The Food and Drug Administration has just sent its recommendation to the White House to ban flavored cigars and menthol cigarettes from retail store shelves. I wholeheartedly support this action.
Flavored cigar manufacturers are brazenly marketing these items to children and young adults. The result? Thousands of young people are now addicted to nicotine products—especially Black youths, who outnumber young White smokers of flavored cigars by two to one.
A similar tragedy has occurred with highly addictive menthol cigarettes, which have been heavily and successfully marketed to Black people for decades. The numbers prove it. A 2022 study found that 30% of White smokers choose menthols, whereas 83% of Black smokers choose them.
A shameless pitch that works
As happened with e-cigarettes (vapes), flavored cigar manufacturers target young people with alluring flavors and youth-focused marketing strategies. A few examples:
- Cigar flavors called “Berry Fusion,” “Iced Donut,” and “Cherry Dynamite.”
- The recruiting of young celebrities who tout these products.
- Flavored cigar ads placed near the candy aisle.
- Colorful packaging that mimics candy wrapping.
- Flavored cigar products placed at youth eye level, so they’re easier to see.
That marketing, coupled with the addictive power of the cigars (thank you, nicotine), is having the desired effect. A recent report from the Rutgers Institute for Nicotine and Tobacco Studies finds that flavored cigars are the second-most popular tobacco product among young people after e-cigarettes.
There are now 500,000 youths who regularly smoke cigars in the U.S., with an average of 800 young people a day trying them for the first time, according to the Rutgers report.
Here’s what these products do to children
Nicotine is powerfully addictive. As I outlined in a post about youth vaping, nicotine works in especially insidious ways on young brains.
Here’s what happens: Up to around age 25, a young person’s brain is still developing. This makes them highly prone to the changes in brain structure and chemistry that nicotine causes. These changes center around the brain’s reward center, the part of the brain that controls our incentive to eat, sleep, fall in love, avoid danger, and countless other behaviors that help us survive as humans.
When a young person becomes addicted to nicotine, it takes the brain hostage. It can convince the brain that it wants nicotine more than it wants food, sleep, or affection from other humans.
At that point, the nicotine addiction also puts a young person at higher risk of other addictions as well. Nicotine thus acts as a classic “gateway drug”.
The path to addiction and premature death
As the chief medical officer at a Jacksonville, Florida-based addiction treatment center, I have no doubt that thousands of patients across the U.S. began their journey to hard-drug addiction by getting hooked on flavored cigars. For that reason and many others, it’s vital that the proposed FDA ban becomes a reality.
Likewise for the proposed menthol cigarette ban that is part of the same FDA initiative. Menthol cigarettes are a key driver behind the higher death rates among Black smokers from stroke, heart disease, and cancer.
As a 2021 study in Tobacco Control found, Blacks make up just 12% of the U.S. population, but they account for 41% of the smoking-related premature deaths caused by menthol tobacco products.
To achieve health equity with lung cancer, banning menthol cigarettes would close the gap in lung cancer deaths between Blacks and whites within five years, according to the above-mentioned 2021 study.
I don’t yet know of a study on the effect that removing flavored cigars from retail shelves will have on the health of our children, but it’s clear from the science that the effect will be profound. Don’t they deserve that?
Goodwin, R.D. et al. (2022) Menthol Cigarette Use Among Adults Who Smoke Cigarettes, 2008–2020: Rapid Growth and Widening Inequities in the United States. Nicotine & Tobacco Research.
Not Your Grandfather's Cigar. (2023). Rutgers Institute for Nicotine and Tobacco Studies
Mendez, D., Le, T. (2021). Consequences of a match made in hell: the harm caused by menthol smoking to the African American population over 1980–2018. Tobacco Control.