing up cigarettes as candy.

But Congress passed on regulating menthol cigarettes, which account for one-third of cigarettes sold in the United States. Instead, it called for a study and more discussion by the Food and Drug Administration.

The FDA brought the debate to Raleigh on Wednesday, when big tobacco executives and public health officials met at a downtown hotel to discuss the new law on cigarettes and how the FDA would enforce it.

Outside, dozens of workers from Lorillard Tobacco in Greensboro, N.C., paced in the bitter cold. They produce Newports, menthol cigarettes that have been their ticket to a middle-class life.

“This is about my livelihood.,” said Darsey Campbell, who has cleaned and serviced Lorillard equipment for 40 years. ” … We have to worry when the government starts messing with one more thing. Don’t they have enough to do?”

The conundrum for federal officials is clear: Cigarettes are bad; jobs are good. Can there be a winner?

“Undeniably, this is a very controversial issue with a lot of moving parts,” said Jeff Ventura, an FDA spokesman.

With cigarettes, the federal government is engaged in an awkward dance. On one hand, America needs jobs more than ever, and government officials want to avoid jeopardizing a major U.S. manufacturer’s product and market share. Cigarette makers insist that banning menthol will simply push production overseas or into an unregulated black market.

But the government also doesn’t want people to smoke. It is the No. 1 preventable cause of death in the U.S. Smoking attacks the lungs, making smokers prone to chronic sickness. The FDA doesn’t want kids to pick up a cigarette habit.

Public health officials want cigarettes to taste as bad as they are for a smoker’s health, and menthol undermines that. The product, which can be made synthetically, tempers the burn cigarettes bring to the throat. If kids feel that burn, they may never pick up another cigarette, some health officials argue. The biggest consumers of menthol cigarettes are young people and minorities, studies show.
Campbell, the Lorillard worker, smokes Newports flavored with menthol. She wants government to stay out of her business.

“I’m grown. It’s my choice,”she said.

Campbell’s bigger concern is about her job. She’s one of about 2,000 people working for Lorillard in Greensboro, where generations have found jobs paying enough for them to buy homes and take care of their families.

Lorillard executives won’t predict what would become of the Greensboro plant should the FDA ban menthol in cigarettes. The company just started making a menthol-free Newport in November, but it’s too soon to say whether it will catch on, said Bob Bannon, Lorillard’s director of investor relations.

Lorillard’s corner of the cigarette market depends on menthol, which workers spray on tobacco before rolling it in paper. They make a third of the menthol cigarettes sold in the U.S., accounting for about 10 percent of the total cigarette market.

FDA officials say they are a long way from having an answer to the menthol question. Congress obliged them to study, and scientists have been meeting to do just that. A report is due to the FDA secretary in March, but there are no deadlines or expectations after that.

A new attack against cigarettes started, this time against menthol cigarettes and all flavored tobacco products. The attack comes from the journal Addiction which issued a supplement comprising of various studies on the effects of menthol flavored cigarettes on consumers. They showed the fact that menthol cigarettes are mostly used by African Americans and young adults and that surprisingly it is harder to quit menthol cigarettes than non flavored ones.

The advertising industry around menthol cigarettes tends to make you forget that they are after all still cigarettes, though they smell and taste better, Dr.Kola Okuyemi, senior editor of the supplement emphasized. This special supplement was funded by the national cancer Institute and has led to an investigation from the U.S Food and Drug Administration.

This newly started war against menthol cigarettes is the result of a law suit filled by the son of an African-American woman against cigarette manufacturer Lorillard Inc for the death of his mother due to menthol cigarettes. Because of a strong marketing campaign which included free menthol giveaways to children, he stated, his mother became a menthol addict at the age of 9.It seems that indeed the tobacco industry has strongly promoted menthol cigarettes especially to minorities.

The public health organization strongly feels that this too is an argument in the battle to ban menthol from the market.

As a response to this banning campaign Lorillard tries to prove through materials posted on their website that menthol cigarettes do not harm people more than non flavored cigarettes do. There is no scientific proof to support their theory, Lorillard declares.

A menthol ban may not go over well for those who are addicted to menthol cigarettes, but it just may happen if the FDA gets their way. Menthol is the most popular cigarette or, smoked by millions of American’s everyday. The menthol ban carries great importance for public health advocates and tobacco executives. But it also has implications in the African American community since that community uses menthol cigarettes most of all.

