Read the Submission from 208 organizations from 61 countries in response to the current draft and their recommendations here.

The joint submission includes key recommendations for the UN Committee to consider to:

1. Strengthen the implementation of the WHO Framework Convention on Tobacco Control;
2. Support culturally competent cessation support;
3. Combat targeted advertising by tobacco companies and flavored tobacco products;
4. Protect indigenous peoples from the tobacco industry; and
5. Affirm the connection between the right to health and the UN Sustainable Development Goals.

A strong General Recommendation from CERD is essential because the UN human rights treaty has been ratified by 182 countries, meaning CERD is law where ratified. General Recommendation 37 will be a global legal recommendation to strengthen tobacco control at the national level.

Learn more about the treaty process by watching ASH’s webinar here.

Reality Check, a youth group out of New York state, hosts this annual event to bring everyone together to Mobilize Against Tobacco Lies (MATL).

For the last few years, this MATL event was held virtually, but everyone was able to come back in-person this time around. These efforts in D.C. included meet-and-greets, activities, trainings, sightseeing, and culminated with a rally against Altria on May 18th.

This rally was held right in front of the Altria lobbyist office, and all the youth stood with signs and chants to make sure their voices were heard.

As Altria had its annual shareholders meeting, these youth had their own message during the rally. One of the key messages was all flavors should be removed in all tobacco products and for all people.

On May 17^th, Counter Tools conducted a training for the youth on the importance of policy and advocating for flavored tobacco product bans. We also had a presence during the rally and throughout the activities during the week.

We want to give a shout out to all the groups participating for their efforts. It was amazing to see people come together for this important cause! These youth spoke out against targeting by the tobacco industry, and made it known through their booming voices and boisterous words, that they will not be pawns in the tobacco industry’s efforts to recruit and retain tobacco users.

We will all come back together next year to continue this momentum and show the tobacco industry we cannot be fooled! To hear more about these efforts, check out our podcast. If you want to learn more about Reality Check and provide support, go to RealityCheckofNY.com and MobilizeAgainstTobaccoLies.com

We write to express our strong support for proposed rules that the Food and Drug Administration has issued to prohibit the manufacture and sale of menthol cigarettes and flavored cigars. FDA’s proposals will substantially improve public health by reducing youth tobacco use, preventing tobacco-caused disease, and saving lives. We urge you to support FDA’s proposed rules and oppose any effort to prevent or delay FDA from finalizing and implementing them. It is time to put an end to the tobacco industry’s targeted efforts to use flavored products to lure youth into a lifetime of deadly addiction.

Tobacco use is the leading preventable cause of death in the U.S., responsible for nearly one in five deaths and more than $241 billion in health care costs each year. While smoking rates have declined, many communities continue to experience high rates of smoking and smoking-caused disease, including people with lower levels of income and education, individuals living in rural areas, Native Americans, people with a behavioral health condition, and the LGBTQ+ community. Congress gave FDA tools to reduce the number of people who die of cancer, heart disease, respiratory disease, and other tobacco-caused diseases. FDA is now proposing to use one of those tools – the ability to set tobacco product standards – to reduce the public health harms caused by menthol cigarettes and flavored cigars. 

Menthol cools and numbs the throat, which helps mask the harshness of tobacco smoke and makes it easier for young people to start smoking. Menthol cigarettes are also more addictive and harder to quit than non-menthol cigarettes. As a result, menthol cigarettes have increased the number of youth who smoke and the number of people who die prematurely from smoking. Black communities, which have been the target of menthol cigarette marketing for decades, have been especially harmed by menthol cigarettes. Removing these products from the market would reduce the number of youth who become addicted to tobacco, save hundreds of thousands of lives, and advance health equity. Researchers estimate that removing menthol cigarettes from the market would prevent up to 654,000 smoking-related deaths over time, including over 255,000 smoking-related deaths among Black Americans. 

