by Carl V Phillips
It is not actually about THR, but as such big tobacco news it is worth commenting on. By the time you read this, those of you who follow the topic will probably have already heard that this morning, the US Food and Drug Administration’s Tobacco Products Scientific Advisory Committee recommended that menthol cigarettes be banned because it would benefit public health.
[Update: There has been much legalistic/political talk about how they did not really recommend a ban. See my later post about this.]
Perhaps insiders have a good reason to believe that this will not actually be done, since the stock price of Lorrilard (a company whose business is basically selling menthol cigarettes) has gone up since the announcement was made. But lots of people were also predicting that the committee would not make this recommendation. Being a political panel more than a scientific one, despite the name, it was assumed that they would not put the FDA in the position of having to overrule one of their major recommendations, which would be embarrassing for all involved.
Others, who believe that the panel actually acts based on science despite ample evidence to the contrary, thought they would have to recommend against a ban based on the fact that smoking menthol cigarettes does not have a detectable difference in risk compared to smoking other cigarettes. But from a scientific perspective, given what the law say, the committee was undoubtedly right, and those arguing that menthol creates no harm are clearly wrong. As I have been trying to tell people for almost a year, though apparently without creating much impression, the law was written so that a ban would be called for if there was any increase in risk at the population level, not for an individual smoker choosing one or the other. And there clearly is.
I know that there are studies that purport to show that menthol cigarettes are “not more addictive”, are not more attractive to teens, all menthol smokers would switch rather than quit, and other similar absurd claims. But claims that these results show that banning menthol would have no effect are just extremely naive bad science. We know that because banning menthol is one of the many things that would lower the benefits of smoking for some smokers, and anything that lowers the net benefits of an activity will reduce the demand for it. Whatever the studies might say, somewhere out there is one menthol smokers who is right on the fence about quitting, and the lowering of quality of the smoking experience by removing menthol is just enough to push her to quitting. So from the perspective of population health people are a bit less healthy, since there is no conceivable way that banning an ingredient could increase demand. This, of course, ignores the huge cost that comes from making a lot of menthol smokers’ lives less happy, in exchange for no benefit (though the FDA committee members generally favor punishing smokers, so they probably consider this a positive effect too).
As I have pointed out before, the law that allows or mandates changes that improve population health (regardless of other costs) means that FDA would be authorized to require that all cigarettes sold be bright pink or smeared with dog feces. Neither of these would make each cigarette more healthy to smoke, but they would lower the benefits of smoking and thus cause at least a few people to quit. I think people thought I was joking when I made points like this. I suspect they might be changing their minds now.