The FDA is under court order to respond to a citizen petition.
The petition stems from a process that lets individuals and community organizations request changes to health policy. It was filed in 2013 by the Public Health Law Center, the African American Tobacco Control Leadership Council, and other public health groups. After the FDA failed to respond to the petition for years, anti-tobacco groups sued to compel a response.
“There’s a driving force with that pending lawsuit, and I don’t think the administration wants a ruling against FDA,” said Eric Lindblom, a former FDA executive focused on tobacco policy under the Obama administration.
More than 19.5 million Americans smoke menthol cigarettes, so it’s not a market tobacco companies are eager to lose.
The industry spent more than $20 million just last year opposing a menthol ban in California, according to campaign finance disclosures. A state-level ban on flavored tobacco products, including menthol, was set to go into effect in January, but implementation was delayed after opponents successfully petitioned to bring the issue to a public referendum.
But anti-tobacco advocates have allies in the administration.
Health and Human Services Secretary Xavier Becerra has a long history of pushing for greater tobacco regulation. He was a key supporter of California’s law to ban menthol cigarettes, and he sued e-cigarette maker Juul for allegedly marketing its products to children while he served as California’s attorney general.
Vice President Harris has also been a vocal proponent of increased regulation of e-cigarettes and as a senator signed a letter accusing the Trump administration of backtracking on its initiatives to combat tobacco.
Another reason a ban is gaining traction: It’s seen as a major racial justice issue.
Only 29 percent of White smokers choose menthol, as opposed to 85 percent of African American smokers, according to a National Survey on Drug Use and Health.
The tobacco industry has sponsored music and events targeted at the African American community. And researchers have found that tobacco companies offer cheaper pricing on menthol cigarettes in Black neighborhoods.
“I understand the concern of taking away a product that a minority group uses, but we’re not talking about a hair product. We’re talking about a product that is disproportionately targeted to racial minority groups and is disproportionately killing them,” said Nia Heard-Garris, a pediatrician who leads health equity work with the American Academy of Pediatrics.
Not everyone is in favor: Some civil rights groups and leaders, including the American Civil Liberties Union and activist Al Sharpton, have opposed menthol cigarette bans, arguing they could increase over-policing in Black communities. But support for a menthol ban has gained momentum among Black lawmakers and groups such as the NAACP, who point out that a ban would target manufacturers and would not create new criminal penalties.
Matt Myers, president of the Campaign for Tobacco-Free Kids, says that a renewed focus on health disparities could help propel a ban forward: “With this administration’s sincere focus on eliminating health disparities and health inequalities, it seems like the right time to do it.”
The industry says it’s unfair to target menthol.
Kaelan Hollon, a spokeswoman for Reynolds American, warned such a rule could lead to “illicit trade and unintended consequences.” Hollon and other tobacco representatives say there is nothing unique about menthol that should make it the target of federal regulations.
But while the FDA says menthol cigarettes are no more toxic than regular ones, a scientific review found it likely “that menthol cigarettes pose a public health risk above that seen with nonmenthol cigarettes.” The review pointed to evidence they may be more addictive and to the desensitizing and cooling properties of menthol, which can make such cigarettes easier to smoke.
The industry has helped scuttle efforts at the federal level before.
The Tobacco Control Act, landmark 2009 anti-tobacco regulation, gave the FDA the power to regulate tobacco products and banned flavored cigarettes, but it made an exception for menthol cigarettes — a carve-out some anti-tobacco advocates blamed on industry lobbying. Instead, the law called for more research on menthol.
In 2013 the results of that research started to emerge: The FDA found that menthol cigarettes led more people to pick up smoking and made it harder for them to quit, especially in Black communities where menthol cigarettes are heavily marketed.
But the Obama administration stopped short of a ban.
Lindblom, the former FDA executive, says it “wasn’t a priority” for the White House. Meanwhile, among the public health community there was a fear of moving too fast after getting the landmark tobacco legislation through.
“It was a terrible strategic mistake, but that was the belief: that we can’t try to do too much too soon,” Lindblom said.
Under the Trump administration, FDA Commissioner Scott Gottlieb called menthol products “one of the most common and pernicious routes by which kids initiate combustible cigarettes.” But his efforts to push through a menthol ban were quashed in the face of opposition from the White House and lawmakers from tobacco-growing states.
Research suggests a ban could save thousands of lives.
A recent study found that menthol cigarettes were responsible for 378,000 premature deaths between 1980 and 2018.
In Canada, after seven provinces banned menthol cigarettes between 2016 and 2018, a study found that about 1 in 5 menthol cigarette smokers quit. If the United States saw similar rates, it would mean millions of people quitting cigarettes.
A ban could also open the door to additional tobacco regulation.
The ban would be the first time the FDA flexes its power to regulate the contents of cigarettes, and there are signs it may go even further.
A recent Wall Street Journal article said the Biden administration is also discussing a move to lower the nicotine levels in cigarettes to make them nonaddictive or minimally addictive.
Anti-tobacco advocates and public health experts say that would be a game-changer — and could save even more lives than a menthol ban.
Ahh, oof and ouch
AHH: The United States will share 60 million AstraZeneca vaccine doses.
