When I was in medical school and it came time to choose a specialty, I found myself asking; what is the biggest, baddest actor in the body and how can I work through patient care and research to limit its influence and foster healing? It’s no surprise that such motivations led me to cancer research and specifically oncology—where I remain, serving residents of New York City dealing namely with lung cancer; the formidable cancer type causing the most cancer deaths, in fact more than breast, colon and prostate cancer combined.
In my 30 years as an oncologist, I’ve come to learn that there are big, bad actors outside of the body that contribute to the prevalence of cancer. For many of my patients, tobacco—the substance and the industry—is the clear cause and main driver of their disease as 90% of all lung cancers are directly caused by tobacco smoke. My patients come from predominantly Black communities across the city where menthol cigarettes receive heavy marketing and contribute to addiction and cancer incidence.
New York City has the opportunity to make a dent in Big Tobacco’s influence by ending the sale of menthol cigarettes across the five boroughs. It’s time the City Council stood up to the bad actor in Big Tobacco that contributes to countless cancer-related deaths a year, in our city alone.
Menthol cigarettes, along with the countless other flavored tobacco products on the market, are designed to improve the ease of tobacco-use. Big Tobacco’s marketing practices around menthol cigarettes advertise as much, claiming a smoother, healthier option. But, in reality, menthol cigarettes mask the harsh effects of tobacco, facilitating nicotine uptake and increasing the product’s overall appeal. Reports show that adults who smoke menthol cigarettes make more attempts to quit but have less success compared to adults who smoke non-menthol cigarettes. Despite data to indicate its harm, menthol cigarettes are still widely accessible and heavily advertised. I have lost far too many patients at too young of an age to smoking-related disease. I applaud Rita Joseph and the 18 co-sponsors of Intro 577 for prioritizing legislation to reverse such harmful trends, especially for Black and LGBTQ+ community members.
From 1980 to 2018, menthol cigarettes were responsible for 10.1 million more people smoking, 3 million life-years lost and 378,000 premature deaths. Due to Big Tobacco’s targeting of Black communities through advertising, price promotions and more, a disproportionate amount of the deaths attributed to menthol cigarettes were those of Black individuals, many of whom lived in urban communities like our own. Nearly 83.1% of African Americans who smoke use menthol cigarettes, compared to 31.6% of whites who do the same. These troubling trends extend to other subpopulations, including the LGBTQ+ community. For example, over half (54.5%) of lesbian or gay adults who smoke use menthol cigarettes, a higher rate than straight adults who smoke.
These disparities in the use of menthol cigarettes are no accident. My patients, your neighbors were targeted to purchase, use and become addicted to menthol. Upholding the sale of menthol cigarettes in New York City will only contribute to and compound on existing health disparities among people of color and queer individuals. With Black people maintaining the highest death rate and shortest survival rate of any racial or ethnic group in the U.S. for most cancers, we cannot afford to wait. Current practices, if sustained, will continue to affect the physical health of those who smoke menthol cigarettes, the mental health of those that love them and the hope of the community that yearns for change.
I do my part every day to treat people suffering from smoking-related cancer, but many times to no avail despite advances in care. I need Lynn Schulman, in her capacity as the Chair of the Health Committee, to do her part to prevent more New Yorkers from getting hooked on menthol by scheduling a Committee hearing and presenting Intro 577 for the Council’s consideration. Doing so will get New York City one step closer to rooting out one of our city’s biggest, baddest actors. Countless lives depend on it. Your relative, friend, colleague could be one of them.
Balazs Halmos, MD, is the Director of the Multidisciplinary Thoracic Oncology Program, Director of the Section of Thoracic Medical Oncology for Montefiore Health Systems and an ACS CAN volunteer.
