September 1, 2022
Re: Flavored Tobacco Products and OUR KIDS
Attn: Chula Vista City Council
Dear Mayor Salas and Council Members Padilla, Cardenas, McCann, & Galvez, As two cofounders of Parents Against Vaping E-cigarettes (PAVe), a national organization founded in 2018 by three moms as a grassroots response to the youth vaping epidemic, we write today to express our strong support for ending the sale of all flavored e-cigarettes and all other FLAVORED tobacco products in Chula Vista, with no exemptions.
PAVe’s passionate parent volunteers have been advocating across California for ending the sale of all flavored tobacco products, participating in successful legislative campaigns in San Diego, Sacramento, San Jose, Santa Ana, Los Angeles and many more California cities and counties. At the state level PAVe parents helped pass SB 793, which is now on hold due to Big Tobacco’s referendum. We are grateful to serve as important partners for California’s county, city, and state tobacco prevention coalitions.
According to the 2021 National Youth Tobacco Survey (NYTS), over 2 million young people are currently vaping, and the research has proven over and over that flavors are hooking our kids. The latest figures show that 8 out of 10 teens who vape use flavors. With 40% of high-school users using an e-cigarette on 20 or more days out of the month, we must take action immediately to protect these teens from becoming an entire generation of nicotine addicts.
A report published by Data Bridge Market Research published on January 13, 2022, stated, "Various flavor offerings with shisha tobacco and widespread adoption by the various themed restaurants as well as theyouth population has been directly impacting the growth of shisha tobacco market. Variety of flavor offerings in shisha tobacco is one of the major driving factors as a large portion of the youth are willing to take up flavored smoking.” For these reasons, we are proud to advocate for a strong tobacco retail license ordinance in Chula Vista that is comprehensive and includes hookah, e-cigarettes, and ALL flavored tobacco products. Please provide the kids of Chula Vista with the same protections enjoyed by the kids in many other surrounding municipalities and prioritize lives, health equity, and prevention during this public health emergency! Thank you for your leadership and bringing this very important issue forward.
Sincerely,
Dorian Fuhrman and Meredith Berkman
Co-Founders, PAVe www.parentsagainstvaping.org
Written Communications
Item #8.2 - Fuhrman and Berkman
Written Communications
Item #8.2 - Knapp
Written Communications
Item #8.2 - Knapp
From: Cynthia Knapp < Cynthia. Knapp@saysandiego. org>
Sent: Tuesday, September 6, 2022 2:15 PM
To: Mary Salas < MSalas@chulavistaca. gov>
Cc: CityClerk < CityClerk@chulavistaca. gov>; Hartman, Lester <Lester. Hartman@childrens. harvard.edu>; JohnDale Noriega < JohnDale. Noriega@saysandiego. org>
Subject: Dr. Hartman: LOS for Tobacco Product Regulation Hello Mayor Salas,
Dr. Lester Hartman, pediatrician and tobacco researcher out of Harvard University, has close ties to the City of Chula Vista. He wrote the attached letter for your consideration in the upcoming flavored tobacco decision. Dr. Hartman cannot join us in- person for the City Council meeting, but is copied on this message. Please reach out with any questions you have regarding his points.
Thank you,
Cynthia
Cynthia ( Cindy) Knapp, MPH | Program Manager
she/ her/ hers
SAY San Diego
Alcohol, Tobacco, and Other Drug Prevention
4275 El Cajon Blvd., Ste. 101 | San Diego, CA 92105
Mobile:
www. saysandiego. org
From: Cynthia Knapp
Sent: Friday, September 2, 2022 2: 33 PM
To: msalas@chulavistaca. gov
Cc: CityClerk
Subject: SAY San Diego: LOS for Tobacco Product Regulation Good afternoon Mayor Salas,
Please accept this letter of support from Social Advocates for Youth ( SAY) San Diego regarding amending Chula Vista’ s Tobacco Retail License program to prohibit the sale of flavored tobacco products. The data shows ordinances like this one reduce youth access to tobacco products, which reduces youth initiation and use.
We appreciate your leadership.
Warm regards,
Cynthia
Warning:
External
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Written Communications
Item #8.2 - Knapp
Cynthia ( Cindy) Knapp, MPH | Program Manager
she/ her/ hers
SAY San Diego
Alcohol, Tobacco, and Other Drugs Prevention
4275 El Cajon Blvd., Ste. 101 | San Diego, CA 92105
Mobile:
www. saysandiego. org
Confidentiality Notice: This message and any accompanying documents contain information that is confidential, privileged, or exempt from disclosure under applicable law and is intended for the exclusive use of the addressee. This information is private and protected by law. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution, or use of the contents of this information in any manner is strictly prohibited Written Communications
Item #8.2 - Knapp
September 6, 2022
Mayor Salas and Chula Vista Councilmembers,
I am a retired Massachusetts-based pediatrician integrally involved in Massachusetts passing Tobacco21 and the tobacco flavor ban, including menthol. Here are some points about vaping you may not know:
1.) 95% of lifetime tobacco users start before the age of 21.
2.) There is a strong association between vape and thyroid cancer, cervical cancer, and leukemia. In my own practice, I saw a 19 year- old who vaped THC and nicotine develop nasopharyngeal cancer which, on average, strikes adult adults age 40 or older.
3.) In Massachusetts, after Tobacco21 age restriction and flavor ban were enacted, the convenience store industry continue to grow at a 3-5% increase. These regulations don’ t put businesses out of business.
4.) E-cigarettes are adolescent nicotine addiction devices, not adult smoking cessation devices.
Several months ago, in a vape shop in Chula Vista, I bought the e- cigarette product called INFINITE 8000. Yes, it has 8, 000 puffs of “ Blu razz” vape. The device fits into the palm of your hand and is equivalent to 30-40 packs of cigarettes.
5.) When Massachusetts initially exempted menthol, Massachusetts kids defaulted to using menthol products. In Vancouver, when menthol was banned, there was a 30- 50% increase in adult quit attempts.
6.) Dr. Hajek’s recent study says nicotine- based e-cigarettes are 2 times more likely to gets you off cigarettes than gum and patches. But what he did not say is gum and patches are 2. 5 times more likely to get you off ALL nicotine containing products.
7.) The goal of Big Vape and Big Tobacco is to delay, delay, delay while they continue to make millions and even billions of dollars. Send a message to Big Tobacco and voters in other towns that you are not waiting for the vote on Proposition 31, you want to stop this youth epidemic NOW!!
8.) Dr. Friedman’ s paper on claiming when flavors were banned kids started using combustible tobacco. Her data was flawed, and she used data before the legislation went from passed to enacted, which is often a 6- month gap. She failed account for this.