Cigars, which come in hundreds of kid-friendly flavors like Cherry Dynamite and Tropical Fusion, are the second most popular tobacco product among youth. In 2022, half a million youth were current cigar smokers. Every day that passes, more than 800 kids try cigar smoking for the first time, and there is extensive evidence about the role flavors play in attracting youth to cigars. We need to protect kids from flavored cigars because cigar smoke is composed of the same toxic and carcinogenic constituents found in cigarette smoke. According to the National Cancer Institute, cigar smoking can cause cancer of the oral cavity, larynx, esophagus and lung. 

FDA should finalize these proposed rules quickly. All flavors except menthol are already prohibited in cigarettes. Removing other flavored tobacco products from the market, including menthol cigarettes and flavored cigars, is supported by strong scientific evidence and is long overdue. We urge you to discourage any delays in the rulemaking process and reject any legislative efforts to restrict the ability of FDA to move forward with these rules or other efforts to reduce tobacco-caused disease and death. Strong FDA action to reduce tobacco use is critical, as tobacco use continues to claim the lives of nearly half a million Americans every year. 

Sincerely, 

Coalition letter to House on menthol cigs and flavored cigars 2.21.23

Coalition letter to Senate on menthol cigs and flavored cigars 2.21.23

By law, the US Postal Service is prohibited from shipping alcohol under U.S. Legal Code 18 § 1716. But a new bill in Congress, the United States Postal Service Shipping Equity Act (H.R. 3287/S. 1663), could change that.  Enabling home delivery of alcohol by USPS would create new health risks and potential for underage drinking, and threaten existing alcohol safety measures. 

The Alcohol Action network has made it easy for you to take action on this important issue. After entering your name and address, the template can be personalized with additional information that may be meaningful to your unique congressional legislators. 

Download this fact-sheet to learn more about issues related to home delivery and USPS.

The undersigned organizations write today to strongly oppose any extension of the comment period for the proposed rule removing menthol as a characterizing flavor. We note that the
Food and Drug Administration (FDA) has received several requests for an extension of the comment period from the tobacco industry. Our organizations note that such extension is not
in the interests of protecting the public health and urge that FDA deny any such requests.

As many of our organizations have noted in numerous communications to FDA spanning a decade, menthol cigarettes pose a serious threat to public health. They are a starter product for
youth, they contribute to smoking dependence, and they make it harder to quit. Further, they contribute to serious health disparities among many minority groups, especially African
Americans. Indeed, we know that menthol cigarettes have slowed the decline in smoking prevalence, and were responsible for 10.1 million extra smokers, and 378,000 premature
deaths from 1980-2018.[1] The African American community has borne a disproportionate burden from menthol cigarettes where they were responsible for 1.5 million new African American smokers and 157,000 premature African American deaths during that same time period.[2] Our country cannot afford to have menthol cigarettes on the market one more day and any extension of the public comment period leaves these deadly products on the market that much longer. Any extension of the public comment period is not appropriate for the protection of public health.

This is not a new issue to FDA. From the outset of FDA’s authority over tobacco products 13 years ago, removing menthol cigarettes from the market has been an issue that FDA has said it
was considering. FDA has opened two public dockets on the issue, it has received a report from its Tobacco Products Scientific Advisory Committee and has conducted at least two of its own
studies, most recently in 2021, titled “Scientific Review of the Effects of Menthol in Cigarettes on Tobacco Addiction: 1980-2021.”[3] Further, in 2013, FDA received a citizen petition from
several public health organizations, including many of the undersigned organizations, requesting action on removing menthol as a characterizing flavor from cigarettes, which
containing detailed information about the need for action. A supplement to that petition was submitted in 2021, updating that data. Each of these steps revealed the overwhelming
evidence that removing menthol cigarettes from the market would protect public health and that urgent action was needed. FDA’s own words in the proposed rule establish the strong
support for not delaying any further action to remove these products: “Prohibiting menthol as a characterizing flavor in cigarettes would help to decrease the nicotine addiction resulting from
menthol cigarette use, and thereby, decrease disease and death.”[4]

Due to the length of time that FDA has been studying this, and the fact that the public have had more than ample opportunity to comment on a product standard to remove menthol from
cigarettes, no further time on the public comment period for the proposed rule is needed. There can be no justification for any extension of the public comment period. Swift action is
needed to finalize this rule – lives are at stake.

