Thursday, 29 April 2021

Banning menthol cigarettes

American politicians have discussed banning menthol cigarettes for years, but the issue is tied up in US race politics. Since menthol cigarettes are much more popular with African-Americans than with whites, the question is whether a ban would be racist because it disproportionately limits the freedom of blacks, or anti-racist because the benefits of the ban will disproportionately fall on blacks.
I don't see any benefits from the ban so it seems pretty racist to me, albeit inadvertently (perhaps). America certainly has a tradition of banning recreational substances that are associated with - or are perceived to be associated with - ethnic minorities. 
Menthol smokers are a minority within a minority. I suspect this is the main reason anti-smoking activists have been campaigning for a ban: less resistance from the public. They claim that menthol cigarettes are particularly appealing and are harder to quit, but if that were true they would be the most commonly consumed type of cigarette rather than a niche product. Whatever the reason, the EU has already banned menthol cigarettes and the same policy is now being seriously pursued in the USA by the FDA under the alleged progressive Joe Biden.
Guy Bentley has given ten reasons why a ban would be a bad idea. Read his article for Reason, but you only need his tenth reason - "Adults should be free to choose which cigarettes they smoke" - and I only want to add a titbit of information from a 2012 study entitled 'Lung Cancer Mortality Risk for U.S. Menthol Cigarette Smokers'...

The overall HR for lung cancer mortality for menthol smokers was 0.69 (95% CI = 0.45–1.06). The HR for lung cancer mortality for menthol smokers at ages 50 and over was 0.59 (95% CI = 0.37–0.95). All-cause mortality net of lung cancer mortality did not differ for menthol and nonmenthol smokers.


We found evidence of lower lung cancer mortality risk among menthol smokers compared with nonmenthol smokers at ages 50 and over in the U.S. population. It is not known, however, if these differences are due to the impact of menthol on cigarette smoking or long-term differences in cigarette design between menthol and nonmenthol cigarettes.

This is not a freak finding. The evidence is pretty solid, it has been shown in other studies and a plausible explanation has been given for it. In a nutshell, it might not the menthol, it could be the filters...

Historically, the most common type of cigarette was the unfiltered cigarette. During the later half of the 20th century, many lifelong smokers switched from unfiltered to filtered cigarettes. More recently, there has been a cohort of smokers who smoked filtered cigarettes exclusively over their lifetime. It is here that the effects of cigarette filtration can be observed. These smokers have a substantially reduced risk of lung cancer compared with lifetime unfiltered smokers, particularly squamous cell carcinoma of the lung (Stellman, Muscat, Thompson, Hoffmann, & Wynder, 1997). 
The market share of menthol cigarettes was quite low until about 1970, reaching perhaps 25% of all smokers. In contrast to nonmenthol brands, menthol brands have been predominantly filtered cigarettes. These differences may very well explain the association observed by Rostron and others. The study effectively compares smokers at a time (1987) when most nonmentholated smokers smoked exclusively or predominantly unfiltered nonmenthol cigarettes over their lifetime, to menthol smokers who smoked predominantly filtered menthol cigarettes. The comparison therefore shows a “protective” effect of menthol. It appears therefore, that the protective effect is an artifact of differences in filter type between the two groups of smokers.

This still leaves a problem for anti-smoking fanatics because they insist that filters don't work. Some of them even want to ban filters. 
You shouldn't really listen to anti-smoking fanatics.

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