Thank you,
Lester J. Hartman, MD MPH FAAP
Westwood-Mansfield Pediatric Associates
Lester. hartman@childrens. harvard.edu | www. wmpeds. com Proactive in your child’ s care. Empowering families for over 60 years." @DrHartmanWMPEDS | # Tobacco21 | # DontBeAJuulFuul | # FlavorsHookKids Written Communications
Item #8.2 - Knapp
Dear Councilmembers,
My previously sent email contained an error, please accept my sincerest apologies and see the corrected message below:
Attached is a letter from the African American Tobacco Control Leadership Council strongly encouraging the Chula Vista City Council to end the sale of menthol cigarettes and all flavored tobacco products in the City.
This is no minor matter; lives are at stake.
New research shows that between 1980-2018 menthol cigarettes were responsible for:
1. 1.5 million new African American smokers;
2. 157,000 smoking-related premature deaths among African Americans; and
3. 1.5 million life-years lost among African Americans (Mendez & Le, 2021) (the full article and an accompanying editorial are also attached.)
Time is of the essence. We can't wait on the State or the FDA. Chula Vista must act now!
Thank you for your leadership.
With gratitude,
Camille Cummings
On Wed, Sep 7, 2022 at 9:36 AM Camille Cummings <[email protected]> wrote:
Dear Councilmembers,
Attached is a letter from the African American Tobacco Control Leadership Council strongly encouraging the Chula Vista City Council to end the sale of menthol cigarettes and all flavored tobacco products in the City.
This is no minor matter; lives are at stake.
New research shows that between 1980-2018 menthol cigarettes were responsible for:
1. 1.5 million new African American smokers;
2. 157,000 smoking-related premature deaths among African Americans; and
3. 1.5 million life-years lost among African Americans (Mendez & Le, 2021) (the full article and an accompanying editorial are also attached.)
Time is of the essence. We can't wait on the State or the FDA. New York City must act now!
Thank you for your leadership.
With gratitude,
Written Communications
Item #8.2 - Cummings
Camille Cummings
--
Camille Cummings, Project Coordinator
African American Tobacco Control Leadership Council
Phone: 888.881.6619 ext. 109
https://www.savingblacklives.org/
Written Communications
Item #8.2 - Cummings
From: Camille Cummings <
Sent: Wednesday, September 7, 2022 9: 36 AM
To: Mary Salas < MSalas@chulavistaca. gov>; Steve C. Padilla < spadilla@chulavistaca. gov>; Andrea Cardenas < acardenas@chulavistaca. gov>; John McCann < jmccann@chulavistaca. gov>; Jill Galvez jmgalvez@chulavistaca. gov>
Cc: CityClerk < CityClerk@chulavistaca. gov>; Adrian Kwiatkowski < Aida C. Castaneda < Valerie Yerger < Carol McGruder
Phillip Gardiner < Camille Cummings
Subject: End the Sale of Menthol Cigarettes and all Flavored Tobacco Products in Chula Vista Dear Councilmembers,
Attached is a letter from the African American Tobacco Control Leadership Council strongly encouraging the Chula Vista City Council to end the sale of menthol cigarettes and all flavored tobacco products in the City.
This is no minor matter; lives are at stake.
New research shows that between 1980- 2018 menthol cigarettes were responsible for:
1. 1.5 million new African American smokers;
2. 157,000 smoking- related premature deaths among African Americans; and
3. 1.5 million life-years lost among African Americans ( Mendez & Le, 2021) ( the full article and an accompanying editorial are also attached.) Time is of the essence. We can't wait on the State or the FDA. New York City must act now! Thank you for your leadership.
With gratitude,
Camille Cummings
Camille Cummings, Project Coordinator
African American Tobacco Control Leadership Council
Phone: 888. 881. 6619 ext. 109
https:// www. savingblacklives. org/
Warning:
External
Email
WrittenCommunications
Item #8.2 - Cummings
1MendezD, LeTTT. TobControl2021;0:1–3. doi:10.1136/tobaccocontrol-2021-056748 Consequencesof a matchmadein hell: the harm
causedby mentholsmokingto theAfricanAmerican
populationover1980–2018
DavidMendez, ThuyTTLe
Brief report
Tocite: MendezD, LeTTT.
TobControlEpubaheadof
print: [pleaseincludeDay
MonthYear]. doi:10.1136/
tobaccocontrol-2021-056748
Additionalsupplemental
materialispublishedonline
only. Toview, pleasevisitthe
journalonline (http:// dx. doi.
org/ 10. 1136/ tobaccocontrol-
2021- 056748).
HealthManagementandPolicy,
Universityof Michigan, Ann
Arbor, Michigan, USA
Correspondenceto
DrThuyTTLe, Departmentof
HealthManagementandPolicy,
Universityof MichiganSchoolof
PublicHealth, AnnArbor48109,
MI, USA; thuyttle@umich. edu
Received28April2021
Accepted16August2021
http:// dx. doi. org/ 10. 1136/
tobaccocontrol- 2021- 056988
Author(s) (or their
employer(s)) 2021. No
commercialre- use. Seerights
andpermissions. Published
byBMJ.
ABSTRACT
Background Formanyyears, nationalsurveyshave
showna consistentlydisproportionatelyhighprevalence
of mentholsmokersamongAfricanAmericanscompared
with thegeneralpopulation. However, to ourknowledge,
no priorstudyhasquantified the harmthat menthol
smokinghascausedon that population. In thiswork, we
estimatethepublichealthharmthatmentholcigarettes
havecausedto theAfricanAmericancommunityoverthe
lastfourdecades.
Methods UsingNationalHealthInterviewSurvey
data, weemployeda well- establishedsimulationmodel
to reproducetheobservedsmokingtrajectoryover
1980–2018in theAfricanAmericanpopulation. Then, we
repeattheexperiment, removingtheeffectsof menthol
on thesmokinginitiationandcessationratesoverthat
period, obtaininga newhypotheticalsmokingtrajectory.
Finally, wecomparedbothscenariosto calculatethe
publichealthharmattributableto mentholcigarettes
over1980–2018.
Results Ourresultsshowthatmentholcigarettes
wereresponsiblefor 1.5 millionnewsmokers, 157000
smoking- relatedprematuredeathsand1.5 millionlife-
yearslostamongAfricanAmericansover1980–2018.
WhileAfricanAmericansconstitute12% of thetotal
USpopulation, thesefiguresrepresent, respectively, a
staggering15%, 41% and50% of thetotalmenthol-
relatedharm.
Discussion Ourresultsshowthat mentholcigarettes
disproportionallyharmedAfricanAmericanssignificantly
overthelast38 yearsandareresponsiblefor
exacerbatinghealthdisparitiesamongthatpopulation.
Removingmentholcigarettesfromthemarketwould
benefit the overallUSpopulationbut, particularly, the
AfricanAmericancommunity.
