BU doctor blasts FDA panel on menthol cigarette report

Dr. Michael Siegel, professor of community health sciences at the Boston University School of Public Health, thinks a report issued by a tobacco advisory panel to the Food and Drug Administration in March is, in a word, bogus. Siegel wrote in a New England Journal of Medicine Perspectives piece published online tonight that the report was “a lost opportunity” and “a disappointing setback.”

The panel issued a report in March that said banning menthol additives in cigarettes would benefit public health. It found that the cigarettes, which make up about 30 percent of the US cigarette market and are the only category exempted from a ban on flavored tobacco, make smoking more appealing to young people and more difficult to quit.

Because the panel did not explicitly recommend a ban, however, stock prices for manufacturers soared after the report’s release and the panel came under criticism from public health advocates.

Siegel said the Tobacco Products Scientific Advisory Committee basically took the industry argument that banning menthol cigarettes would create a black market. “Far from issuing a call for a ban on menthol cigarettes, then, the advisory committee has punted the issue back to the FDA,” he wrote.

He went on to say that group not only failed to push the FDA to action but it provided an avenue for further delay by recommending study of potential black-market effects:

At the end of the day, it is difficult to understand the rationale for a policy that bans every other type of cigarette flavoring — including chocolate, strawberry, banana, pineapple, cherry, and kiwi — yet exempts the one flavoring that is actually used extensively by tobacco companies to recruit and maintain smokers, a finding that has been documented extensively by the TPSAC itself. Ironically, it is because removing menthol would actually improve the public’s health by reducing the consumption of cigarettes that we are not going to see such an action from the federal government. There is no political risk in banning chocolate and strawberry cigarettes, since no companies are currently selling such products and they play no role in smoking initiation. Menthol, however, is a major contributor to smoking initiation and continued addiction, and for this reason, it will continue to enjoy the protection of a federal government that seems afraid to alienate any corporation, whether it’s part of Big Pharma, Big Insurance, or Big Tobacco.

Dr. Jonathan M. Samet, chairman of the advisory committee, and member Dr. Neal L. Benowitz issued a somewhat tepid opinion of their own in the journal. The doctors recounted the panel’s findings and said the committee fulfilled its duty:

The TPSAC report answered the committee’s charge of assessing the public health impact of menthol cigarettes and offers a foundation for future action by the FDA, which holds regulatory authority. The TPSAC, a scientific advisory committee, was not charged with addressing regulatory options and did not have the time or expertise to analyze regulatory scenarios including any involving inadvertently opening a door for the introduction of contraband menthol cigarettes into the U.S. market. The committee issued a clear message that menthol in cigarettes poses a significant public health risk. Now, the TPSAC stands prepared to respond to FDA questions on additional scientific issues that may arise as the agency does its regulatory job.

By Chelsea Conaboy

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