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By Bechara Choucair, MD, Senior Vice President, Chief Health Officer
In our continued fight to achieve a tobacco-free nation and prevent nearly half a million tobacco-related deaths each year, Kaiser Permanente unequivocally supports removing all flavored tobacco products from the market, including menthol cigarettes and flavored e-cigarettes.
Despite decades of regulation, tobacco companies continue to find new ways of addicting generations — including using flavored tobacco and e-cigarettes to lure younger users — which can lead to a lifetime of tobacco-related health issues.
Both sides — tobacco companies and the public health community — know that the younger people are when they start using nicotine, the more likely they are to become addicted.
The health risks of flavored tobacco
Make no mistake: Flavors are hooking kids.
Flavored e-cigarettes are often packaged to look like candy with the same flavor. Flavored cigarillos like Swisher Sweets are even cheaper than candy. Sweet flavors entice young people, and strong doses of nicotine addict them — potentially for life. Many kids using flavored e-cigarettes are unaware they’re using nicotine.
There are immediate health effects that cannot be overlooked. Nicotine in any form can harm adolescent brain development, which impacts attention, memory, and learning. Many flavors in e-cigarettes, which remain largely unregulated by the U.S. Food and Drug Administration, have been found to be toxic and can expose users to carcinogenic chemicals such as formaldehyde and lead.
Once addicted, flavors help to tighten tobacco’s grip on the individual. This is especially true for menthol products, which tobacco companies have used to target African American communities since the 1950s.
Let’s end flavored products
Continuing a long tradition of collaboration on public policy to prevent tobacco-related disease, health care leaders are working together with public health officials and prevention organizations to respond to these threats. During the past few years, 10 states and hundreds of localities have taken action against flavored tobacco through rulemaking and laws banning all flavors.
The FDA is currently considering a new rule to ban menthol in cigarettes and all flavors in cigars. Kaiser Permanente supports the FDA in its efforts. We strongly encourage the agency to issue a policy with robust tracking and enforcement as soon as possible. We also support rigorous enforcement at the state and local level of the Tobacco 21 law, which raised the age to purchase nicotine to 21.
California’s Proposition 31 is another action Kaiser Permanente supports. The California bill banning all flavored tobacco products was passed by the legislature and signed by Gov. Gavin Newsom in 2020. It hasn’t gone into effect because the tobacco industry collected enough signatures to force a referendum challenging the law, requiring the voters to determine its fate.
California has aggressively passed measures to prevent tobacco use and recover tobacco-related health care costs from tobacco companies. This gives me confidence that in November, when Proposition 31 appears on the ballot, voters will vote yes to affirm the decision of their elected officials to remove these products from store shelves and make California the second state in the country after Massachusetts to ban all flavored tobacco products.
It is critical that state and federal policymakers maintain the momentum we are building despite the expected storm of disruption and opposition from the tobacco industry. Kaiser Permanente is committed to being a strong voice in advocating for laws at all levels of government that will protect our youth from these products.
Twenty-five years ago, we succeeded in removing Joe Camel — the cigarette-promoting cartoon character highly recognized by children — from the market. Today, we must rise to the occasion again to protect our kids and help secure a healthier future for all.