BACKGROUND
For over 60 years, tobaccocompanieshavetargeted
menthol cigarettesto the African Americancommu-
nity through aggressive marketing and promo-
tion.1–3 It is well known that a disproportionately
high number of African Americans smoke menthol
cigarettes. According to the 2018 National Survey
on Drug Useand Health, 85% of African American
smokers used menthol versus39% of those in the
general population. This is not a recent phenom-
enon. In 1980, for example, menthol prevalence
among African American smokerswas66% vs33%
among the general population, according to the
National Health Interview Survey (NHIS).
Several articles4have addressedthe prospec-
tive harm to the black community that could be
avoided if menthol cigaretteswere bannedfrom the
market; and while other studies35–9 haveaddressed
the historical causesthat have made menthol the
preferred choice of cigarette products among
African Americans, to our knowledge, no prior
study has quantified the health harm that menthol
smoking hasalready inflicted on that population.
Following a recent study10that calculated the
health damagecausedby menthol smoking on the
entire US population over 1980–2018, the current
work estimatesthe shareof suchharm borne by the
African American community, and its disproportion
compared with the total menthol toll in the USA.
Our results may be helpful to the Food and Drug
Administration as they continue evaluating the
benefit of a menthol ban.
METHODS
Weusedthe samesimulation model and calibration
processas in the Le- Mendez article10with param-
eters specific to the African American population.
The model formulation, definition of model param-
eters and how some parameters were calculated
were thoroughly describedin Le- Mendez’s work. 10
The African American- specific parameters were
taken from several data sourcesdescribedbelow
and summarisedin online supplementaltable A1.
For our initial year (1980), we obtainedthe African
Americanpopulation by singleyear of agefrom the
Centers for DiseaseControl and Prevention.11 For
subsequentyears, we got the African Americanbirth
cohorts from 1981 through 2018 from the National
Vital StatisticsReports.12 13 The overall age- specific death rates for the African American population,
updated every 5years, were extracted from the
1980–2018 USLife Tables.14 Weusedrelativerisksof
mortality specificto the AfricanAmericanpopulation,
derivedfrom CancerPreventionStudyII (CPS- II data;
Relativerisksfor AfricanAmericancurrentandformer
smokerswerederivedfrom CPS- II dataand provided
by Dr Michael Thun from the American Cancer
Societyfor the 2011 TobaccoProductsScientificAdvi-
sory Committee (TPSAC) Menthol Report. Available
in online supplementaltableA5) to calculatethedeath
ratesby age for never, current and former smokers
following the sameproceduredescribedin Le- Men-
dez’s article.10 Smoking prevalencefor current and
former smokersand the proportion of menthol use
amongsmokersin 1980 were estimatedusingNHIS
data. We calculatedthe overall smoking cessation
ratesfor African Americansby adjustingthe general
population’soverallsmokingcessationratespresented
in Le- Mendez’s work10with the ratio of cessation
copyright. on
September20, 2021at
2 MendezD, LeTTT. TobControl2021;0:1–3. doi:10.1136/tobaccocontrol-2021-056748 Brief report
ratesbetweenthe African Americanand generalpopulations (0.66) reportedin ref 15. Then, usingthe menthol cessationmultiplier for African Americansestimatedby Mills et al16 (0.47, 95% CI 0.24 to 0.91) and the proportion of menthol smokersamong current African Americansmokers, we applied the sameprocessusedin ref 10 to compute the cessationratesfor African American non- menthol and menthol smokers. The specificformulation and cessa- tion valuesfor 1980 are shown in the Supplementto ref 10 and online supplementaltablesA2 and A3.
The annual adult smoking initiation rates for African Amer- icans were computed by taking the average NHIS smoking
prevalenceamong 18–24year- olds, consistent with ref 10. The switching ratesbetweenmenthol and non- menthol smokerswere calculatedasin the 2011 menthol report17 (2.29% switching to menthol and 1.08% to non- menthol cigarettes). An extensive sensitivity analysis (see online supplemental table A4) showed that these parametersexert little influence on the results. The ratio of yields from experimenter to smoker1819 and menthol mortality multiplier for the African Americanpopulation remains asin the Le- Mendez work, 10 following their samearguments.
As in ref 10, we first usedNHIS smoking prevalencedata over 1980–2018 (when the NHIS surveywas conducted) to calibrate the model. Then, we usedthe calibratedmodel to replicateAfrican Americans’ smoking prevalence trajectory during 1980–2018.
Finally, to quantify the harmful effectof menthol useon the African Americanpopulation, we repeatedthe previousstepto generatean alternativesmokingtrajectoryfor AfricanAmericansduringthesame period, eliminatingthe effectof mentholsince1980. Weachieved this by adjustingthe smokinginitiation and cessationratesto elimi- natethe effectof menthol on thoseparameters (seethe Appendices to the 2011 TPSACMenthol Report17andtheLe- Mendezpaper10).
Finally, we compared our resultsfrom both scenarios (with and without menthol cigarettes) to calculatethe impact of menthol on smokingprevalence, life- yearslost and smoking- relatedpremature deaths. Additionally, we comparedour resultswith those for the generalpopulation reported in Le- Mendez’s work10and calculated the disproportionateharm inflicted on the African Americanpopu- lation dueto menthol.
RESULTS
The simulatedsmoking prevalencefor African Americansclosely capturesthe NHIS reportedsmokingprevalenceover 1980–2018 with pseudo- R2=0.95 (pseudo- R2=1[ Errors Sum of Squares]/[- TotalSumof Squares]) (seeonline supplementalfigure A1 and A2).
Table1 showsthe harm attributable to menthol cigarettesfor the generalpopulation (from Le- Mendez’s work10), the African Amer- ican population and the hypothetical low- menthol African Amer- ican population. A completesensitivityanalysison the valuesin table1 is presentedin online supplementaltableA4.
The values in the first three columns of the table are self- explanatory; the numberswithin parenthesesshow the percent- agesthat those valuesrepresent, relative to thosefor the general population. The last column shows the average proportion over 1980–2018) of the corresponding population referred to on eachrow, relative to the entire US population. For example, the table shows that, among African Americans, menthol was responsible for 1.5 million extra smokers, 157 000 smoking- related premature deaths and 1.5 million excesslife- years lost during 1980–2018, representing 15%, 41% and 50% of the
total menthol toll, respectively. However, during the same period, African Americans constituted only around 12% of the overall USpopulation.
The last row of the table showsa hypothetical African Amer- ican population that exhibits the samementhol smoking- related parametersasthe generalpopulation. Wesimulatedthis scenario by setting the values of menthol- affected parameters for the African American population to those of the general popula- tion. In this hypothetical group, the estimatedmenthol smoking excessinitiation, premature deaths and life- years lost would have represented 13%, 16% and 21% of the overall menthol harm, respectively; much more in agreementwith the propor- tional (relative to the entire US) sizeof this population (12%). It is worth noting, though, that the menthol death toll in the low- menthol population is still above its proportional share. This is due to the mortality rates among African American smokers, which are higher than in the generalpopulation.