Letter opposing extension of menthol cigarette comment period 5-25-22 (PDF)

1 Le TT, Mendez D. An estimation of the harm of menthol cigarettes in the United States from 1980 to 2018. Tob Control. 2021 Feb 25. https://pubmed.ncbi.nlm.nih.gov/33632809/
2 Mendez D, Le TT. Consequences of a match made in hell: the harm caused by menthol smoking to the African American population over 1980-2018. Tob Control. 2021 Sep 16. https://pubmed.ncbi.nlm.nih.gov/34535507/
3 * FDA. “Scientific Review of the Effects of Menthol in Cigarettes on Tobacco Addiction: 1980-2021.” Silver Spring, MD: HHS, FDA, Center for Tobacco Products, 2022. Available at https://www.fda.gov/media/157642/download
4 Tobacco Product Standard for Menthol in Cigarettes. Docket No. FDA-2021-N-1349. https://www.regulations.gov/document/FDA-2021-N-1349-0001

Today, we write in response to several requests the Food and Drug Administration (FDA) received to extend the public comment period for the proposed rule to remove all characterizing flavors, except for tobacco, from cigars. We strongly oppose any extension of the comment period, and we urge FDA to deny any such requests.

FDA has been reviewing the role of flavors in tobacco products generally, and cigars specifically for many years. Indeed in 2018, FDA opened an Advanced Notice of Proposed Rulemaking on
flavored tobacco generally, which included flavored cigars. FDA received more than 525,000 comments on this docket. Further FDA has conducted its own review of the scientific literature
on flavored cigars.[1] The proposed rule under consideration today is long overdue, and allowing flavored products like cigars to stay on the market is antithetical to the protection of public
health, the standard by which FDA must view actions on tobacco products. A 60-day comment period is appropriate and sufficient to provide the information requested, particularly since this
is at least the second public comment period covering this topic. All interested parties should have more than adequate time to prepare their responses in the current time frame.

However, the 960,000 middle and high school students who have smoked cigars in the last 30 days[2] – more than half of which (58.3%) used flavored cigars[3] – do not have the luxury of time.
Nor do the 3,163 young adults who try a cigar every day.[4] We know that flavors in cigars attract youth and young adults to these products, which in turn results in an increased likelihood that they will progress to regular cigar smoking. Further, as FDA notes in the proposed rule, youth and young adults, racial minorities, those with low-income, and those in the LGBTQ population are disproportionately impacted by cigars with higher prevalence and use rates, higher frequency of use, all of which lead to tobacco-related health disparities.[5] Removing flavors from cigars will do much to reduce the appeal of these products and therefore reducing the 9000 deaths they cause each year.[6] Extending the comment period leaves these products on the market, causing more damage with each day.

The public health threat posed by flavored cigars requires speedy action by FDA to remove these products from the market. Allowing an additional extension at this stage is unacceptable.
We appreciate your consideration and urge FDA to deny all requests to extend the comment period.

Letter opposing extension of cigar comment period 5-25-22 (PDF)

1 FDA, ‘‘Scientific Assessment of the Impact of Flavors in Cigar Products.’’ Silver Spring, MD: HHS, FDA, Center for Tobacco Products, 2022.
2 Gentzke, A.S., T.W. Wang, A. Jamal, et al., ‘‘Tobacco Product Use Among Middle and High School Students — United States, 2020.’’ Morbidity and Mortality Weekly Report, 69(50):1881–1888, 2020. Available at http://dx.doi.org/10.15585/mmwr.mm6950a1
3 Parms, T.A., S.K. Head, M.D. Sawdey, et al., ‘‘Characteristics of Past 30-Day Cigar Smoking, U.S. Adolescents, 2020.’’ American Journal of Preventive Medicine, 62(1):e39–e44, 2022. Available at https://doi.org/10.1016/j.amepre.2021.06.011.
4 Substance Abuse and Mental Health Services Administration (SAMHSA), Key Substance Use and Mental Health Indicators in the United States: Results from the 2019 National Survey on Drug Use and Health. HHS Publication No.PEP20–07–01–001, NSDUH Series H–55. Rockville, MD: HHS, SAMHSA, Center for Behavioral Health Statistics and Quality, 2020. Available at https://store.samhsa.gov/sites/default/files/SAMHSA_Digital_Download/PEP20-07-01-001-PDF.pdf
5 Tobacco Product Standard for Characterizing Flavors in Cigars. Docket No. FDA-2021-N-1309. https://www.regulations.gov/document/FDA-2021-N-1309-0001
6 Nonnemaker, J., B. Rostron, P. Hall, et al., ‘‘Mortality and Economic Costs from Regular Cigar Use in the United States, 2010.’’ American Journal of Public Health, 104(9):e86–e91, 2014. Available at https://doi.org/10.2105/AJPH.2014.301991.

