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WASHINGTON -- A group of anti-tobacco activists and their supporters held a "menthol funeral" here Thursday, demanding that the Biden administration release a long-delayed final rule banning the sale of menthol cigarettes and other menthol-flavored tobacco products.

"Let us bury menthol cigarettes; enough is enough," said Rev. Horace Sheffield, CEO of the Detroit Association of Black Organizations, during a rally in Lafayette Park across from the White House. The rally, which was organized by the African American Tobacco Control Leadership Council (AATCLC) was preceded by a funeral procession beginning at Black Lives Matter Plaza that featured a casket designed to look like a giant cigarette package. A New Orleans-style jazz band played as the procession marched down 16th Street to the park.

All of the speakers focused on the role menthol cigarettes play in the lives of Black smokers, of which 80% smoke menthol cigarettes. "Any further delay continues to benefit industry at the expense of Black lives," said John Bowman, executive vice president for U.S. programs at the Campaign for Tobacco-Free Kids. The delay in issuing the final rule, the first version of which was released 12 years ago, "has cost more than 200,000 lives since 2011," Brown said.

Rule Delayed Several Times

The Biden administration has delayed the final rule several times recently, saying it would be published in August 2023, then pushing that date back to the end of the year, and most recently saying it will be published in March.

When asked about the delays, an FDA spokesperson said in an email that the agency "remains committed to issuing the tobacco product standards for menthol in cigarettes and characterizing flavors in cigars as expeditiously as possible; these rules have been submitted to OMB [the Office of Management and Budget] for review, which is the final step in the rulemaking process. As we've made clear, these product standards remain at the top of our priorities."

"Regulations such as product standards go through an extensive rulemaking process, which includes interagency review," the spokesperson said. "At this stage in rulemaking, the FDA is limited from further discussions about the rules before they are published."

Kirsten John Foy, president and CEO of The Arc of Justice, a human rights organization in Brooklyn, New York, discussed the long history of Blacks and tobacco in the U.S. "In 1607, slave ships arrived and set up tobacco plantations in Virginia," he said. "We came in physical bondage; 400 years later we're chained in biochemical bondage."

Pushback Against Idea of Discrimination

Speakers at the rally pushed back against comments by prominent Black figures such as Rev. Al Sharpton, that banning menthol cigarettes was a form of discrimination against Black people. "Rev. Al can also be wrong too, and I'll let him be wrong on that issue," Rev. Jesse Brown, a pastor at Christ Lutheran Church in Philadelphia, told MedPage Today.

"The real issue is saving lives, making sure that our young people are not being targeted by the industry, making sure that we eliminate as many possibilities for families to get cancer and individuals to get cancer," continued Brown, who is also the former executive director of the National Association of African Americans for Positive Imagery. "That's our goal; that's always the goal. We've got to stop this industry from targeting people -- Black, white, green, purple, young or old for that matter, for their product is destructive to the lives of many, many families in America."

In fact, said AATCLC Co-Chair Phillip Gardiner, the discrimination has gone the other way -- in 2009, the government banned 13 flavors of tobacco products from the marketplace, but left only one -- menthol -- on the market.

Advocates also dismissed the idea that banning menthol cigarettes from the market would result in increased police harassment of Black people -- in particular, Black smokers. Policies such as the one being considered by the Biden administration "uniformly do not penalize the purchase, the use, or the possession of these products," Kevin O'Flaherty, Northeastern Region director of the Campaign for Tobacco-Free Kids, told MedPage Today in an interview. "So you could smoke menthol cigarettes in front of the police station, and you're not breaking the law. The only people who would be breaking laws are the retailers who would have sold that product."

In Massachusetts, for example, which banned sales of all flavored tobacco products -- including menthol -- in 2020, no such problem has emerged, he said. Instead, "it's working extraordinarily well. Smoking rates have gone down among adults and youth, both in menthol- and non-menthol-flavored cigarettes."

Helping With the Cancer Moonshot

Speakers at the rally also noted that getting rid of menthol cigarettes would help meet the goals of President Biden's Cancer Moonshot. "The Biden administration has repeatedly stated that smoking causes 30% of all cancer deaths in the U.S. ... The administration has a bold goal to cut [the U.S.] cancer rate by half in the next 25 years. Prohibiting menthol cigarettes is critical to meeting this goal," said Bowman. He noted that he had lost three people very close to him as a result of their smoking menthols.

Another possible reason given for the delay in issuing the final rule is that the Biden campaign may be afraid that issuing the rule could alienate Black voters at a time when Biden is seeking reelection. But that idea could backfire, warned Michael Emanuel Smith, a Detroit resident who came to Washington for the rally. "I recently turned 18 and will be voting for the first time," he said. "I will be waiting to see if [the president] will stand up to make me free of menthol."

In not banning menthol, the U.S. is lagging behind other countries, said Chris Bostic, policy director at Action on Smoking and Health in Washington. "Governments have a duty to protect people's right to health," he said. "Other governments have banned menthol, led by the European Union and Canada." Bostic noted that his organization joined with AATCLC to sue the FDA in 2020 over its failure to publish a proposed rule on the ban.

"The tobacco industry earns about $6,000 for every life they take," he said. "Worse, the tobacco industry has spent 70 years and untold amounts of money targeting particular communities in its never-ending mission to replace its dead customers, and no community has been targeted more than African Americans. That is immoral and unjustifiable ... This should also be illegal."

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