DISCUSSION
Since the 1960s, the tobacco industry has targeted the African American community for the consumption of menthol cigarettes through aggressive marketing, including intense advertising and price discounts. Simultaneously, the industry supported numerousAfrican American organisationsto gain the trust of the African American community. Several publications39 describe the marketing efforts by the tobacco industry to establish a specialconnection betweenmenthol cigarettesand the African American community. In a fascinating article entitled ‘ The African Americanization of menthol cigarette usein the United States’,3 Gardiner recounts the long history of, and explains the facts behind, the relationship between African Americans and menthol cigarettes, and how those products became an inte- gral part of the African American culture. In essence, the iden- tification of African American smokers with menthol has been purposely orchestratedby the tobacco industry following their goal of maximising their profits.
Unfortunately, this marketing strategy turned out to be a huge successfor the tobacco industry, but deadly for the black community. Besidescreating a brand with which African Ameri- canscould identify and call their own, the industry exposedthis population to a substancethat amplifies the damagingeffectsof cigarette smoking. Menthol intensifies this harm by increasing the chancesthat individuals transition from experimentation to regular smoking,18 19 and by increasing dependency, which leadsto delayedcessation.16 Theseeffectsincreasethe number of smokersand the amount of time they remain smoking.
Table1 Excesssmokinginitiation, smoking- relateddeathsandlife- yearslostdueto mentholcigarettesover1980–2018for theadultgeneral, AfricanAmericanandhypotheticallow- mentholAfricanAmericanpopulation Cumulativeexcesssmoking
initiators (%) Cumulative excessdeaths (%)
Cumulativeexcesslife- years
lost (%)
Averagepercentageof
population (%)
Generalpopulation 10137808 (100) 377528 (100) 2951533 (100) 100 AfricanAmericanpopulation 1508913 (15) 156471 (41) 1476198 (50) 12 Hypotheticallow- menthol
AfricanAmericanpopulation
1286848 (13) 61132 (16) 606840 (21) 12
copyright. on
September20, 2021at
3MendezD, LeTTT. TobControl2021;0:1–3. doi:10.1136/tobaccocontrol-2021-056748 Brief report
Thenegativeimpactof mentholcigaretteson thepublic’shealthis significant, asLeandMendezdescribedin ref 10. ForAfricanAmer- ican smokers, though, the harm wrought by menthol smoking is muchhigherthanthat for the restof the population. Despitehaving a similar overall smoking prevalenceas the generalpopulation,20 it is well known that African Americanssuffer, proportionally or disproportionately, moreserioussmoking- attributablehealthconse- quences.21 Main probablecausesfor this phenomenonarethe high overall mortality ratesdue to economicand socialconditions and the high prevalenceof menthol amongAfrican Americansmokers, which causesthem to be more addictedand quit less. In fact, our resultsshow that menthol was responsiblefor 157 000 smoking- relateddeathsamongAfrican Americansduring 1980–2018, over two and a half timestheir proportional shareof menthol deaths comparedwith the generalpopulation. And, what is even more depressing, 50% of all the life- yearslost to mentholsmokingduring 1980–2018 occurredamong African Americans. Additionally, our results (shownin online supplementalfigure A1) alsoindicatethat, without menthol, smokingprevalenceamongAfrican Americansin 2018 would havebeen8.3%, insteadof the NHIS reported14.9% a 44% reduction). We note that our resultsmay be considered conservative, sincewe do not take into accountthe future harm that menthol smoking over 1980–2018 will causeto the African Americanpopulation.
Consideringthat cigarettesmoking is the number one causeof preventabledeathsin theUSA, mentholin cigarettesisanimportant factor in creatingandexacerbatinghealthdisparitiesin this country.
Removingmenthol cigarettesfrom the market will savethousands of AfricanAmericanlivesperyearandhelpreducehealthdisparities at a time wheninequalitiesamongminority andsocioeconomically disadvantagedgroupsareincreasinglysalient.
What this paper adds
Mentholcigaretteshavebeendisproportionatelyusedamong
AfricanAmericans.
Mentholcigarettesexacerbatehealthinequalitiesfor the
AfricanAmericancommunity.
Removingmentholcanhavethedoubleeffectsof savinglives
andreducinginequalities.
Acknowledgements Theauthorswouldliketo thanktheUniversityof Michigan DataAnalysisandDisseminationCoreledbyDr. JihyounJeonforprovidingussome datafor thiswork.
Contributors DMandTTTLconceptualisedtheproject. TTTLcalibratedthemodel andconductedall theanalysis. DMsupervisedthework. Bothauthorscontributedto thewritingof themanuscript.
Funding Theresearchreportedin thispublicationwassupportedbythe NationalCancerInstituteof theNationalInstitutesof HealthandFoodandDrug AdministrationCentreforTobaccoProducts (awardnumberU54CA229974).
Competinginterests Nonedeclared.
Patientconsentfor publication Notrequired.
Provenanceand peer review Notcommissioned; externallypeerreviewed.
ORCIDiD
ThuyTTLehttp:// orcid. org/ 0000- 0002- 3106- 4045
REFERENCES
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2 DavisRM, GilpinEA, LokenB. Theroleof themediain promotingandreducing tobaccouse. USA, 2008.
3 GardinerPS. TheAfricanAmericanizationof mentholcigaretteusein theUnited States. NicotineTobRes2004;6 Suppl1:55–65.
4 LevyDT, PearsonJL, VillantiAC, etal. Modelingthefutureeffectsof a mentholban onsmokingprevalenceandsmoking- attributabledeathsin theUnitedStates. AmJ PublicHealth2011;101:1236–40.
5 AndersonSJ. Marketingof mentholcigarettesandconsumerperceptions: a reviewof tobaccoindustrydocuments. TobControl2011;20 Suppl2:ii20–8. 6 SuttonCD, RobinsonRG. Themarketingof mentholcigarettesin theUnitedStates:
populations, messages, andchannels. NicotineTobRes2004;6 Suppl1:83–91. 7 DelnevoCD, GanzO, GoodwinRD. Banningmentholcigarettes: a socialjusticeissue longoverdue. OxfordUniversityPressUS, 2020.
8 CadhamCJ, Sanchez- RomeroLM, FleischerNL, et al. Theactualandanticipated effectsof a mentholcigaretteban: a scopingreview. BMCPublicHealth 2020;20:1–17.
9 RobertN. Proctor, goldenholocaust: originsof thecigarettecatastropheandthecase forabolition, 2012.
10 LeTTT, MendezD. Anestimationof theharmof mentholcigarettesin theUnitedStatesfrom1980to 2018. TobControl2021. doi:10.1136/ tobaccocontrol-2020-056256. [Epubaheadof print: 25 Feb2021]. 11 Populationbyagegroups, race, andsexfor1960-97. centersfordiseasecontroland prevention.
12 MartinJA, HamiltonBE, OstermanMJ. Births: final datafor 2015, 2017. 13 ed..MartinJ, HamiltonB, OstermanM. Births: final datafor 2018. In: Nationalvital statisticsreports. ServicesDoHaH, 2019.