The undersigned public health, medical, education and community organizations write to express our support for the Food and Drug Administration’s commitment to issuing proposed rules this Spring to prohibit menthol as a characterizing flavor in cigarettes and prohibit all characterizing flavors in cigars. Once issued, we urge FDA to move quickly to finalize and implement these life-saving rules.

The public health and medical community has long been united in calling on FDA to use its authority under the Family Smoking Prevention and Tobacco Control Act (TCA) to issue product standards ending the manufacture and sale of flavored tobacco products. There is no question that flavored products are particularly attractive to young people, leading to increased tobacco initiation. As FDA already has found, “the availability of tobacco products with flavors at these development stages attracts youth to initiate use of tobacco products and may result in lifelong use.”[1] The FDA/NIH Population Assessment of Tobacco and Health study found that almost 81% of 12-17 year olds who had ever used a tobacco product initiated use with a flavored product.[2]

Among other efforts to call on FDA to take action against flavored products, in 2013 various organizations filed a Citizen Petition urging FDA to remove cigarettes that have menthol as a characterizing flavor. As a result of litigation against FDA brought by the African American Tobacco Control Leadership Council, Action on Smoking and Health, the American Medical Association and the National Medical Association alleging “unreasonable delay” by the agency in addressing the specific issue of mentholated cigarettes, on April 29, 2021, FDA made a public commitment to issue, within one year, proposed rules prohibiting menthol as a characterizing flavor in cigarettes and prohibiting all characterizing flavors in cigars. [3] The undersigned groups are united in urging FDA to fulfill this commitment and issue these proposed rules without delay. This is the only decision consistent with the public health standard set out in the TCA, as well as the relevant science, as FDA itself repeatedly has recognized.

Menthol in cigarettes leads to greater initiation of smoking among youth, makes it harder to quit smoking and has a disproportionate adverse impact on the health of Black Americans. As directed by Congress in the TCA, the Tobacco Products Scientific Advisory Committee (TPSAC) issued a report in 2011 (TPSAC Report), with two primary conclusions: (1) “Menthol cigarettes have an adverse impact on public health in the United States,” and (2) “There are no public health benefits of menthol compared to non-menthol cigarettes.”[4] TPSAC made the following “overall recommendation” to FDA: “Removal of menthol cigarettes from the marketplace would benefit the public health in the United States.”[5]

Two years after issuance of the TPSAC Report, FDA completed its own independent, peer-review evaluation of the available science concerning menthol cigarettes. FDA’s Preliminary Scientific Evaluation of the Possible Public Health Effects of Menthol versus Nonmenthol Cigarettes reached the overall conclusion, consistent with TPSAC’s, that it is “likely that menthol cigarettes pose a public health risk above that seen with nonmenthol cigarettes.”[6]

FDA has never wavered in its conclusion that menthol cigarettes have an adverse impact on public health. Indeed, in November of 2018, then-Commissioner Scott Gottlieb announced the agency’s intention to “advance a Notice of Proposed Rulemaking that would seek to ban menthol in combustible tobacco products, including cigarettes and cigars. . . .,” after expressing his “deep concern” about “the availability of menthol-flavored cigarettes,” which “represent one of the most common and pernicious routes by which kids initiate on combustible cigarettes” and “exacerbate troubling disparities in health related to race and socioeconomic status.”[7]

