Tobacco-Free Kids Supports New York City Bills to Restrict Sales of Menthol Cigarettes and Flavored E-Cigarettes

Testimony of Matthew L. Myers, President, Campaign for Tobacco-Free Kids
January 30, 2019

Campaign for Tobacco-Free Kids President Matthew L. Myers testified before the New York City Council Committee on Health today in support of bills to restrict the sale of menthol cigarettes and flavored e-cigarettes. He strongly urged the City Council to adopt the measures introduced by Council Members Mark Levine and Fernando Cabrera, noting that, together, these two bills will have an enormous impact in reducing the number of people who die from tobacco use, the number of young people who become addicted and the death toll of tobacco on New York City’s African-American population.

Here is his testimony:

Good afternoon, Chairman Levine and Members of the Committee. Thank you for the opportunity to speak in support of Int-1345 and Int-1362. I am Matthew Myers, President of the Campaign for Tobacco-Free Kids. The Campaign is the largest advocacy organization in the U.S. dedicated exclusively to reducing the toll of tobacco by supporting public policies that prevent kids from starting to smoke, encourage and help smokers to quit and protect everyone from the harms of secondhand smoke.

Actions taken by the Council over the past two decades have been instrumental in reducing smoking among New York City kids and adults and have made New York City a world leader in this regard.

The two bills you are considering today, one to restrict the sale of flavored e-cigarettes and one to restrict the sale of menthol cigarettes, are critical next steps that we strongly support. Each fills an important gap. Together, these two bills will have an enormous impact on the effort to reduce the number of people who die from tobacco use, significantly reduce the number of young people who become addicted and dramatically reduce the death toll of tobacco on New York City’s African-American population.

First, I’ll address Chairman Levine’s bill on e-cigarettes.

E-cigarette Use by Youth is Skyrocketing and Kids Are Getting Addicted

We are at a critical juncture in our nation’s public health history. After making tremendous progress in reducing youth tobacco use over the past several decades, e-cigarettes, and Juul in particular, are threatening to undermine declines in overall youth tobacco use. The number of youth now using e-cigarettes is alarming and raises serious concerns that e-cigarettes could be an entryway to nicotine addiction and use of regular cigarettes.

Two recent national surveys show that youth use of electronic cigarettes has skyrocketed in the United States, reaching what the Food and Drug Administration (FDA) Commissioner and the U.S. Surgeon General have called “epidemic” levels.

  • The 2018 National Youth Tobacco Survey (NYTS) showed that between 2017 and 2018, current e-cigarette use increased by 78 percent among high school students and by 48 percent among middle school students. In 2018, more than 3.6 million middle and high school students were e-cigarette users – an alarming increase of 1.5 million students in just one year. Similarly, the 2018 Monitoring the Future survey found that youth vaping of nicotine nearly doubled in 2018 among 12th and 10th graders – the single largest increase in youth use of any substance in the survey’s 43-year history.
  • Data from the New York State Department of Health’s Youth Tobacco Survey also show a rapid rise in e-cigarette use among high school students; between 2014 and 2018, e-cigarette use increased 160 percent, and now 1 in 4 New York high school students use e-cigarettes.
  • Contrary to what the e-cigarette industry will tell you, as FDA Commissioner Scott Gottlieb has said, there is mounting evidence that large numbers of youth are not just experimenting, they are becoming addicted. The same national survey found that nearly 28 percent of current high school e-cigarette users – more than 840,000 teens – used the products on at least 20 days in the past month.
  • Alarmingly, research shows that e-cigarette use increases the risk of smoking cigarettes. Last year, the National Academies of Science, Engineering & Medicine released a comprehensive report that found that there was substantial evidence that e-cigarette use increases risk of ever using cigarettes among youth and young adults.
  • These products aren’t replacing cigarettes. They are expanding the number of young people addicted to nicotine. Studies demonstrate clearly that the youth using e-cigarettes are not the kids who probably would have smoked cigarettes; they are the kids who are the least likely to smoke.

Sadly, the numbers and research are confirmed by parents and pediatricians across the country. E-cigarette use, especially Juul, has permeated schools and the daily life of hundreds of thousands of youth.

It is clear that large numbers of teen e-cigarette users are struggling with nicotine addiction and withdrawal. In November, the New York Times profiled Matt Murphy from Reading, Mass., who had his first Juul when he was 17. He described the euphoric head rush of nicotine as “love at first puff.” He quickly became addicted to Juul’s intense nicotine hits. He became so dependent on the Juul that he nicknamed the device his “11th finger.” He is not alone. The problem is so bad that two weeks ago, FDA convened a public hearing to gather input on how to help youth addicted to the nicotine in e-cigarettes. No one is quite sure how to help these youth quit. I-1362 will prevent these kids from ever getting hooked.