The White House announced yesterday that doses of the vaccine, which has not yet been authorized for emergency use by the FDA, will be sent to other countries once it clears product quality reviews.
The move represents a major increase from a promise last month that the U.S. would share 4 million doses with Mexico and Canada. Administration officials have yet to finalize where the additional doses will go.
The White House stressed that the new initiative will not affect the vaccine drive in the U.S. “We do not need to use AstraZeneca in our fight against covid,” White House press secretary Jen Psaki told reporters.
“The question of when and how to send vaccine overseas has been a vexing one for the White House. President Biden’s promise to rid the United States of the coronavirus was a top campaign pledge, and he does not want to be seen as prioritizing other countries. Yet he also speaks often of restoring the United States to moral leadership in the world and showing compassion for other nations,” The Post’s Tyler Pager, Annie Linskey and Emily Rauhala report.
- The administration is also moving to share raw materials of the AstraZeneca vaccine with India amid a devastating surge in cases. Biden spoke with India Prime Minister Narendra Modi on Monday to pledge assistance.
OOF: Biden is expected to announce updated mask guidance.
The updated guidance is expected to deal with whether people who are vaccinated need to continue wearing masks outdoors. A November review estimated that the risk of outdoor transmission was about one-nineteenth the risk of indoors transmission. The risk is even further reduced for the more than 95 million Americans who have been fully vaccinated.
Anthony Fauci, Biden’s chief medical adviser, hinted that new guidance was upcoming in an interview on Sunday.
“I think it’s pretty common sense now that outdoor risk is really, really quite low, particularly — I mean, if you are a vaccinated person, wearing a mask outdoors, I mean, obviously, the risk is minuscule,” Fauci said on ABC News’s “This Week.”
Leana Wen, public health professor at George Washington University and former Baltimore health commissioner:
OUCH: The United States grew at its slowest pace since the 1930s, according to the 2020 census.
“The first numbers to come out of the 2020 Census show the U.S. population on April 1, 2020 — Census Day — was 331.5 million people, an increase of just 7.4 percent between 2010 and 2020. It is the second-slowest rate of expansion since the government began taking a census in 1790. In the 1930s, the decade with the slowest population growth, the rate was 7.3 percent,” The Post’s Tara Bahrampour, Harry Stevens and Adrian Blanco report.
Declining immigration and a drop in birthrates explain some of the trend. The current fertility rate in the United States is 1.73, below the 2.1 figure considered to the be the replacement rate.
Even as fewer Americans are being born, some are dying at younger ages. “Life expectancy has dipped in the past couple of years — a reversal that has been driven by factors such as drug overdoses, obesity, suicide and liver disease and that sharply accelerated last year during the pandemic,” our colleagues write.
Elsewhere in healthcare
Montana’s governor signed three antiabortion bills into law.
The bills signed by Gov. Greg Gianforte (R) include a ban on abortion after 20 weeks of gestation, a requirement that health providers give women the opportunity to view an ultrasound before receiving an abortion, and several restrictions on abortion pills, including a requirement that they be administered in person rather than through telehealth, the Associated Press’s Iris Samuels reports.
Republican lawmakers in the state have repeatedly tried to pass measures aimed at restricting abortions but have historically seen those bills vetoed by Democratic governors. Gianforte is the first Republican governor in the state in 16 years.
On Monday, Oklahoma Gov. Kevin Stitt (R) signed a law banning abortions at the onset of a fetal heartbeat, which can occur at the sixth week of gestation, before many women know they are pregnant. The law would effectively ban abortions in the state.
The laws in both states are likely to face challenges in the courts. Several GOP-led states have moved to restrict abortion in recent months. Some Republican leaders have said that it is part of a strategy to push the conservative-dominated Supreme Court to reconsider Roe v. Wade.
The Supreme Court declined to hear a case on brain damage in wrestlers.
The court declined to hear an appeal from pro wrestlers who claim that World Wrestling Entertainment failed to protect them from repeated head injuries that led to brain damage.
“Monday’s decision, which the Supreme Court did not explain under its usual practice, put an end to the last remaining lawsuits in an array of litigation originally filed six years ago in Connecticut against the WWE over concussions and other injuries,” the Associated Press’s Dave Collins reports. “More than 50 former wrestlers, most of them stars in the 1980s and 1990s, sued the WWE, saying they suffered repeated head injuries including concussions that led to long-term brain damage. ”
Despite worries the pandemic would cause a real-estate collapse, the D.C. housing market had another strong year.
The coronavirus still affected home sales: More people, freed of a daily commute, sought to move out to the suburbs, and housing inventory was scarce as some potential sellers were reluctant to put their homes on the market and invite strangers in for showings, The Post’s Kathy Orton reports.
Advocacy groups are pushing CMS to innovate.
The United States of Care, a health advocacy nonprofit, released recommendations for the innovation center at the Centers for Medicare and Medicaid Services, which is charged with testing models of care to improve patient health. The recommendations include testing whether using doulas or midwives reduces maternal mortality, investigating whether more providers would accept Medicaid if it could pay at Medicare rates, and developing models for more in-home care for people with disabilities.