14 AriasE, XuJ. UnitedStateslifetables: 2017, 2019.
15 BabbS, MalarcherA, SchauerG, et al. QuittingSmokingAmongAdults - United States, 2000-2015. MMWRMorbMortalWklyRep2017;65:1457–64. 16 MillsSD, HaoY, RibislKM, et al. Therelationshipbetweenmentholcigaretteuse, smokingcessation, andrelapse: findingsfrom waves1to 4 ofthe population assessmentof tobaccoandhealthstudy. NicotineTobRes2021;23:966–75. 17 MendezD. Resultsfroma PopulationDynamicsModelof theConsequences of MentholCigarettesforSmokingPrevalenceandDiseaseRisks. Appendix A, 2011. Available: http://wwwfdagov/downloads/AdvisoryCommittees/ CommitteesMeetingMaterials/TobaccoProductsScientificAdvisoryCommittee/ UCM247689pdf
18 NonnemakerJ, HerseyJ, HomsiG, et al. Initiationwithmentholcigarettesandyouth smokinguptake. Addiction2013;108:171–8.
19 NonnemakerJ, FeirmanSP, MacMonegleA, etal. Examiningtheroleof menthol cigarettesin progressionto establishedsmokingamongyouth. AddictBehav 2019;98:106045.
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copyright. on
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1YergerV. TobControlMonth2021Vol0 No0
What more evidence is needed?
Removementhol cigarettes from
the marketplace— now
ValerieYerger 1,2
Tobacco remains the leading cause of
preventable death and diseasein the USA
and many other countries. However,
among all racial and ethnic groups in the
USA, African Americans bear the greatest
burden from tobacco- related morbidity
and mortality.1 Every year, 45 000 African
Americans prematurely and unnecessarily
die from tobacco- causeddiseases. An esti-
mated 85% of them smoked menthol
cigarettes.2
Menthol’s sensory properties reinforce
smoking, increaseuptake of nicotine and
toxic smoke components, and discourage
cessation. Menthol’s cooling, anaesthetic
and analgesiceffectseaseinitiation among
new smokers by masking the harshness
and irritation of tobacco smoke, reducing
pain sensationsin the mouth and throat,
and enabling deeperinhalation that facili-
tatesgreater exposureto nicotine.3
On 3 March 2009, Representative
Henry Waxman and 124 congressional
cosponsors introduced H.R. 1256— the
Family Smoking Prevention and Tobacco
Control Act.’4 Representative Waxman’s
Committee Report expressed concerns
about the disproportionate useof menthol
cigarettes among African Americans, the
targeted marketing of menthol cigarettes
in black communities, and the higher
ratesof lung canceramong African Amer-
ican smokers compared with non- African
American smokers, urging the Secretary
of Health and Human Servicesto move
quickly to address the unique public
health issuesposed by menthol cigarettes.
Yet, although most other characterising
flavours in cigarettes were prohibited in
2009 under the final version of the Family
Smoking Prevention and TobaccoControl
Act, menthol was inexplicably excluded.5
It has been estimated that hundreds of
thousandsof African Americansand other
menthol smokers are destined to die
prematurely if the exemption of menthol
is allowed to continue.6
The disproportionatetoll of mentholciga-
rettesamongAfrican Americanscompared
with the generalpopulation is a socialinjus-
tice. The black community has long been
subjected to the predatory marketing of
mentholatedtobacco products, particularly
in lower incomeareas, where there are not
only more advertisements, but more promo-
tions and cheaperprices for menthol ciga-
rettes when compared with more affluent
neighbourhoods.7 Tobaccocompaniesalso
heavilyrely on their cooptation of commu-
nity leaders to defuse tobacco control
efforts.8 Black- led organisationswith finan-
cial tiesto the tobaccoindustry haveplayed
a critical role in disseminatingmisinforma-
tion throughout the black community. Such
misinformation, for example, includesthe
ideathat localpoliciesprohibiting the saleof
mentholatedtobaccoproductsareracistand
will increasethe criminalisationof individ-
ualswho possessor smokethem, exploiting
legitimateconcernsabout racist policing to
defendthetobaccoindustry’stargetedpreda-
tion on theblackcommunity.9 10
Authors Mendezand Le, in their article
Consequencesof a match made in hell:
the harm causedby menthol smoking to
the African American population over
1980–2018,’11 show why none of us can
remain silent and complicit. This paper
should serve as a kick upside the head
for those who are in a position to remove
these deadly products from the market-
place. Until this paper, no prior study has
fully quantified the health harm inflicted
on African Americans by menthol ciga-
rettes. Yet, for at least three decades,
African American tobaccocontrol activists
have been out there resisting the perva-
sive presenceof the tobaccoindustry and
their deadly products in black communi-
ties,12–15 including filing a lawsuit to get
the Center for Tobacco Products of the
US Food and Drug Administration ( FDA)
to act on menthol.16 Now the evidenceis
irrefutable: menthol cigarettes are killing
our people at a rate unmatched by any
other assaultson our community.
Though constituting only 12% of
the total US population, African Amer-
icans bear an alarming amount of the
total menthol- related harm: 41% of the
smoking- related premature deaths and
50% of the life- years lost. This anal-
ysis demonstrates the contribution of
menthol cigarettes toward the annihila-
tion of a people already under siegeby a
racist society and its myriad of inequities,
governmental policies and political domi-
nation.17 18 Institutionalised racism, its
long historical impact, and the associated,
yet unresolved, intergenerational trauma
experienced by black people in America
have made them vulnerable to the clever
marketing and predatory dumping of
mentholated tobacco products in their
communities.
For decades, the tobacco industry has
exploited social and economic inequities
to foster the uptake and use of menthol
cigarettes, and createbrand loyalty among
African Americans. Tobacco companies
strategicallytargeted menthol cigarettesto
low- income African Americans, blanketing
inner city communities with marketing,
free samples, and music promotions,19 and
thereby contributing to the tobacco- related
healthdisparitiesobservedtoday, asMendez
and Le have now confirmed. We can no
longer ignore the intersecting, overlapping
and distinctive systemsof oppressionthat
shape ‘being black in America’ and how
menthol cigarettescontribute to sustained
andwideninghealthdisparities.20
This paper is compelling on its own
merit; however, read in tandem with the
authors’ previous paper,21 one can fully
appreciate the significant role menthol
cigarettes have played in addicting
millions of young people to nicotine and
in the deathsof thousandsdue to tobacco.
As the authors emphasise, mentholated
cigarettes have a ‘significant detrimental
impact on the public’s health and could
continue to posea substantialhealth risk.’