These conclusions have been bolstered by recent comments filed in the FDA’s Citizen Petition Docket (FDA-2013-P-0435-0001) by a coalition of 68 public health, medical and community organizations; an extensive supplement to the Citizen Petition filed by the petitioners and other public health organizations; separate comments filed by the National Medical Association; comments filed by 46 scientific experts, led by Jonathan Samet, M.D., M.S. the first chair of TPSAC and its chair at the time of the TPSAC report; and comments filed by 23 state attorneys general.[8] As the chief law enforcement officers of their respective states, the attorneys general addressed the tobacco industry’s longstanding assertion that a menthol ban would lead to a burgeoning illicit market. They concluded that “[t]here is little reason to suggest that prohibiting menthol cigarettes will cause the emergence of an illicit market that will threaten the public health gains from prohibiting menthol cigarettes or that state and federal authorities will be unable to prevent the emergence of such illicit activity. The FDA should not be swayed by the tobacco industry’s doomsday predictions of an increase in illicit trade.”

Researchers recently quantified the population harms caused by menthol cigarettes between 1980 and 2018, finding that they were responsible for 10.1 million additional new smokers, 378,000 premature deaths and nearly 3 million life years lost. This amounts to nearly 10,000 premature deaths and over 265,000 new smokers each year over the 38-year period.[9] These findings illustrate the very real cost of FDA’s delays. Due to decades of targeting marketing directed at the Black community, menthol cigarettes have had a particularly pernicious impact on the health of Black Americans; over the same 38-year period, they have accounted for 41% of the premature deaths from menthol cigarettes (157,000 deaths), even though Black Americans constitute only 12% of the population.[10] This disproportionate impact has worsened already serious health disparities.

It is also imperative that FDA fulfill its commitment to issue a rule prohibiting characterizing flavors in cigars. Flavored cigars have proliferated in recent years and are sold in hundreds of kid-friendly flavors like chocolate, cherry dynamite and tropical twist.[11] As a result, cigars are now the second most popular tobacco product among high schoolers and are especially popular among Black youth.[12] Additionally, a new report on premium cigars from the National Academies of Sciences, Engineering, and Medicine concluded that adding flavors to premium cigars could result in greater appeal to nonusers and more frequent use, thereby increasing nicotine intake, addiction potential, and exposure to smoke constituents.[13] The FDA has previously concluded that “all cigars pose serious negative health risks” and that “all cigar use is harmful and potentially addictive.”[14] Indeed, each year about 9,000 Americans die prematurely from regular cigar use.[15] Issuance of both rules will maximize the public health impact and prevent the tobacco industry from selling cigarettes masquerading as cigars. Without a rule prohibiting characterizing flavors in cigars, menthol smokers may shift to using flavored cigars, undermining the public health impact of a menthol cigarette product standard.

If FDA is to adhere to its longstanding commitment to entirely science-based decision-making, it must adhere to its commitment to issue proposed rules by this April and move quickly to finalize a rule to prohibit menthol as a characterizing flavor in cigarettes and all characterizing flavors in cigars. Finally, FDA’s issuance of these rules should be the first step toward a broader set of product standards prohibiting all non-tobacco flavors in all tobacco products.

