We couldn't be happier that San Francisco has officially voted in favor of Proposition E that maintains a clear and certain ban on all flavored tobacco -- including menthol. When the FDA didn't act to accomplish this nationally in 2009, we knew cities would have to work one by one to get the job done. Big Tobacco made a $12 million attempt to discourage voters from supporting the ban, but a cohesive stance in favor of public health ultimately won.
Most recognize that candy flavors are usually intended to attract children. Big Tobacco's long game has always seemed to depend on youth initiation. Flavors like peppermint, strawberry and Fruit Loops are critical in creating a delightful first-time puff that leads to that life-long addiction. Since nearly 50% of Big Tobacco's most loyal customers are killed by the product, attracting new, unassuming kid-customers never seemed unintentional. Big Tobacco wasn't fooling San Francisco, and we commend their voters for protecting children.
But tobacco prevention is not just for kids, and this flavor ban's inclusion of menthol is meaningful for adults as well. Most smokers choose menthol-flavored tobacco, especially African Americans. This is not only because menthol has been heavily marketed as cool in Black culture, but also because its cooling effect makes that first puff easier to handle. Surveys have shown that African Americans want to and attempt to quit smoking more often than others, but fail. Many attribute this struggle to menthol because it is said to be harder to quit. Some researchers have even found that people with high levels of melanin may be more susceptible to addiction because of the way nicotine metabolizes in the body. These could explain the lower success rates of African American quitters. The good news is that a ban on menthol would encourage African Americans to keep trying. We know this is true because smokers also report that if menthol were banned, they wouldn't switch to another product--they would put the pack down altogether.
What would a mass quit attempt in San Francisco look like? It would look like a reduction in the 45,000 Black lives lost each year to tobacco. It would look like a smoke-free generation who doesn't grow up normalizing tobacco. It would look like a city of people who are perceptive enough to affirm that Black lives really matter.
So congratulations, San Francisco, in joining cities like Oakland and Chicago in making the kind of policy changes that improve African American health.