Ahead of decisions by the U.S. Food & Drug Administration (FDA) that could ban menthol cigarettes and flavored cigars, Stanford University and the American Heart Association released a study that tracked decades of predatory marketing efforts from cigarette companies and found that they are still targeting young people, Black people and women. 

Dr. Robert Jackler, a co-author of the study, said the goal of the analysis was to provide the strongest possible evidence of not only the historic, but ongoing practices the companies engage in when marketing menthol cigarettes.

“It would be a big mistake to think, ‘My gosh, they were very irresponsible back then in the 1950s or the 1970s,’ because they are in fact doing the same kinds of messaging today,” Jackler said. 

Advocates for the bans say they would decrease tobacco-related health disparities and curb youth smoking. Critics say the ban will be detrimental for small business tobacco retailers and farmers and will push the sale of menthol products to unregulated, illegal markets.

Menthol, a substance found in mint plants, naturally relieves pain and creates a cooling sensation, lessening the harshness of the smoke. When added to cigarettes, the chemical makes them easier to smoke and harder to quit. 

Though menthol products make up 37 percent of the market, 85 percent of Black smokers and 90 percent of Black teen smokers use menthol products. More than half of teen smokers are introduced to smoking via menthol products. According to the study, 44 percent of women who smoke use menthol, compared with 35 percent of men. Gender-nonconforming people, people with low income and people with mental health conditions are also more likely to use menthol cigarettes. The long-term health effects are noticeable: A study at the University of Michigan in 2021 found that Black people, though they made up about 12 percent of the population of the United States, accounted for 41 percent of smoking-related premature deaths.  

According to experts, that’s no coincidence.

“The growing popularity of menthol cigarettes did not evolve organically driven solely by evolving consumer preferences. Rather, growth among Black people and youthful starter smokers was purposefully engineered by decades of advertising campaigns designed to target these market segments,” the Stanford study read. 

The study presents hundreds of examples of targeted ads since menthol was introduced in the 1920s. The ads presented in the study target three groups: Black people, youth and women.

Internal marketing studies focused on Black consumers referred to them as poverty markets. Market reports for R.J. Reynolds Tobacco Company described Black consumers as having “a greater ‘sense of powerlessness’ in their lives than the general market counterparts due to the country’s economic condition which impacts them more directly because of lower educational levels resulting in reduced financial and social influence.”

Ads targeting young people were intended to attract them as long-term customers, distributing samples around spring break spots and using language such as “fresh” and “cool.” 

“Industry is always trying to find another market for their products. They have to replace their old customers because they die sooner than other people,” said Dr. Rose Marie Robertson, chief science officer of the American Heart Association. 

As social norms changed, the companies also began to target women, attaching themselves to the emerging idea of the independent woman. They began to use themes that appealed to women’s senses of beauty and fashion through supermodels and clothing brands, and the desire to be thin with brands like Virginia Slims. 

Menthol was key in targeting each of these groups.

Julia Osagie, a Black woman, was about 14 years old when the effects of menthol cigarettes touched her life. Her uncle, who had been a smoker for as long as she remembered, died after suffering with heart disease and chronic obstructive pulmonary disease. Both health issues could be tied back to smoking. 

Before he died, he told Osagie that he’d gotten started smoking menthol cigarettes because of deceptive marketing that said they would relieve his asthma. After her uncle’s death, Osagie went on to do work around tobacco control. She became a fellow with the Truth Initiative, a nonprofit group dedicated to eradicating tobacco usage, and helped to develop a tobacco-free campus policy at Howard University.

Deceptive advertising hooked Osagie’s uncle, she said, and the study points out that it still persists. In current advertisements, tobacco companies participate in what the Stanford researchers described as “greenwashing,” portraying products as healthier, plant-based or organic. 

“When things make money, integrity just flew out of the window for that industry. They really hooked an entire generation, generations, on deeply harmful and seriously addictive products,” Osagie said. 

The FDA in April announced its proposals to ban menthol cigarettes and flavored cigars. It is the latest round of scrutiny for the tobacco industry. President Richard Nixon signed a ban in 1970 on television ads for cigarettes. In 2009, the Family Smoking Prevention and Tobacco Control Act introduced a plethora of regulations, including a ban on the sale of flavored cigarettes, with the exception of menthol and tobacco. 

Even as lawmakers have cracked down on some of the tobacco industry’s practices, it has evolved its pushing of menthol products, constantly finding ways to circumvent regulations by creating new product offerings and using multifaceted marketing strategies. 

Tobacco companies infiltrated Black neighborhoods through billboards and giveaways at events, funded Black organizations like the NAACP and the Rev. Al Sharpton’s National Action Network, sponsored music festivals and donated money to the Congressional Black Caucus. 

They created post-market additives including flavor sprays, capsules, and infusion cards that allow people to continue adding flavors. 

“The fact that they have so many different kinds of menthol cigarettes, different names, different by their description, appealing to different groups or different people, makes the point by itself that menthol is really essential to their keeping people addicted and buying cigarettes despite the great efforts of public health to educate the public about why it’s so important to quit,” Robertson said. 

California and Massachusetts have adopted legislation prohibiting the sale of flavored products, including menthol. The tobacco industry fought back in California, and the state will vote next month on a referendum requiring a majority public vote to uphold the law.

The FDA is reviewing nearly 250,000 public comments on its proposed bans.