2022_04_22_Coalition-Letter-Menthol-Action [PDF]
[1] FDA, Advance Notice of Proposed Rulemaking, Regulation of Flavors in Tobacco Products, 83 Fed. Reg. 12,294-95 (March 21, 2018).[2] Bridget K. Ambrose, et al., Flavored Tobacco Product Use Among US Youth Aged 12-17 Years, 2013-2014, 314 J. Am. Med. Ass’n 17, 1871-3 (2015), https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6467270/.[3] FDA Press Release, “FDA Commits to Evidence-Based Actions Aimed at Saving Lives and Preventing Future Generations of Smokers,” (April 29, 2021) https://www.fda.gov/news-events/press-announcements/fda-commitsevidence-based-actions-aimed-saving-lives-and-preventing-future-generations-smokers[4] TPSAC, FDA, Menthol Cigarettes and Public Health: Review of the Scientific Evidence and Recommendations, 2011, https://wayback.archiveit.org/7993/20170405201731/https:/www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/T
obaccoProductsScientificAdvisoryCommittee/UCM269697.pdf (TPSAC Menthol Report).[5] Id. at 225.[6] FDA, Preliminary Scientific Evaluation of the Possible Public Health effects of Menthol versus Nonmenthol Cigarettes, 2013, https://www.fda.gov/media/86497/download (FDA Report).[7] FDA Statement, FDA Commissioner Scott Gottlieb, M.D. on proposed new steps to protect youth by prevention access to flavored tobacco products and banning menthol in cigarettes, Nov. 15, 2018, https://www.fda.gov/news-events/press-announcements/statement-fda-commissioner-scott-gottlieb-mdproposed-new-steps-protect-youth-preventing-access.[8] See comments filed in Tobacco Control Legal Consortium, et al – Citizen Petition, April 12, 2013, Docket ID: FDA-2013-P-0435, Prohibit Menthol as a Characterizing Flavoring of Cigarettes and Cigarette Smoke, https://www.regulations.gov/document?D=FDA-2013-P-0435-0001.[9] Le, TT, “An estimation of the harm of menthol cigarettes in the United States from 1980 to 2018,” Tobacco Control, published online February 25, 2021.[10] Mendez, D and Le, TT, “Consequences of a match made in hell: the harm caused by menthol smoking to the African American population over 1980-2018,” Tobacco Control, published online September 16, 2021.[11] Delnevo, CD, Giovenco, DP, & Miller, EJ, “Changes in the Mass-merchandise Cigar Market since the Tobacco Control Act,” Tobacco Regulatory Science, 3(2 Suppl 1):S8-S16, 2017.[12] Gentzke, A, et al., “Tobacco Product Use and Associated Factors Among Middle and High School Students—National Youth Tobacco Survey, United States, 2021,” MMWR 71(5): 1-29, March 10, 2022, https://www.cdc.gov/mmwr/volumes/71/ss/pdfs/ss7105a1-H.pdf[13] National Academies of Sciences, Engineering, and Medicine, Premium Cigars: Patterns of Use, Marketing, and Health Effects, Washington, DC: The National Academies Press, 2022, https://doi.org/10.17226/26421.[14] 81 Federal Register 29020, 29022 (May 10, 2016).[15] Nonnemaker, J, et al., “Mortality and Economic Costs from Regular Cigar use in the United States, 2010,” American Journal of Public Health 104(9):e-86-91, September 2014.

We write to urge you to respond to a new and growing threat to our nation’s youth: e-cigarette manufacturers’ use of synthetic nicotine to evade Food and Drug Administration (FDA) oversight. E-cigarette manufacturers, including the e-cigarette brand that is most popular with youth, are switching from using tobacco-derived nicotine in their products to synthetic nicotine in order to circumvent tobacco product regulations and to keep flavored e-cigarettes that are attracting and addicting youth on the market. We urge you to quickly address this serious public health situation by enacting legislation at the earliest possible opportunity that enables FDA’s Center for Tobacco Products to regulate synthetic nicotine products.

The Family Smoking Prevention and Tobacco Control Act gave FDA the authority to oversee tobacco products and defined a “tobacco product” as a product made or derived from tobacco. Manufacturers of synthetic nicotine and e-cigarettes that contain synthetic nicotine have suggested that their products are not subject to FDA regulation because synthetic nicotine is not derived from tobacco and, therefore, does not fall within the definition of “tobacco product.” FDA has acknowledged that an e-cigarette made with synthetic nicotine may fall outside of the definition of tobacco product and has indicated it intends to make these determinations on a case-by-case basis.

The repercussions of this situation have become alarming over the past year. In 2020, Puff Bar, a disposable e-cigarette product marketed with kid-appealing flavors, withdrew from the market after receiving a warning letter from FDA for being out of compliance with tobacco product requirements. But in 2021, it announced that it was re-entering the market as a synthetic nicotine product in the same kid-appealing flavors. This switch to synthetic nicotine was a blatant attempt to avoid FDA oversight and, so far, has been successful. Puff Bar e-cigarettes continue to be sold, and Puff Bar is the most popular e-cigarette brand among youth. According to the 2021 National Youth Tobacco Survey, 26.8 percent of middle and high school e-cigarette users report Puff Bar as their usual brand.

