Gustavo Torrez
Program Manager
Brazil Leading the World in Tobacco Control
The Brazilian Agência Nacional de Vigilância Sanitária (National Health Surveillance Agency, Anvisa) announced its decision on Tuesday to ban the sale of flavored cigarettes across the country.
The agency is banning all additives in cigarettes that create flavors like menthol, honey, cherry, tutti-frutti and chocolate, saying the additives used are what lure young people to start smoking in the first place.
Interestingly, tobacco industry representatives are also in favor of banning these additives that create flavored cigarettes (whats the catch you ask), they wanted to continue producing menthols, saying there is no scientific proof that substances in that particular flavor make cigarettes more addictive. Tobacco Control advocates can agree that menthol is a huge issues here in the States and that a menthol ban would greatly benefit public health and communities severely impacted by menthol tobacco use and help to curb youth smoking rates.
Flavored cigarettes can still be exported out of Brazil to be sold elsewhere, and sugar can still be added to Brazilian-made cigarettes and those imported into the country. The tobacco industry will have 18 months once the decision is officially published to remove their flavored cigarettes from the national market, and 24 months to pull other flavored tobacco products from shelves. Hopefully there will be evaluation early on to see the effects the ban, and the the impact it has on the young people of Brazil.
We all know that the tobacco companies have long targeted specific populations with menthol and flavored cigarettes, which can be seen by the high rates of menthol use among youth, African Americans, Latinos and LGBT populations. Next time you go to your local corner store do a brief evaluation of the tobacco advertisements and product placement and I can almost guarantee that menthol advertisements and placement is more predominant over other products. Even more so in communities of color.
According to the American Lung Association, “Use of menthol cigarettes is disproportionately high among African Americans. Almost 84 percent of African Americans smokers aged 12 years or older reported smoking a mentholated brand of cigarette compared to 24 and 32 percent of their Caucasian and Hispanic counterparts, respectively.”
According to Legacy, “33.9% of current smokers smoke menthols and an astonishing 82.6% of African American smokers smoke menthols. In addition, a disproportionate number of Hawaiian/Pacific Islander, Hispanic/Latino, Asian, American Indian/Alaskan Native, and multiracial smokers smoke menthols compared to white smokers.” (see graph on right)
According to a report from the National LGBTQ Young Adult Tobacco Project (PDF), 71 percent of LGBT youth who smoke cigarettes smoke menthol cigarettes.
From a study at the Cancer Institute of New Jersey, “Overall, menthol smoking was more common among females and young adults, ages 18 to 24. Menthol smoking varied considerably by race/ethnicity; among blacks, 71.8 percent smoked menthols, which is significantly greater than whites (21 percent) and Hispanics (28.1 percent). However, among Hispanics there were wide variations. Menthol smoking was more common among those of Puerto Rican descent (62 percent) than among those of Mexican (19.9 percent) and other Hispanic origins (26.5 percent).” and “The study further found that menthol cigarette smoking was associated with lower levels of smoking cessation compared to non-menthol smokers, and this relationship was more pronounced among blacks and those of Puerto Rican descent.” Based on the study findings, the authors stated “Because our evidence suggests that the presence of menthol may partially explain the observed differences in cessation outcomes, the recent calls to ban this flavoring would be prudent and evidence-based”.
As you can see communities of color and LGBT communities are smoking menthol at alarming rates. We can only hope that the FDA will follow Brazils lead and ban menthol. We know the tobacco industry is going to fight a US ban on menthol and create “science” to show that there is “no scientific proof that substances in that particular flavor make cigarettes more addictive”. The thing we all know is that if the Tobacco Industry fights hard for something there is obviously a reason for that and we cannot let the tobacco industry win. We need to ban together and fight this issue, and support efforts to regulate/ban menthol use for the health of our communities.
LGBT HealthLink, The Network for Health Equity 
It would be intriguing to learn how the tobacco industry accounts for the disproportionate use of mentholated cigarettes by LGBTQ communities and people of color. Clearly, the rates cannot be attributed to personal choice when group differences are this glaring.
Anyway, let’s hope Brazil’s groundbreaking decision has reverberating effects with our FDA; that menthol is treated as another flavored substance that should be eliminated completely.
On another note, what sort of absurdity of logic are we operating under, that demands that health advocates bear the onus of producing the scientific evidence about the harmful effects of menthol? Shouldn’t the pressure be diverted to the tobacco industry to prove the case that it isn’t harmful?
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Let’s hope Brazil’s groundbreaking decision has reverberating effects with our FDA;