'Addiction is the Exact Opposite of Choice': FDA weighs Ban on Menthol Cigarettes

From [HERE] Phillip Gardiner started smoking after he quit his college basketball team. He soon switched from Winstons, then the country's topselling brand, to Kool menthols.

"It was cool to smoke Kools," Gardiner explains.

Over the more than 40 years since Gardiner — who is black — opted for Kools, menthol cigarettes have become increasingly popular with African-American smokers.

Today, black smokers are four times more likely to choose menthols than white smokers. (Gardiner quit smoking long ago.) By 2005, half of black smokers smoked Newports, the most popular menthol brand.

Gardiner, a scientist with the Tobacco-Related Disease Research Program at the University of California Office of the President, calls this the "African-Americanization of menthol cigarette use." Once a niche product smoked mainly by women, menthols became the cigarette of choice for black smokers thanks in part to targeted marketing in urban centers and in publications aimed at black readers.

Now the Food and Drug Administration is considering a ban on menthol cigarettes, fueling a debate about how such a move would impact African Americans. The FDA's Tobacco Products Scientific Advisory Committee has been reviewing the health effects of menthol cigarettes for the past year and is due to submit its final report and recommendations to the agency any day. The FDA usually, but not always, goes along with its advisory panels. However, Lorillard, maker of Newports, and R.J. Reynolds, maker of Kools, filed a lawsuit Feb. 25 to block the committee's recommendations. The suit alleges that the committee can't provide fair advice because three members have conflicts of interest.

Drafts of a few chapters posted online recently provide a preview of the panel's report: While there is insufficient evidence to conclude that menthol smokers are more likely to be diagnosed with tobacco-caused diseases than non-menthol smokers, "the evidence is sufficient to conclude that it is biological(ly) plausible that menthol makes cigarette smoking more addictive."

The latest draft chapter, posted Monday in advance of the panel's meeting Thursday and Friday, cites a 2010 report that found African Americans across-the-board—no matter their income, age, sex, marital status, region, education, age they started or length of time smoking—are more likely to smoke menthols than any other racial or ethnic group.

Newports are the lifeblood of Lorillard, the oldest U.S. tobacco company, which has framed the debate as a civil rights issue. One Lorillard ad, with a photo of an African-American woman, bears the headline "Freedom of Choice for Grown-ups" and states "informed grown-ups who decide to smoke should have the freedom to choose menthol cigarettes."

In op-ed pieces published on a number of websites over the past few months, Jessie Lee, executive director of the National Organization of Black Law Enforcement Executives, and Malik Aziz, national chair of the National Black Police Association, argue that a menthol cigarette ban would lead to an illegal market.

Meanwhile, John Payton, president of the NAACP's Legal Defense Fund, has been vocal in his support of a ban. Lorillard's argument that smokers should have the right to choose menthol "is so hypocritical it's unbelievable," Payton says. "Addiction is the absolute opposite of choice."

Research has shown that flavored cigarettes attract young new smokers. The Family Smoking Prevention and Tobacco Control Act, signed by President Obama in June 2009, authorized the FDA to ban all cigarette flavors except minty menthol, whose brands represent more than a quarter of cigarettes sold in the USA.

In an open letter to Congress in 2008, seven former secretaries of Health and Human Services or Health, Education, and Welfare and a former surgeon general urged that the act ban menthol cigarettes as well.

"Banning flavored cigarettes, which mask the harshness of tobacco—something that can deter some first-time smokers, especially children—is a positive move," they wrote. "But, by failing to ban menthol, the bill caves to the financial interests of tobacco companies and discriminates against African Americans."

Four packs a day

In a lengthy deposition videotaped a few weeks before she died of lung cancer, Marie Evans recalled getting free sample packs of Newport cigarettes starting when she was 9. Glamorous women dressed in the colors of the Newport package handed them out at the housing project where Evans grew up in Boston's Roxbury section, called "the heart of black culture" on the city's website.

At first, Evans traded them with her sister for candy. But she said she began smoking the Newports herself by the time she was 13 and continued for the rest of her life. Decades later, Evans, a single mother, and her only child sued Lorillard, alleging that it had targeted black children in her neighborhood.

Evans sometimes smoked as many as four packs of Newports a day, according to the lawsuit. The first time Willie Evans can remember talking to his mother about her smoking was in the mid-1980s after she had suffered a heart attack. He was in his teens, and she wasn't yet 40.