Other e-cigarette manufacturers are pursuing this same tactic. After FDA completed its premarket reviews of some e-cigarettes, including those with flavors that appeal to youth, and found that they did not meet statutory requirements for remaining on the market, there were reports that manufacturers were discussing reformulating their products with synthetic nicotine in order to try to stay on the market. If left unaddressed, there is every reason to expect manufacturers of thousands of other e-cigarettes to switch to synthetic nicotine to try to evade the public health protections that Congress intended when it required new tobacco products to undergo a premarket review by FDA. We are also likely to see growth in the number of other tobacco products using synthetic nicotine, such as nicotine pouch products.

Youth e-cigarette use is a serious public health problem. The 2021 Monitoring the Future survey, released in December, found that 19.6 percent of high school seniors reported that they vaped nicotine in the past month. While this is a decline since youth e-cigarette use peaked in 2019, it is nearly the same level as 2018 when the U.S. Surgeon General, FDA, and other public health authorities declared youth e-cigarette use to be a public health epidemic. Nicotine is addictive, whether it is derived from tobacco or made synthetically. The continued availability of unregulated synthetic nicotine products will make reducing high levels of youth e-cigarette use more difficult. A recent article in the New England Journal of Medicine warned that synthetic nicotine products “may threaten ongoing public health efforts to reduce e-cigarette use among adolescents and young adults” and argued that there “is an urgent need for the FDA to assert its regulatory authority over these products.”

Time is of the essence. Inaction will result in more manufacturers switching to synthetic nicotine, allow flavored e-cigarettes that have helped fuel the youth e-cigarette epidemic to remain on the market, and undercut efforts to protect kids from nicotine addiction and tobacco use. Further delay on synthetic nicotine will also enable other products made with synthetic nicotine to enter the market and evade FDA regulation. We urge you to prioritize the development of bipartisan, bicameral legislation that would give FDA’s Center for Tobacco Products the authority to regulate synthetic nicotine products as tobacco products and to quickly enact it into law.

Download the pdf:

Coalition Letter on Synthetic Nicotine 3.7.22

In 2009, Congress gave FDA authority over the manufacture, sale and marketing of all tobacco products because all tobacco products can cause serious adverse health effects. Using this authority, FDA published a final rule in 2016 that enabled the agency to begin to oversee cigars and all other tobacco products that it had not been regulating.

S. 438 would prohibit FDA from promulgating any public health protections related to what the cigar industry calls “traditional large and premium cigars,” despite the known health risks of cigar smoking. The bill defines this new category of cigar very broadly and opens the door for product manipulation to qualify for the exemption, which the industry has done before. It would specifically exempt from FDA oversight some machine-made cigars, including those that can cost as little as $1.00 to $2.00 each, and would not prohibit kid-friendly, flavored cigars from qualifying for an exemption. No cigars should be exempt from oversight, but especially not inexpensive and flavored cigars which appeal to youth and young adults.

The implications of the exemption would be far reaching. It would prevent FDA from including all cigars in a forthcoming proposed rule to prohibit flavored cigars and would exempt “traditional large and premium cigars” from a premarket review requirement that protects the public from new tobacco products that are not “appropriate for the protection of the public health.” Under this bill, even the most basic FDA requirements like ingredient disclosure and its youth access and marketing restrictions would not apply to “traditional large and premium cigars.”

If enacted, this legislation could undercut FDA’s ability to protect youth and young adults from the health consequences of cigar smoking. Cigar smoking is not limited to adults. Nearly one million youth reported current cigar use last year. The 2020 National Youth Tobacco Survey shows that cigars are the most popular tobacco product among Black high school students and the second most popular tobacco product after e-cigarettes among all high school students. FDA has found that, while youth and young adults tend to smoke mass market cigars, they also use premium cigars. Many youth are likely to be attracted to inexpensive, flavored cigars that could qualify as “traditional large and premium cigars” under this legislation.

Cigar smoke is composed of the same toxic and carcinogenic constituents found in cigarette smoke. According to the National Cancer Institute, cigar smoking causes cancer of the oral cavity, larynx, esophagus and lung, and cigar smokers are also at increased risk for an aortic aneurysm. Daily cigar smokers, particularly those who inhale, have an increased risk of heart disease and chronic obstructive pulmonary disease (COPD). Each year, about 9,000 Americans die prematurely from regular cigar use.