More than a decadeafter the FDA was
givenauthorityto regulatetobaccoproducts,
long after other flavours favouredby white
children were banned from most tobacco
products, and long after the first of several
scientificreportsfound mentholcigarettesto
poseapublichealthrisk abovethat seenwith
non- mentholcigarettes,22–24 theFDA still has
not acted. The black community has been
abandonedat the federallevel, leavingactiv-
iststo seeklocalandstatepolicy changes. So,
the questionfor me is: Given the mountains
of evidence, will anythingpushthe federal
governmentto considersocialjusticeandact
on its commitment to finally ban menthol
cigarettesandall flavouredcigars?25 26
The recent highly publicised killings of
black men and women, including George
Floyd, Ahmaud Arbery, Breonna Taylor
and many others, brought to the forefront
1SocialandBehavioralSciences, Universityof California
SanFrancisco, SanFrancisco, California, USA
2AfricanAmericanTobaccoControlLeadershipCouncil,
SanFrancisco, California, USA
Correspondenceto DrValerieYerger, Socialand
BehavioralSciences, Universityof CaliforniaSan
Francisco, SanFrancisco, California94143-0612, USA;
Valerie. Yerger@ucsf. edu
Editorial
copyright. on
September20, 2021at
2 YergerV. TobControlMonth2021Vol0 No0
Editorial
of our nation’s consciencehow pervasively
racismpermeateseverydaylife. Whetherone
is on the receivingor perpetuatingend of
racist behavioursor if one benefitsfrom or
is negativelyimpactedby racistpolicies, we
all recentlywatchedhow quickly the world
mobilisedto support the BlackLivesMatter
movement. Are we in a moment to leverage
thismovement?
If menthol cigarettesare allowed to stay
in the marketplace, the lives of African
Americansand others remain at increased
risk. Conversely, removing these terrible
products will benefit not only the black
communitybut alsoother racialand ethnic
groups, the lesbian, gay, bisexualand trans-
gender community, youth and those with
behaviouralhealthissues, sincethesegroups
also disproportionately smoke mentho-
lated cigarettesover non- mentholatedciga-
rettes.27–30 I askthat othersstandwith usto
repairawrong doneto theblackcommunity,
aswestandwith you. Thereissimplyno ethi-
cally acceptablereasonto allow the tobacco
industry to continueusinga flavouring that
makesit easierto startsmokingandharderto
quit. Whetherwework atthefederal, stateor
local level, we areempoweredin our collec-
tive work to protect our communitiesfrom
our number one killer, a corporateindustry
of federally adjudicated racketeers.31 This
paperprovidesuswith addedammunitionto
getthat vital work done. It is long pasttime
for the FDA to get inoculatedagainstwhat-
everthe hell is keepingit from gettingthese
deadlyproductsout of the marketplace.
Contributors Asthesoleauthor, VY, I made
substantialcontributionsto theconceptionanddesign
of thework. I draftedtheworkandrevisedit critically
for importantintellectualcontent. Asthesoleauthor,
I providedfinal approvalofthe versionpublishedand
amaccountablefor allaspectsof theworkin ensuring
thatquestionsrelatedto theaccuracyor integrityof the
workareappropriatelyinvestigatedandresolved.
Funding Theauthorshavenot declareda specific
grantforthisresearchfromanyfundingagencyin the
public, commercialor not- for- profit sectors.
Competing interests Nonedeclared.
Patientconsentfor publication Notapplicable.
Provenanceand peer review Commissioned;
internallypeerreviewed.
Author(s) (or theiremployer(s)) 2021. Nocommercial
re- use. Seerightsandpermissions. PublishedbyBMJ.
Tocite YergerV. TobControlEpubaheadof print:
pleaseincludeDayMonthYear]. doi:10.1136/
tobaccocontrol-2021-056988
http:// dx. doi. org/ 10. 1136/ tobaccocontrol- 2021- 056748
TobControl2021;0:1–2.
doi:10.1136/tobaccocontrol-2021-056988
ORCIDiD
ValerieYergerhttp:// orcid. org/ 0000- 0003- 2469- 402X
REFERENCES
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2 VillantiAC, MoweryPD, DelnevoCD, et al. Changes
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proposedMarylandmentholban. Washington
InformerNewspaper. Available: https://www.
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proposed- maryland- menthol- ban/ [Accessed11 Feb
2021].
11 MendezD, TTLe. Consequencesof a match
madein hell: theharmcausedbymenthol
smokingto theAfricanAmericanpopulationover
1980–2018. TobControl2021. doi:10.1136/%20
tobaccocontrol-2021-056748
12 AfricanAmericanTobaccoControlLeadershipCouncil.
What’smentholgotto dowithit? Everything! (Still):
theplightofAfricanAmericansandmentholated
tobaccoproducts. Washington, D.C: InternationalPress
Briefing, NationalPressClub, 2019. https:// youtu. be/
7wT9Lbn8nmk
13 SixfootahthePoet. Whatmentholcigaretteshave
takenfromme. SanFranciscoBayviewnationalblack
newspaper. Available: https:// sfbayview. com/ 2020/
04/ what- menthol- cigarettes- have- taken- from- me/
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15 SuttonCD, RobinsonRG. Themarketingof menthol
cigarettesin theUnitedStates: populations, messages,
andchannels. NicotineTobRes2004;6 Suppl1:83–91.
16 AfricanAmericanTobaccoControlLeadershipCouncil
v. USDepartmentof HealthandHumanServices, Case
No. 4:20- cv-4012- KAW (N.D. Cal.), 2021. Available:
https://www. publichealthlawcenter. org/ sites/ default/ files/ AATCLC- v- FDA- Defs- Second- Motion- to- Dismiss. pdf
17 AlexanderM. ThenewJimCrow: massincarceration
in theageof colorblindness. NewYork, NY: TheNew
Press, 2012.
18 DawesD. Thepoliticaldeterminantsof health.
Baltimore, MD: JohnsHopkinsUniversity, 2020.
19 YergerVB, PrzewoznikJ, MaloneRE. Racialized
geography, corporateactivity, andhealthdisparities:
tobaccoindustrytargetingof innercities. JHealthCare
PoorUnderserved2007;18:10–38.
20 KongAY, GoldenSD, BergerMT. Anintersectional
approachto thementholcigaretteproblem: what’s
race(ism) got to do with it? CritPublicHealth
2019;29:616–23.
21 LeTT, MendezD. Anestimationof theharmof
mentholcigarettesin theUnitedStatesfrom
1980to 2018. TobControl2021. doi:10.1136/
tobaccocontrol-2020-056256. [Epubaheadof print:
25Feb2021].
22 TobaccoProductsScientificAdvisoryCommittee, US
FoodandDrugAdministration. Mentholcigarettesand
publichealth: reviewof thescientific evidenceand
recommendations, 2011. Available: https:// wayback.
archive- it. org/ 7993/ 20170405201731/ https:// www.
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isoryCommittee/ UCM269697. pdf [Accessed04Sep
2021].