"My concern was I might not have my mom to watch me graduate from high school," says Evans, who, at his mother's urging, attended Boston Latin, a highly selective public school. "She promised that she would stop smoking and do everything she could to stop{hellip}She tried absolutely everything. The patch, the pill." But the longest she ever stopped was around three months.

Marie Evans, a high-school dropout who went on to get her GED and an associate's degree, lived to see her son graduate not only from Boston Latin but from Harvard Law School. She died at age 54 in 2002. Her son turns 41 next week.

In December, after deliberating for six days, the Boston jury found in favor of Willie Evans and his mother's estate and awarded them $152 million in damages. It's thought to be the first case to focus on cigarette giveaways, which continued into the 1970s.

"I certainly didn't file this suit thinking I would receive millions in an award," Evans says. "I've never seen a jury value the life of an African American in that way." Says Michael Weisman, the Boston lawyer who represented Evans: "There was such clarity about what Lorillard had done. The evidence was so overwhelming."

Lorillard is appealing the verdict. In a statement, the company said, "the plaintiff's 50-year-old memories were persuasively contradicted by testimony from several witnesses."

More than a half-century since Marie Evans first collected free Newports, tobacco companies continue to market menthol cigarettes more heavily to blacks and other minorities in Boston, researchers from the Harvard School of Public Health reported last summer in the American Journal of Health Promotion.

They compared storefront cigarette advertisements in two urban neighborhoods: Brookline, a predominantly white, high-income community, and Dorchester, a predominantly minority, low-income community.

The researchers found that Dorchester had more tobacco retailers than Brookline, and the cigarette advertisements in Dorchester were more likely to be larger and promote menthol brands than those in Brookline.

In an interview, David Howard, a spokesman for R.J. Reynolds, maker of Kools and three other menthol brands, disputed the notion that tobacco companies market menthols more heavily to blacks. "We market our brands to all adults who chose to smoke, regardless of their ethnic background," Howard said. "All of our marketing approaches are to appeal to as broad an audience as possible."

Documents released

One need only scan the Internet for images of menthol cigarette ads from the 1960s and 1970s to gain some insight into their popularity among black smokers.

Many feature carefree African-American models or celebrities. Phillip Gardiner says ads featuring Kool spokesman Elston Howard of the Yankess, the first black player to win the American League's Most Valuable Player award, helped woo him in the 1960s.

A 1978 internal Lorillard memo, with the subject "Black Marketing Research — Findings & Recommended Actions to Date,"suggests such promotions as calendars depicting black athletes and black women and distribution of free Newport samples at "Black conventions, expos, etc."

That industry document is one of thousands released as a result of the 1998 Master Settlement Agreement between tobacco companies and 46 states. They provide an inside look at how the industry forged ties with African-American organizations such as the National Organization of Black Law Enforcement Executives and the NAACP. (Despite its name, the NAACP Legal Defense Fund, is a totally separate organization.)

Valerie Yerger, a scientist at the Center for Tobacco Control Research and Education at the University of California, San Francisco, reviewed and analyzed more than 700 of the previously secret pre-1998 documents. She says she found evidence of tobacco industry involvement with dozens of African American organizations.

Lorillard provided economic support to the NAACP, the Southern Christian Leadership Conference, the Congressional Black Caucus and the National Conference of Black Mayors and others, according to the documents. R.J. Reynolds did so with the National Black Police Association, the National Urban League and the National Black Caucus of State Legislators, among others, the documents show.

Neither Jessie Lee of the National Organization of Black Law Enforcement Executives nor Malik Aziz of the National Black Police Association replied to USA TODAY's requests for information about their groups' current or past relationship with Lorillard. Their recently published op-ed pieces echoed Lorillard's argument that a menthol ban would lead to a contraband market for menthol cigarettes.

Lorillard spokesman Gregg Perry acknowledged that the company hired a public relations firm to pitch the anti-ban op-ed pieces written by leaders of African-American organizations. But Perry declined to discuss the extent of Lorillard's involvement with such groups. "'I'm not going to comment one way or another on financial contributions to any groups," he said. "'I'm not going to get into what organizations the company currently is active with."

Yerger says she's puzzled black leaders would oppose a ban, since smoking-related diseases disproportionately affect African Americans. "Do they really get what's going on in terms of the health effects on our people when it comes to smoking in general, menthol use in particular?"