FDA should be permitted to continue to oversee all cigars. The science continues to support FDA’s conclusion in 2016 that there is no public health justification for exempting any cigars from FDA oversight because all cigars pose significant health risks. We are also concerned that the number of cigars exempted from FDA oversight would increase over time because S. 438 would create an incentive for cigar manufacturers to modify their products or change their manufacturing processes to qualify for the exemption.

Our organizations strongly urge you to protect public health and kids and reduce the health and economic burden of tobacco-caused disease by opposing S. 438.

Download the full pdfs:

Senate – Opposition to Traditional Cigar Manufacturing and Small Business Jobs Preservation Act 11.29.21

House – Opposition to Traditional Cigar Manufacturing and Small Business Jobs Preservation Act 11.29.21

We are writing to express our strong support for S. 1314, the Tobacco Tax Equity Act of 2021, which would increase the federal excise tax on cigarettes and set federal tax rates for other tobacco products at an equivalent level. This legislation would generate substantial benefits to public health by helping prevent young people from starting to use tobacco products and helping current users to quit. At the same time, it would increase federal revenues, including by closing existing tax loopholes that have created incentives for tax avoidance.

Our organizations strongly support increasing and equalizing tobacco taxes. The evidence is clear that raising tobacco prices, including through higher taxes, is one of the most effective ways to reduce tobacco use, especially among youth, who are more sensitive to changes in price than adults. Decades of economic studies and Surgeon General reports show that significantly increasing the prices of tobacco products can reduce and prevent youth use of tobacco products. We estimate that the bill’s doubling of the federal cigarette tax would reduce the number of adult smokers by 1.1 million in the first year and would, over time, avoid 250,000 smoking-related premature deaths. It would also prevent 507,000 kids alive today from becoming smokers, which would further reduce smoking-related disease and premature death.

Increasing tobacco taxes will also help reduce health disparities. Americans with lower levels of education and income disproportionately experience the substantial health and financial burdens of smoking. The U.S. Centers for Disease Control and Prevention, the Task Force on Community Preventive Services, the World Health Organization, and other health experts recognize that these individuals will be more likely to quit due to a tobacco tax increase. Nearly half of the lives saved due to smoking reductions from the most recent federal tobacco tax increase in 2009 will be among those below the poverty line.

The federal tobacco tax code has not kept up with the latest generation of tobacco products on the market. E-cigarettes, which are currently not taxed at the federal level, are by far the most popular tobacco product among youth, and the U.S. Surgeon General and the Food and Drug Administration have called youth use of e-cigarettes an “epidemic.” In 2020, 3.6 million middle and high school students were currently using e-cigarettes, including 19.6 percent of high school students. In 2018, the Surgeon General called for “aggressive steps to protect our children from these highly potent products that risk exposing a new generation of young people to nicotine.” The federal tax on e-cigarettes that your bill would establish is a long overdue response to the youth e-cigarette epidemic.

Furthermore, the current federal tobacco tax code contains loopholes that have created incentives for tax avoidance. The Government Accountability Office (GAO) has highlighted how certain manufacturers have avoided paying higher taxes on roll-your-own tobacco by re-labeling the product as “pipe” tobacco, which is taxed at substantially lower rates under the current tax code. The GAO also noted that some manufacturers have avoided the higher tax rates for cigarettes and small cigars by slightly modifying their products to qualify as large cigars. The GAO estimates that federal revenues lost as a result of these two loopholes ranged from $2.6 billion to $3.7 billion from April 2009 through February 2014. By equalizing tax rates for all tobacco products, your bill would eliminate existing tax loopholes and generate additional revenue.

Federal tobacco tax rates have not increased in more than a decade, and the tobacco product landscape has changed significantly during this time. It is long past time that we implement this evidence-based policy again to reduce tobacco use and save lives. We applaud the introduction of this bill and appreciate your support for reducing tobacco’s terrible toll on our nation’s health.

Download the Tobacco Tax Equity Act Coalition Letter (PDF)