23 USFoodandDrugAdministration. Preliminaryscientific
evaluationof thepossiblepublichealtheffectsof
mentholversusnonmentholcigarettes. SilverSpring,
MD: CenterforTobaccoProducts, FoodandDrug
Administration, 2013.
24 TobaccoControlLegalConsortiumet al. Citizen
Petitionto theUSFoodandDrugAdministration,
Prohibitmentholasa characterizingflavorin
cigarettes, 2013. Available: https://www. publiche
althlawcenter. org/ sites/ default/ files/ resources/ tclc- fdacitizenpetition- menthol- 2013. pdf
25 FDAcommitsto evidence- basedactionsaimedat
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smokers, 2021. Available: https://www. fda. gov/ news-
events/ press- announcements/ fda- commits- evidence-
based- actions- aimed- saving- lives- and- preventing-
future- generations- smokers [Accessed29Apr2021].
26 StatementbyHHSSecretaryXavierBecerraonFDA
tobaccoactionsonmentholcigarettesandflavored
cigars, 2021. Available: https://www. hhs. gov/ about/
news/ 2021/ 04/ 29/ statement- hhs- secretary- xavier-
becerra- fda- tobacco- actions- menthol- cigarettes-
flavored- cigars. html [Accessed29Apr2021].
27 MukherjeaA, WackowskiOA, LeeYO, etal.
AsianAmerican, NativeHawaiianandPacific
Islandertobaccousepatterns. AmJHealthBehav
2014;38:362–9.
28 DelnevoCD, VillantiAC, GiovinoGA. Trendsin menthol
andnon- mentholcigaretteconsumptionin theU.S.A.:
2000-2011. TobControl2014;23:e154–5.
29 FallinA, GoodinAJ, KingBA. Mentholcigarette
smokingamonglesbian, gay, bisexual, and
transgenderadults. AmJPrevMed2015;48:93–7.
30 Young- WolffKC, HickmanNJ, KimR, etal. Correlates
andprevalenceof mentholcigaretteuseamong
adultswith seriousmentalillness. NicotineTobRes
2015;17:285–91.
31 EubanksSY, GlantzSA. Badacts: theracketeering
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copyright. on
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September 7, 2022
To: Mayor Mary Casillas Salas, Councilmember StevePadilla, Councilmember Andrea Cardenas, Councilmember John McCann, and Councilmember Jill Galvez From: The African American TobaccoControl Leadership Council ( AATCLC) Re: End the Sale of Menthol Cigarettes and all Other Flavored Tobacco Products in Chula Vista! No Exemptions: All Flavors, All Products at All Locations! The African American Tobacco Control Leadership Council ( AATCLC) strongly encouragesthe Chula Vista City Council to end the sale of menthol Cigarettes and all flavored tobacco products, with no exemptions. We are glad to seethat the Council is considering this issue. Frankly, this couldn’t come at a better time. We already know that 80% of youth, 12-17 start smoking using flavored cigarettes (Ambrose et al., 2015). Indeed, in the midst of the ongoing COVID 19 pandemic, nothing could be more important than getting theseproducts out of our community. We already know that smokers are more susceptible to COVID infection CDC, 2020). If the Council truly wants a healthier Chula Vista, and we believe that you do, then it is imperative that menthol-flavored cigarettes and other flavored tobacco products be prohibited. This will end the predatory marketing of these products that disproportionately impact poorer communities, marginalized groups, youths, and communities of color.
Menthol the Ultimate Candy Flavor; It Helps the Poison Go Down Easier! This is no minor matter. Menthol cigarettes and flavored tobacco products are driving tobacco-related deathsand diseasesnationwide. While the use of non-flavored tobacco cigarettes has been decreasing, the useof menthol cigarettesis on the rise, among youth and adults; among Latinos, Blacks, and Whites ( Villanti, 2016). Let’s be clear, the majority of women smokers smoke menthol cigarettes; folks from the LGBTQ community disproportionately smoke these products; 47% of Latino smokers prefer menthol cigarettes, with 62% of Puerto Rican smokers using menthol; nearly 80% of Native Hawaiians; a majority of Filipinos; and a majority of smokers with behavioral health issues smoke menthol cigarettes. Frankly, the most marginalized groups disproportionately use these so-called “ minty” products ( CDC, 2010; Fallin, 2015; Forbes, 2013; Delnevo, 2011; Hawaii State Dept. of Health, 2009; Euromonitor, 2008; Hickman, 2015).
Be appraised that 85% of African American adults and 94% of Black youth who smoke are using menthol products ( Giovino, 2013). These striking statistics arise from the predatory 1 WrittenCommunications
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marketing of these products in the Black Community, where there are more advertisements, more lucrative promotions, and most disturbing menthol cigarettes are cheaper in the Black community compared to other communities ( Henriksen et al., 2011; Seidenberg et al., 2010).
These predacious practices for the past 50 years have led to Black folks dying disproportionately from heart attacks, lung cancer, strokes, and other tobacco-related diseases (RSG, 2014).
Take note that new research shows that menthol cigarettes were responsible for 1.5 million new smokers, 157,000 smoking- related premature deaths, and 1.5 million life- years lost among African Americans from 1980–2018. While African Americans constitute 12% of the total US population, these figures represent, respectively, a staggering 15%, 41%, and 50% of the total menthol- related harm ( Mendez & Le, 2021).
The Council should be aware that menthol is an anestheticby definition, and asif to add insult to injury, masks the harsh taste of tobacco and allows for deeper inhalation of toxins and greater amounts of nicotine. The greater the nicotine intake, the greater the addiction. Hence, it is no surprise menthol cigarette usersfind it harder to quit than non-menthol cigarette users (Ton et al., 2015; Levy et al., 2011). The “cool refreshing taste of menthol” heralded by the tobacco industry is just a guise; ultimately, menthol and all flavors allow the poisons in cigarettes and cigarillos “to go down easier!”
Hookah: The Manipulation of Culture for Industry Profits! While we have all become aware of the meteoric rise of E-Cigarette use, especially among kids, another addictive product is growing in popularity: flavored shisha / Hookah. Let’s not be fooled: passing tobacco smoke through water does nothing to stop the user from inhaling all the toxins, nicotine, and cancer-causing chemicals associatedwith tobacco smoking. Let’s be clear, Hookah is just as deadly as cigarettes, if not more. Studies show that in a single hookah smoking session of 40 minutes, smokers consume 25 times the tar, 125 times the smoke 2.5 times the nicotine, and 10 times the carbon monoxide comparedto smoking a cigarette (Primack et al., 2016). Moreover, both patrons and employeesat Hookah lounges are exposedto elevated levels of 2ndhand smoke an already recognized causeof cancer (Zhou et al., 2016) Then there is the fiction that Hookah smoking is a 1000-year-old tradition in the Middle East. Look, tobacco only made its way to Europe some 500 years ago and only gradually made its way to the Middle East 3 to 4 hundred years ago. Make no mistake about it, it’s the Hookah Lounge owner’s manipulation of culture argument that is used to attract more business and profits. Flavored shisha like Blue Mist, Irish Kiss, and Sex on the Beach has nothing to do with Middle Eastern Culture. Once it was determined in the 1960s that smoking kills, Islamic Leaders deemed tobacco, Hookah, and Shisha Forbidden. At bottom, Hookah 2 WrittenCommunications
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lounges with their nightclub atmosphere have nothing to do with Middle Eastern Culture, rather it’s all about the Benjamin’s! It’s not about getting rid of all hookahs or all tobacco products, it' s about getting rid of all flavors, at all places, in all products, period.
