Former U.S. surgeons general: The U.S. should ban menthol cigarettes

As former U.S. surgeons general, we call on the Biden administration to immediately finalize Food and Drug Administration rules that will prohibit the sale of menthol cigarettes and flavored cigars.

Over the decades, cigarettes have been responsible for death and disease in millions of Americans. January marked the 60^th anniversary of U.S. Surgeon General Luther Terry’s landmark Report, “Smoking and Health,” which definitively documented the causal link between smoking, disease, and death. The report had a monumental impact on the public health approach to smoking. Tobacco control policies implemented between 1964 and 2014 saved 8 million lives in the United States. In 1964, 42% of people in America smoked; today, less than 12% do.

Despite considerable progress since 1964, smoking remains a top cause of preventable death in the United States. As Surgeon General David Satcher wrote in a seminal 1998 report, tobacco use is a major cause of disease and death among certain racial and ethnic minority groups, including African Americans, who are more likely to suffer and die from tobacco-related diseases such as heart disease and diabetes.

Much of the blame should be placed on menthol cigarettes. A 2021 FDA report estimated 18.6 million Americans smoke menthol cigarettes. Because of decades of marketing in Black communities, the use of menthol cigarettes among people who smoke is not uniform. In 2020, more than 80% of Black people who smoked used menthol cigarettes, compared with just 35% of white people who smoked.

Menthol masks the harshness of tobacco smoke and enhances nicotine addiction. Yet it  is the only characterizing flavor, other than tobacco, that is still allowed in cigarettes. As the FDA itself states, the move to prohibit menthol cigarettes and flavored cigars is “based on clear science and evidence establishing the addictiveness and harm of these products.”

The FDA estimates that taking menthol cigarettes off the market would save up to 654,000 lives over the next 40 years, including as many as 238,000 Black lives.

The solution is simple: Prevent tobacco companies from selling these products. Ban menthol by finalizing the long-awaited FDA rules. It has been 15 years since the Family Smoking Prevention and Tobacco Control Act prohibited all characterizing flavors in cigarettes except tobacco and menthol.

The Biden administration nearly banned menthol cigarettes and flavored cigars in December 2023, but then suddenly delayed action. We urge the Biden administration not to be distracted by the tobacco industry and its apologists. The administration should act instead in the interests of children, families and communities.

As surgeons general during both Republican and Democratic administrations, we have consistently pointed out the enormous toll of tobacco use, highlighted the stark health disparities that continue to ravage Black and minority communities, and emphasized evidence-based measures to reduce smoking rates and save lives. We believe strongly that to protect public health, menthol cigarettes and flavored cigars should no longer be sold.

We join leaders nationwide in urging the White House to follow the science and get rid of these deadly products for good.

Regina Benjamin, M.D., MBA served as the 18^th U.S. surgeon general (2009-2013) and is a member of the American Heart Association National Board of Directors. Jerome Adams, M.D., MPH, served as the 20^th U.S. surgeon general (2017-2021).