Thankyou For Smoking popped up on my Blockbuster movie feed as we scouted for a movie to watch. My teenage son and I curiously clicked on the link to stream it as our weekend watch. It was the story of a lobbyist whose job was to sell cigarettes.
Marketing 101 says you have to catch them young. It’s a strategy that companies like Phillip Morris use to sell tobacco to adolescents – like candy – adding a drop of menthol to make the smoke palatable, keeping tobacco available, within easy reach at every street corner, selling cigarettes individually if a pack is too expensive for a new smoker, but selling them in packs to those who want to quit their habit.
Nicotine is given a new twist and JUULing is made cool.
Eighty percent of youth smokers start with a flavored tobacco product; almost fifty percent start with menthol cigarettes – menthol disguises the taste of tobacco and makes it less harsh to smoke.
Menthol amplifies nicotine-induced changes in the young brain’s reward system that contribute to addictive behaviors, says the CDC. According to the National Institute of Drug Abuse, studies have suggested that smokers of mentholated cigarettes display more severe nicotine dependence and have greater difficulty quitting smoking, compared to smokers of non-mentholated cigarettes.
Menthol then is not merely a flavor additive but may contribute to addiction, especially in youth.
Youth who vape are four times more likely to smoke one year later. JUULing or vaping is designed to increase the rate of nicotine delivery (JUUL dominates the e-cigarette market). Eighty-five percent of teen vapers use flavored e-cigarettes, said John Chung, Community Health for Asian Americans at an GlobalMediaX briefing on October 20th, 2021.
The amount of nicotine in one JUUL cartridge is roughly equal to the amount of nicotine in a pack of cigarettes, said Alison Wohlgemuth, Program Director- East Bay, Bay Area Community Resources.
India banned e-cigarettes like Juul Labs Inc and Philip Morris two years ago. There is no production, manufacturing, import or export, transport, sale or distribution, storage, and advertising related to e-cigarettes anymore. Preeti Sudan, Secretary, Ministry of Health and Family Welfare to Outlook explained that failure to comply is punishable by “ one-year imprisonment or a fine of Rs 1 lakh. Repeat offenses could lead to three-year imprisonment or a penalty of Rs 5 lakh or both.”
The gateway to the arc of addiction starts with menthol. Menthol flavored tobacco products – the pied piper of candy – reel them in during early adolescence. Flavors hook kids who follow a trail of candy smoke to a lifetime of addiction.
Gateway drugs used in early adolescence (age 11–20 years) are significantly associated with marijuana use, illegal drugs, and cocaine in older adolescence and are important predictors of drug use in adulthood, write Stephen Nkansah-Amankra and Mark Minelli in their study, “Gateway hypothesis” and early drug use: Additional findings from tracking a population-based sample of adolescents to adulthood.”
It is this path to destruction that must be nipped in the bud, warned Dr. Phillip Gardiner, PhD, at the briefing.
“Enough is enough”, he said. “Remove menthol from the marketplace.”
Currently, Dr. Gardiner is the Co-Chair of the African American Tobacco Control Leadership Council.
Preventing tobacco product use among youth is critical to ending the tobacco epidemic in the United States, agrees CDC. On its website, it lists several factors associated with youth tobacco product use – social and physical environments, for example, in which “the way mass media show tobacco product use as a normal activity can make young people want to try these products, “ and biological and genetic evidence showing that youth may be sensitive to nicotine and that teens can feel dependent on nicotine sooner than adults economic status, including lower-income or education.
The CDC warns if cigarette smoking continues at the current rate among youth in this country, 5.6 million of today’s Americans younger than 18 will die early from a smoking-related illness. That’s about 1 of every 13 Americans aged 17 years or younger who are alive today.
Push for change so kids can live, said Nathan, an invited youth speaker from Contra Costa county where almost half (49%) of Antioch retailers and 61% of Pittsburg retailers selling tobacco products are within 1,000 ft of a youth sensitive area (school, park, playground or library). At the briefing, community advocates from Contra Costa county urged companies to increase the price of flavored tobacco and not to sell singles.
A single cigarette, cigar, or pouch sold at a fraction of the price of a “pack” makes the product more accessible to all users, but especially appealing to youth who might be experimenting with different tobacco products and are extremely price sensitive.
“Banning flavored tobacco is the most impactful public health matter we can take in our community, said Dr. Ori Tzvieli, Contra Costa Health Services. “We can save many, many lives over many many generations.”
Ritu Marwah was a 2020 California reporting and engagement fellow at USC Annenberg’s Center for Health Journalism.
Edited by Meera Kymal, Contributing Editor at India Currents