We Can’t Wait on the State or the FDA
The AATCLC is calling upon the City Council of Chula Vista to join a growing number of cities, counties, and states around the country that are prohibiting, jurisdiction- wide, the sales of menthol cigarettesand all other flavored tobacco products. In June2018, SanFrancisco voters passedthe first- ever citywide restriction on the salesof all flavored tobacco products, including menthol cigarettes and flavored e-cigarette juices. This “ strongest flavor ban law ever” was rapidly replicated in numerous cities in California and around the country, including Oakland, Alameda, Hayward, Fremont, Berkeley, and Sacramento, just to mention a few. Just recently, the County of Sacramento adopted its own menthol and flavor restrictions. Today over 72 municipalities prohibit the sale of all menthol tobacco products including flavored e-juices no-smoke.org/wp-content/uploads/pdf/flavored- tobacco-product-sales.pdf Indeed, in June of 2020, the State of Massachusettsbecamethe first state to prohibit the saleof menthol cigarettes and all flavored tobacco products state-wide and in August of 2020 California followed suit and became the second state to do so. With the tobacco industry forcing a referendum of SB 793, now Prop 31, it becomeseven more imperative that local jurisdictions take stepsto protect their citizenry. We can’t wait on the State, let’s take stepsto make Chula Vista healthier now! While it is important that the FDA finally beganthe rulemaking processin April of 2021 to remove menthol cigarettes and flavored little cigars from the marketplace, this process will take years. First, the proposed rule was only made public in April of 2022. And we have just come through a summer where the tobacco industry dragged out the comment period to August of this year. We already know that 100,000’s of comments have been sent to the FDA, the majority of them from the tobacco industry. Once the public comment is over, the “rule” is sent to the Office of Management and Budget (OMB), whose review could take a number of months.
Once a final rule is made public and there is more public comment, the industry will sue to stop the processfrom going forward. And may sue for numerous reasons. The bottom line is that we can’t wait on the FDA. Cities like Chula Vista must take steps to protect the health of our citizens, lives are at stake.
Who Are the Racists: The Tobacco Control Advocates or the Tobacco Industry? Some groups funded by the tobacco industry insist that removing menthol cigarettes and flavored little cigars would be taking away “our” cigarettes; we’d be discriminatory; racist. This line of argumentation stands history on its head. As was pointed out earlier, it was and is the tobacco industry that predatorily markets these products in the Black Community. The facts are 3 WrittenCommunications
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these: there are more advertisements, more lucrative promotions, and most disturbing is that menthol cigarettesare cheaper in the Black Community comparedto other communities Henriksen et al., 2011; Seidenberget al., 2010). This is how theseflavored deathsticks became our” cigarettes, they pushedthem down our throats!
Still, other groups, spurred on and funded by the tobacco industry, have been spreading falsehoods, stating that restricting the sale of menthol cigarettes and flavored tobacco products, including flavored e-juices will lead to the “criminalization” of particularly young Black men.
Nothing could be further from the truth. All ordinances adopted around the country would prohibit the sale of flavored products, it would not prohibit the possessionof theseproducts.
The facts are that the adoption of menthol restrictions will not lead to police having any greater interaction with any youth; it won’t be illegal to possesstheseproducts, just retailers cannot sell them.
These same groups rail about “unintended consequences.” We respond: Look at the Intended Consequences! As mentioned before, Black folks die disproportionately from tobacco-related diseasesof heart disease, lung cancer, and stroke compared to other racial and ethnic groups. ( RSG, 2014); menthol cigarettes and flavored little cigars are the agents of that destruction. It is estimated that 45,000 Black folks die each year from tobacco-related diseases RSG, 1998). In this regard, the Committee should remove all criminal penalties associatedwith the purchase, use, and possessionof all tobacco products. Decriminalize tobacco! Hold retail owners responsible, not clerks, don’t punish kids!
The AATCLC
Formed in 2008, the African American TobaccoControl Leadership Council is composed of a cadre of dedicated community activists, academics, public health advocates, and researchers. Even though basedin California, we are national in our scope and reach. We have partnered with community stakeholders, elected officials, and public health agencies, from Chicago, Boston, and Minneapolis to Berkeley and San Francisco. Our work has shaped the national discussion and direction of tobacco control policy, practices, and priorities, especially as they affect the lives of Black Americans, African immigrant populations, and ultimately all smokers. The AATCLC has been at the forefront in elevating the regulation of mentholated and other flavored tobacco products on the national tobacco control agenda, including testifying at the FDA hearings in 2010 and 2011 when the agency was first considering the removal of menthol cigarettes from the marketplace. In November of 2019 we testified on Capitol Hill in support of HR 2339 (The Pallone Bill), this bill would prohibit the manufacturing and sale of menthol and all flavored tobacco products throughout the United States. This Bill was passedin 4 WrittenCommunications
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the House of Representativesin February of 2020 but went nowhere in the Senate. In June of 2020 the
AATCLC along with its partner Action on Smoking and Health (ASH) filed a lawsuit against the FDA for dragging their feet by leaving menthol on the marketplace with overwhelming scientific evidence showing that it should be removed immediately. Subsequently and importantly the American Medical Association ( AMA) and the National Medical Association ( NMA) have joined the lawsuit as plaintiffs.
Call to Action!
Now is the time to adopt strong tobacco control measuresthat can protect our families.
We already know that menthol and flavors “ make the poison go down easier.” Let’s not now allow menthol to make COVID- 19 go down easier too! The City Council needsto put the health of Chula Vista at the forefront of their thoughts, not the interests and profits of the tobacco industry, the vaping industry, and their surrogates. This is not the time for half-steps, like continuing to allow these products to be sold in adult-only venues, rather it is time to take a stand for the public’s health and say: No Selling of Menthol Cigarettes and All Other Flavored Tobacco Products, including Flavored E-Juices and Flavored Hookah in Chula Vista! Say “No” to the continued predatory marketing of menthol-flavored tobacco products to our youth and say “Yes” to the health and welfare of our kids, who are the most vulnerable. Say Yes” to the protection of all residents of Chula Vista.
We are all counting on you!
Sincerely,
Phillip Gardiner, Dr. P.H. Co- Chair AATCLC www. savingblacklives. org Carol McGruder, Co- Chair AATCLC
Valerie Yerger, N.D., Co-Chair AATCLC
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