The Food and Drug Administration has taken up the regulation of tobacco products as a key issue to focus on in 2023, particularly prohibiting the sale of menthol cigarettes and flavored cigars and cigarillos.
FDA Commissioner Dr. Robert Califf and other agency officials have said that completing the rulemaking process for these products is a top priority for 2023, but cannot say when the ban will be issued. The agency wants to be clear that the ban is targeting industry and not the individual.
“We want to make sure that everyone understands what the rule is saying. It’s entirely written for manufacturers, distributors and those selling the products,” said Califf, who was in Atlanta on Tuesday for a conference. “There is no enforcement against an individual person who may be using these products.”
According to the Centers for Disease Control and Prevention, cigarette smoking is the leading cause of preventable death in the U.S., with 480,000 people dying yearly from smoking-related diseases. In 2019, 85% of Black adults and 48% of Hispanic adults who smoked used menthol cigarettes, compared to 30% of non-Hispanic white adults.
A report published by the American Heart Association and Stanford Medicine says that the tobacco industry has led campaigns for decades promoting such products as menthol cigarettes and flavored cigars and cigarillos — targeted to Black people, women, youth and vulnerable populations, such as LGBTQ+ and Native American communities.
“There’s nothing that will save more lives in the United States than reducing the use of combustible tobacco, and menthol and flavored cigars are a big player,” said Califf.
Dr. Michael Eriksen, former director of the Centers for Disease Control and Prevention’s Office on Smoking and Health and the founding dean of the School of Public Health at Georgia State University, said public health officials hope that a ban would lead more Black people and others to quit smoking.
“There needs to be a much larger concerted effort to help people quit smoking... and not just go to another type of cigarette or to buy them illicitly,” Eriksen said.
He raised the concern held by others that a ban would be another reason for police enforcement against Black people that would only result in harm.
Califf said, however, the FDA has emphasized that the proposed rules not target users and has worked across federal agencies to ensure this throughout the process.
Dr. Alice Little Caldwell, an associate professor of pediatrics at the Medical College of Georgia and tobacco-free coordinator of the Georgia Chapter of the American Association of Pediatrics, is concerned about the increasing influence of social media and other media forms depicting smoking and vaping — something she says needs more restrictions.
According to the Centers for Disease Control and Prevention, in 2019, 51% percent of young adults, ages 18 to 25 who currently smoked cigarettes reported using menthol cigarettes. In 2021, nearly 8 in 10 youth who reported using tobacco products used flavored varieties.
“Their consumers eventually die off. They [the tobacco industry] always have to create a new market,” Caldwell explained. “So, kids are very vulnerable to peer pressure and advertising.”
Califf recognized the need to to regulate ads and online sales in conjunction with increased tobacco product regulations is “an everyday battle” and said that there is work being done on digital surveillance to find out who is advertising and selling products and how they are being enforced by the government.
“The easy thing to say is we’re going to enforce, and we are, but people should be aware that it’s not as straightforward as just walking in and taking products off of the shelf,” Califf explained.
According to Caldwell, Georgia has shown no initiative to increase state taxes on tobacco products. Georgia has the second-lowest price for a pack of cigarettes at $5.35, coming behind Missouri, where the cheapest cigarettes are $5.21.
Califf said there is an interagency committee working on ensuring support for people who are addicted to tobacco, especially those who have been targeted by tobacco industry campaigns.
“We need to shore up joint support,” Califf said. ”These people have a chronic problem that requires much more than just stop-smoking advice. It’s a real addiction.”
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