Statement of Brandel France de Bravo, MPH, on Menthol Cigarettes

To the Tobacco Products Scientific Advisory Committee on Menthol Cigarettes

March 31, 2010

I am pleased to have the opportunity to testify on behalf of the National Research Center for Women & Families, and its Cancer Prevention and Treatment Fund. I have a Master’s in Public Health from Columbia University, and in addition to my position at the National Research Center for Women & Families, I am an Associate of the Johns Hopkins Bloomberg School of Public Health in the Department of Health, Behavior & Society.

Our Center is dedicated to improving the health and safety of adults and children, and we do that by scrutinizing medical and scientific research to determine what is known and not known about specific treatments and prevention strategies. We do not accept contributions from companies that make medical products or from the tobacco industry.

I should disclose that my mother has stage IV lung cancer but she was never a smoker of menthol cigarettes.

Like most smokers, she began smoking as a teenager. We know from what we heard yesterday that adolescents are more likely to smoke menthol cigarettes than adult smokers. We also know that while smoking is declining among adults and adolescents, menthol cigarettes are becoming more popular among both adults and kids ages 12-17.

Anything that makes smoking more attractive or tolerable in adolescence-whether it’s a flavor or the perception that the models in ads for menthol cigarettes are younger- will only add to our country’s burden of addiction and lung disease, including lung cancer. We know that if kids can get through adolescence without smoking, they stand an excellent chance of never smoking. Dr. Rising shared with us yesterday these facts: about 90% of smokers tried their first cigarette before 18, and about 70% were smoking daily by age 18.

We also learned yesterday from Dr. Hoffman that menthol smokers-young and old-appear more dependent on cigarettes by many measures than non-menthol smokers. Among 2,000 secondary school kids surveyed in 2006, Black youth scored highest on all the measures of dependence, which included number of cigarettes smoked in their lifetime, number of days per month they smoke; shortest time since last cigarette; and likelihood of being a daily smoker.

We know that African Americans are more likely to smoke menthol cigarettes than any other racial or ethnic group, and that magazines and billboards targeted to African Americans are far more likely to advertise menthol cigarettes than non-menthol cigarettes.

The literature review presented yesterday raised as many questions as it answered. It’s clear that more research needs to be carried out, and members of this committee have suggested many worthwhile topics. As scientists, we’re primed to ask questions and ask that research be done to answer them. As public health experts, however, I think we can agree on a few things without doing any additional research. Some of our most vulnerable populations, including communities with huge health disparities, appear to be the most susceptible to menthol’s appeal: adolescents, Blacks, Hispanics, and women. And as a result, they will develop lifelong habits that will lead to disease and disability.

As their overall U.S. market declines, cigarette manufacturers have seized on menthol’s competitive advantage, introducing light menthol brands for new and young smokers who prefer that, and stronger menthol cigarettes for the more experienced and older smokers who crave that. Now that all flavors other than menthol have been banned, menthol has become the industry’s last holdout and last hope for disguising the taste of tobacco.

Several studies cited by Dr. Hoffman suggest that part of the problem with menthol is that it masks problems: smokers of menthol cigarettes may not be able to perceive changes in health as readily. A spoonful of sugar makes the medicine go down, but cigarettes aren’t medicine. They are the main cause of lung cancer, the #1 cause of cancer deaths, and they are poisonous to our health. We should not allow companies to sweeten the poison. Industry will try to convince us that the research on the dangers of menthol cigarettes isn’t convincing; there will be pressure to study and stall, but I am here today to beg you: don’t drink the Kool-Aid. Just because it’s cool and refreshing, doesn’t mean it won’t kill you.

We urge you to advise banning menthol cigarettes just as other flavored cigarettes have been banned.