The FDA will have the help of a scientific advisory panel who will advise them on regulating tobacco. They opened a two-day meeting on Tuesday and began reviewing hundreds of published studies on menthol cigarettes. The panel which is largely made up of scientists, physicians and public health experts, has a year to make a recommendation to the FDA on whether to ban menthol cigarettes. The ban would be a big hit to cigarette companies since menthol cigarettes are used by about 26 percent of smokers and make up almost one-third of the $70 billion U.S. cigarette market.
It would also be a hit because most teenage smokers begin with menthol at a young age. Their ban would probably decrease the amount of teens who start smoking and in the long run help them lead a healthier life.

What do you think? Should menthol cigarettes be banned?

The U.S. Food and Drug Administration’s ban on caffeinated alcoholic drinks presents a risk for the tobacco sector, and menthol cigarettes in particular. While the drinks targeted by the FDA have faced a barrage of negative publicity linked to underage abuse and harm, the primary focus of the regulator’s Tobacco Products Scientific Advisory Committee (TPSAC) hearings on hol is underage and minority smoking.

Tobacco is also regulated by the FDA, which is currently conducting a study of the health impact of menthol cigarettes, which account for 30% of U.S. cigarette volume and gaining.

“A caffeinated alcohol ban indicates a more aggressive FDA, willing to intervene against consumer products it views as harmful to public health, particularly when it involves underage users,” Deutsche Bank analyst Marc Greenberg said in a note to clients.

With all other flavours banned in 2009, menthol is the only remaining legal flavored cigarette. However, Mr. Greenberg noted that the menthol review is intended to be science-based, so it is unlikely to expect a quick decision as seen with the caffeinated alcohol bank. Menthol is also a bigger target that is more established with consumers and with more industry supporters.

The analyst noted that a menthol ban poses a significant black market risk, which the FDA needs to keep in mind and companies will argue aggressively over in the coming months.

Nonetheless, the tobacco industry faces an important regulatory risk, particularly Lorillard Inc. since 90% of its sales (and nearly 100% of EBITDA) come from menthol leader Newport. Mr. Greenberg thinks the FDA review is a major driver of the company’s decision to start test-marketing a non-menthol version of Newport this month.

Reynolds American Inc. has the second biggest exposure, with an estimated 30% of its cigarette volume in menthol, while Altria Group Inc. has the lowest relative exposure with an estimated 15% to 20% of cigarette volume.

Congress of Racial Equality’s National Spokesperson Niger Innis today questioned whether a Food and Drug Administration committee is headed toward a “government-knows-best moment” as they examine menthol cigarettes. A FDA scientific panel is meeting today and tomorrow as part of a review of menthol cigarettes. Innis believes that this panel is the beginning of a process that could lead to the prohibition of menthol cigarettes, which are popular with African-Americans who smoke.

“This is the wrong way to attack the legitimate problem of health disparities in the Black community,” Innis said. “Government’s efforts to demonize menthol flavored cigarettes will simply add yet another government imposed prohibition on a legal activity, hence another government restriction on people’s ability to exercise their liberty.”
Niger pointed to clearly immoral past government initiatives like the Tuskegee Experiment and similar trials performed on several hundred Guatemalans in the 1940s, both launched with the best intentions of improving Americans’ public health. He said “before government promotes actions like these that usurp individual choice and liberty, they should remember the horrific ‘unintended consequences’ that can result.”
He added: “CORE is urging the FDA, in the strongest terms, not to jump to conclusions about menthol cigarettes – simply because they are popular among blacks. It would be a serious mistake to single out a flavor popular with blacks without solid scientific evidence regarding any harmful effects of menthol.”

A possible federal ban on menthol cigarettes could hurt convenience store business and create a black market for the minty smokes, a still-growing part of the shrinking cigarette market, the National Association of Convenience Stores said Thursday. The group is urging a Food and Drug Administration scientific panel examining menthol cigarettes to consider the unintended consequences of a “hasty decision,” said Lyle Beckwith, senior vice president of government relations for the group representing more than 2,100 retail and 1,500 suppliers mostly in the U.S.

“Fanning the flames on a black market economy is something we’re very concerned about, not only from a viability of the store perspective, but also from a public health perspective,” said Beckwith, who likened a ban on menthol to Prohibition.

The Alexandria, Va., group also warned that a large black market could make it easier for children to get cigarettes because those involved in criminal activity won’t check identification to verify someone’s age.

