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Menthol Cigarettes Marketed as 'Healthier,' FDA Panel Says
Date:3/18/2011

By Jenifer Goodwin
HealthDay Reporter

THURSDAY, March 17 (HealthDay News) -- Marketing messages for menthol cigarettes disproportionately target youths and blacks and are crafted to imply that menthols are safer than other cigarettes, although they are not, according to a newly released draft section of a long awaited FDA advisory committee's report.

While direct claims of menthol cigarettes' health benefits dwindled after the 1950s, marketing materials continue to depict menthols as "refreshing" and "soothing," while use of the color green on menthol packaging implies "nature" and healthfulness, according to the report.

"Analyses of tobacco industry internal documents and marketing messages the industry produced provide corroborating evidence of explicit and unwarranted claims that smoking menthol cigarettes would improve smokers' health," according to the draft report, which was released Thursday.

"Over time, marketing messages increasingly relied on sensory descriptors and imagery to imply that menthol cigarettes are safer than non-menthol cigarettes," the report noted.

While contemporary tobacco marketing efforts have been "constrained by legislation that restricts advertising in traditional media," the draft report continued, "the powerful advertising messages used in the past are reinforced and continued by...menthol marketing messages such as 'smooth' and 'fresh' that are implicitly linked to health benefits," the report declared.

The draft report also says that menthol marketing has targeted youth, women and blacks, and that "consistent with these targeted marketing efforts, menthol cigarettes are disproportionately smoked by African-American smokers."

According to a study cited in the FDA's draft report, nearly 81 percent of black middle schoolers who smoke and about 85 percent of black high school smokers regularly smoke menthol cigarettes, usually Newports, the leading brand.

That is in contrast to about 43 percent of white middle school smokers and 37 percent of white high school smokers.

The Tobacco Products Scientific Advisory Committee, which was scheduled to meet March 17 and 18 in Washington, D.C., is tasked with determining how menthol cigarettes should be regulated and whether the science justifies an outright ban.

Sections of the report released earlier have concluded that the evidence doesn't prove menthol cigarettes are any more dangerous to health than other cigarettes, but that it is possible they are more addictive because the mint flavoring masks the harsh tobacco taste.

Many anti-smoking organizations hope the FDA will eventually ban menthols.

"Menthols should be banned, and that such a decision would be, in the words of the statute, 'appropriate for the protection of the public health'," said Ellen Vargyas, general counsel for the American Legacy Foundation, a Washington, D.C.-based advocacy organization that was founded in 1999 with funding from the landmark Master Settlement Agreement between the tobacco industry and state governments.

"We think there are two key scientific underpinnings," Vargyas continued. "One is the link between menthol smoking and youth initiation. The science shows the younger and the newer the smoker the more likely they are to smoke menthols. The second very important reason is the science shows they make more quit attempts than non-menthol smokers, but they are less successful at quitting."

The efforts to more stringently regulate tobacco products come as a the result of the Family Smoking Prevention and Tobacco Control Act, signed into law by President Obama in June 2009. The law gave the FDA broad new powers to regulate the sale, marketing and content of tobacco products and directed the FDA to establish an advisory committee to review the science and make recommendations.

The law banned fruit and candy-like flavorings from cigarettes, but exempted menthol, by far the most popular flavor. Menthol accounts for 27 percent of all cigarettes sold in the United States in 2009, according to the FDA's report.

Instead, menthol became the Tobacco Products Scientific Advisory Committee's (TPSAC) first order of business.

The advisory committee is made up of nine voting members including physicians, scientists and public health experts. The tobacco industry is represented by three, non-voting members.

Among the questions the committee is considering: Are menthol cigarettes more harmful than regular cigarettes? Does the mint flavor encourage youth to start smoking? Are cigarettes containing menthol harder to quit?

Although the advisory committee has said the science doesn't show that menthols are more dangerous to health, that's not the most important question, said Vargyas, of the American Legacy Foundation. The foundation's mission includes making smoking prevention and cessation programs widely available.

"The tobacco industry wants to answer a particular question: Are menthol cigarettes more dangerous to individual established smokers? The answer to that question is that the scientific evidence does not establish that menthol carries greater risks for the individual, established smoker," Vargyas said. "The more important question is the impact of menthol on initiation and cessation."

On Feb. 25, Lorillard, Inc., the Greensboro, N.C-based maker of Newports, R.J. Reynolds Tobacco Co., based in Winston-Salem, N.C. and the makers of Camel and Winston, sued the FDA and asked the court to prevent the agency from considering recommendations from the advisory committee. The tobacco companies contend that several members of the committee have a conflict of interest, which runs counter to the requirement that the committee be fair and not beholden to special interests.

The FDA "failed to constitute the committee in accordance with the law and failed to properly address legitimate concerns regarding fairness and impartiality," said Ronald S. Milstein, senior vice president and general counsel of Lorillard, in a statement.

And that's almost certainly not the last of the lawsuits from the tobacco companies, Vargyas said.

The advisory committee's recommendations are not binding, although the FDA typically goes along with their scientific committees' advice.

When the committee's conclusions are released, which is expected to occur by March 23, menthol regulation will enter into a lengthy rule-making process, in which the FDA would begin crafting a proposed rule and the public and the tobacco industry would be given time to weigh in.

One of the suggested tactics for making cigarettes less addictive is to prohibit nicotine in cigarettes. According to the tobacco control law, the FDA cannot reduce levels to zero, but it may be able to sharply curtail nicotine.

More information

There's help in quitting smoking at Smokefree,gov.

SOURCES: Ellen Vargyas, J.D., general counsel, American Legacy Foundation, Washington, D.C.; U.S. Food and Drug Administration Report, March 17, 2011; statement, Lorillard Inc., Greensboro, N.C.


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