Flavored E-Cigarettes Have Fueled the Popularity of These Products Among Kids

E-cigarettes didn’t become popular with kids by accident. E-cigarette makers have introduced products with thousands of flavors that appeal to young people and engaged in the kind of marketing that mirrors what the cigarette industry did for decades.

In recent years, there has been an explosion of sweet-flavored e-cigarettes. As of 2017, there were more than 15,500 unique e-cigarette flavors available online.

It is flavors in e-cigarettes that are driving the epidemic. A government survey found that 81 percent of kids who have ever used tobacco products started with a flavored product. Eight in 10 youth e-cigarette users saying they used the product “because they come in flavors I like.”

I urge the Council to support Chairman Levine’s bill to restrict the sale of flavored e-cigarettes and that the bill be amended to include menthol flavored e-cigarettes.

Menthol Cigarettes Increase Youth Tobacco Use and Use Among African-Americans and are a Major Cause of Tobacco-Related Health Disparities

We are also here to support Councilman Cabrera’s bill regarding menthol cigarettes. While e-cigarette use justifiably gets a lot of attention, no single product contributes more to the death and disease caused by tobacco use than menthol cigarettes. The scientific evidence leaves no doubt that menthol cigarettes increase the number of people, particularly kids, and especially African-American kids, who try the product, become addicted and die a premature death as a result. Passing Councilman Cabrera’s bill to restrict the sales of menthol cigarettes is one of the most important things you can do to protect the health of New York City kids.

Tobacco companies have long known that menthol cigarettes reduce the harshness of their products and make them easier to use by new users, almost all of whom are under age 18. As a result, menthol cigarettes increase the number of kids who experiment with cigarettes and who become regular smokers. And young people who initiate using menthol cigarettes are more likely to become addicted daily smokers.

It is shocking but more than 50 percent of youth who smoke cigarettes start with and then use menthol cigarettes. The number is even worse among African-American youth. Over 70 percent of African-American youth smokers smoke menthol cigarettes.

Menthol Cigarettes Have a Devastating Impact on the Health of African Americans

Menthol cigarettes have had a particularly destructive impact on the African-American community. Over 80 percent of African-American smokers smoke menthol cigarettes.

Menthol cigarettes are a major reason why tobacco use is the leading preventable cause of death for African Americans. Smoking kills 45,000 African Americans each year. Lung cancer kills more African Americans than any other type of cancer.

The evidence is now unequivocal. Menthol increases the intensity of addiction and makes it harder for smokers to quit. The impact is greatest for African Americans. Studies show that African-American smokers have higher levels of nicotine dependence because of their preference for menthol cigarettes. While African-American smokers are more likely than white smokers to try to quit, they are less likely than white smokers to successfully quit smoking.

In 2011, an FDA scientific advisory committee found that menthol cigarettes reduce smoking cessation, especially among African Americans, and increase the overall prevalence of smoking among African Americans. The same FDA advisory committee estimated that by 2020, 4,700 excess deaths in the African-American community will be attributable to menthol in cigarettes, and over 460,000 African Americans will have started smoking because of menthol in cigarettes.

The Tobacco Industry Targets African Americans and Youth with Menthol Cigarette Marketing

It’s no accident that African Americans and youth smoke menthol at higher rates than other demographic groups. It is a direct result of a decades-long marketing campaign by the tobacco industry.

Decades of research and the tobacco industry’s internal documents demonstrate that the industry employed campaigns and strategies to aggressively target African Americans. Beginning in the 1950s, the tobacco industry targeted communities with marketing for menthol cigarettes through sponsorship of community and music events, targeted magazine advertising, youthful imagery and marketing in the retail environment.

It isn’t a coincidence then that while just 5 percent of African Americans smoked menthol cigarettes in the early 1950s, by 1968 the number had risen to 14 percent, and today the percentage of African Americans who smoke menthol cigarettes is over 80 percent. Make no mistake: this is a crisis that is the direct result of the conscious decisions of the major tobacco companies.

This targeting continues today: menthol cigarettes continue to be heavily advertised, widely available and priced cheaper in certain African-American communities, making them more appealing, particularly to price-sensitive youth. A wealth of research indicates that African-American neighborhoods have a disproportionate number of tobacco retailers, pervasive tobacco marketing, and in particular, more marketing of menthol products.

This is why Councilman Cabrera’s bill is so important. You can do something about this. Councilman Cabrera’s bill will help prevent and reduce the destructive impact caused by menthol cigarettes.

Thank you for your time.