Beckwith also said a potential ban could impact retailer’s profits.

The about 145,000 convenience stores across the U.S. post about $624billion in total sales each year, with tobacco as their top-selling item, according to the trade group.

“Tobacco customers bring in foot traffic. They don’t just buy cigarettes, they buy other things,” Beckwith said. “We will lose a significant number of customers.”

The panel appointed by the FDA’s Center for Tobacco Products is meeting soon to discuss the public health impacts of menthol cigarettes and how to regulate them. It is required to make recommendations to the federal agency by March.
Philip Morris USA parent Altria Group Inc., Reynolds American Inc., and Lorillard Inc. have gone on the offensive, saying scientific evidence does not show that menthol cigarettes create greater health risk than non-menthol cigarettes.

The share of smokers using menthol cigarettes increased from 31 percent in 2004 to 33.9 percent in 2008, with more pronounced increases among young smokers, according to a study released by the Substance Abuse and Mental Health Services Administration.

It also showed that among black smokers, 82.6 percent used menthol cigarettes, compared with 32.3 percent for Hispanic smokers and 23.8 percent for white smokers.

Material from: www.sbsun.com

With their enticing cool and minty flavor, menthol cigarettes have emerged as one of the most controversial products made by the tobacco industry. Kids are particularly drawn to them, with nearly 45 percent of smokers aged 12 to 17 using menthol cigarettes, according to a 2009 National Survey on Drug Use and Health. Most black teenaged smokers — and 82.7 percent of black adult smokers — favor menthols, the same survey found.

“The manufacturers would have you believe there is not a scintilla of evidence that menthol is no more dangerous than other cigarettes to the individual smoker, but we do not agree,” said Ellen Vargyas, general counsel for the American Legacy Foundation, a smoking prevention and cessation organization in Washington, D.C., founded with funding from the landmark Master Settlement Agreement between the tobacco industry and state governments. “Over 80 percent of African-American smokers smoke menthol, and African-America smokers have the highest rates of lung cancer. We also know African-Americans with lung cancer are more likely to die from lung cancer.”

In addition, the popularity of menthols among younger, newer smokers suggests that maybe the minty taste does encourage people to start, perhaps by masking the harsh taste of regular cigarettes, she added.

“We know the younger you are and the newer the smoker you are, the more likely you are to smoke menthol,” said Vargyas. “There is a very strong correlation between being a teenaged smoker and menthol cigarettes.”

That’s no coincidence, say smoking opponents: The tobacco industry has long targeted youth and minorities for menthol cigarette marketing, even manipulating menthol content in different brands in an effort to recruit new smokers among youth, according to the National Cancer Institute and the Harvard School of Public Health.

The debate over how menthols should be regulated lit up again last month, during the second round of hearings held by the U.S. Food and Drug Administration’s Tobacco Products Scientific Advisory Committee.

The advisory committee was established by the Family Smoking Prevention and Tobacco Control Act, signed into law by President Barack Obama in June 2009. The legislation gave the FDA unprecedented power to restrict the marketing of tobacco products.

While the law bans cigarette makers from adding candy or fruit-like flavors such as clove, cinnamon, vanilla, cocoa or strawberry to cigarettes, legislators hedged when it came to menthols, the most popular flavoring by far.

Although menthol was not banned from cigarettes, the law stressed that nothing prevented it from regulating menthol as well. In fact, the act required the FDA advisory committee to consider menthol cigarettes impact on public health — including its use among children and minorities– as its first order of business.

During the first round of hearings in March, the advisory committee sought answers about the addictiveness of menthol cigarettes, whether they are more harmful than regular cigarettes and whether the flavor encourages kids in particular to take up smoking.

Anti-smoking advocates say there is no evidence that menthols — which account for an estimated 33.9 percent of the U.S. cigarette market — are less deadly than any other cigarette. Research from the University of Medicine and Dentistry of New Jersey, in fact, suggests that they are more addictive, making it harder for smokers to quit, particularly blacks and Latinos.

During the hearings, tobacco industry representatives defended their products, saying menthols are no more harmful than other cigarettes and should not be singled out for a ban.

“We don’t think there is any evidence or even any suggestion that youth would choose not to smoke if menthol products weren’t available,” said Bill True, senior vice president of research and development for Lorillard Tobacco Co., the makers of Newport’s. “Kids don’t smoke because there are menthol cigarettes. Kids smoke for a variety of reasons which are probably quite complex.”

“Cigarettes do pose significant dangers to an individual’s health,” True added. “In dealing with regulating the product, we believe the FDA should be looking at those things that are the most significant.”

On that point, anti-smoking advocates agree. Cigarettes are by their very nature a deadly product, and legislation to sharply regulate their manufacture, sale and marketing can’t come a moment too soon, said Vargyas.

Mitch Zeller, vice president for policy and strategic communications at Pinney Associates in Washington, D.C. and the director of the FDA’s Office of Tobacco Programs during the Clinton Administration, noted that there were some limitations to the family smoking prevention laws reach. While the FDA has far more power over the industry than before, it cannot ban all cigarettes outright, nor can it force cigarette companies to reduce nicotine levels to zero, he said.

However, he said, the legislation requires tobacco companies to disclose comprehensive information about the contents and manufacturing process for tobacco products. The tobacco companies, he added, have been less than forthcoming with their data about the marketing and manufacture of menthols.

“The industry presentation on the issues that matter the most — those related to marketing that influences kids and any issue related to the initiation of smoking — was non-responsive,” Zeller said. “The advisory committee is in need of more information to do its job.”

The FDA advisory committee has nine members and includes physicians, scientists and public health experts; the tobacco industry is represented by three non-voting members. The committee has until March 2011 to report its menthol findings to the U.S. Secretary of Health and Human Services.

For about one-third of smokers, menthol makes a cigarette taste better — but it doesn’t make it harder to quit and doesn’t appear to entice teens to smoke, tobacco companies told a key federal panel yesterday. And they’ve found no evidence that menthol cigarettes are more toxic than regular smokes, the companies told the U.S. Food and Drug Administration’s Tobacco Products Scientific Advisory Committee.

The panel, meeting yesterday in Gaithersburg, Md., is supposed to recommend how menthol cigarettes are regulated by next year — including whether they should be banned.

For the industry, billions of dollars of sales a year are at stake.

Menthol cigarette sales are declining, though R.J. Reynolds marketing operations director Monica J. Graves said there has been a slight recent rise in the percentage of smokers choosing menthol brands.

“This dynamic is not explained by marketing or by the amount of menthol in the product,” she said, adding that sales and price data show tobacco companies offer fewer promotions for menthol cigarettes.

“The menthol in Lorillard brands is simply designed to complement tobacco taste. Assertions Lorillard is trying to generate a physiological effect are simply not correct,” William R. True, senior vice president for research and development at Lorillard Tobacco Co., the top seller of menthol cigarettes.

There aren’t inadvertent biological effects, either, said Jane Lewis, senior vice president at Henrico County-based Altria Client Services, a sister company of the nation’s top cigarette-maker, Philip Morris USA.

“Menthol added to cigarettes does not increase risks of smoking. Menthol does not increase cigarette dependence. It does not affect cessation,” she said.

Altria anchored much of its case on an internal one-year study of 3,585 adult smokers, including 1,104 menthol smokers. In addition, the study looked at 1,077 non-smokers.

That study, one of the largest ever of people smoking naturally as opposed to the often-forced or paced smoking in laboratory studies, found:

•no sign that menthol smokers ingested more smoke;

•menthol smokers tended to smoke fewer cigarettes a day;

•no sign menthol smokers showed more biological changes that can foreshadow illness or cancer;

•no sign menthol affected how smokers metabolize nicotine, the addictive substance in cigarettes;

•no sign menthol affects how smokers metabolize nicotine-derived nitrosamine ketone, a potent carcinogen; and

•no sign menthol smokers were more likely to score higher on a standard test of nicotine dependence.

Altria’s Lewis said that supported findings in published epidemiological studies that menthol smokers are not more likely to suffer smoking-related diseases than other smokers.

In its submission, Altria said only one study has ever looked at whether menthol cigarettes particularly appeal to teenagers — and found no significant differences in teen’s sensory reactions to menthol as opposed to regular cigarettes. Other studies found no difference in when smokers of menthol and regular cigarettes started, the companies said.

Altria’s written submission also reported that nine national studies of smokers — ranging from 1,021 people who sought help quitting to 19,545 current and former smokers — found no difference in the percentages of menthol and non-menthol smokers who quit.

An informal group of tobacco control experts yesterday said menthol’s anesthetic effect tricks smokers into thinking their cigarettes are less harsh and therefore safer.

Article from: timesdispatch.com, July 16, 2010