Cleveland’s proposed menthol ban: adding barriers to smoking will work

Depending on who you ask, anywhere from about one in four to one in three Clevelanders are smokers. This ranks Cleveland as one of the unhealthiest cities in the United States by percentage of residents who smoke. For context, theoretically, you are more likely to randomly meet a Clevelander who smokes than you are to meet a Clevelander who owns a cat, or who drives an electric car or who has a tattoo.  And while I have no insight into the statistical likelihood of running into someone with all three of these characteristics, this tattooed, hybrid car driving cat-owning Clevelander is happy to announce that they are no longer dependent on smoking nor nicotine.

Anywhere from about one in four to one in three Clevelanders are smokers.

When I heard about legislation proposed this month by Cleveland’s department of public health to ban the sale of all flavored tobacco and vaping products, as well as menthol cigarettes within the city, I immediately saw the merit in this legislation from my lived experience.

I started smoking when I was fourteen, and while I was never a traditionally “heavy” smoker, I was certainly a committed one. While I was always able to find gas stations that had no problem selling to me while I was under age, the expensive cost of cigarettes was always a barrier. When I left Baltimore to came to Ohio for college, the cheap tobacco prices were particularly exciting for a coastal native like myself. But despite multiple efforts to kick the habit after college, I just couldn’t stop. It wasn’t until I made the very expensive switch to vaping in 2018—and then panicked switched to nicotine cessation mints in 2020 when the verdict was still out on the dangers of Covid-19 and smoking—that I ever stood a chance of quitting entirely. Maintaining the habit was remarkably easy and accessible once I moved to Ohio. Quitting was complicated and expensive.

I have to acknowledge my privilege throughout the quitting experience. I could afford to switch from cigarettes to vaping, a costly process that involved navigating mail subscriptions (which was substantially cheaper than buying them at my local gas station). I had access to a primary care physician who was willing to code my cessation efforts so that my Flexible Spending Account (FSA) account would cover the costs of my Costco-Brand nicotine mints. And I have a workplace with such supportive Health Savings Account (HSA) benefits, that I hadn’t paid for cessation products in nearly two years before quitting. Few smokers trying to quit will ever be this privileged and well-resourced, and I still feel like it’s a miracle I’ve made it to this point.

But do you know what I never had to contend with? Big tobacco companies specifically targeting me and my neighborhood to get me to start, and keep me smoking. My former colleague Hope Lane wrote passionately about how big tobacco “conspired to addict Black and low-income communities to nicotine using higher amounts of menthol flavor to help cigarettes taste less harsh and seem more appealing to new smokers and young people.” This was accomplished through targeted and aggressive marketing campaigns using elements of Black culture.

Another colleague, Natasha Takyi-Micah, expertly detailed how despite smoking fewer cigarettes than white Americans, Black Americans are less likely to be successful at quitting, in part because of this deliberate and disproportionate marketing. It should be no surprise to learn then that Black people are more likely to die from smoking related-illnesses than white people as well.

Despite smoking fewer cigarettes than white Americans, Black Americans are less likely to be successful at quitting.

This disparity is disgusting and engineered for profit. Reverend Zachery Williams PhD, the policy director at the north East Ohio Black Health Coalition, said this about Cleveland’s proposed ban on menthol and other flavored tobacco products: “Ending the sale of mentholated cigarettes and other flavored products that damage the health and well-being of African Americans, and the historical targeting of the black community must be a matter of local priority and regional necessity.” The tobacco industry has admitted to engaging in these behaviors; using aggressive marketing of flavored tobacco to target young people, Black, and LGBTQ+ communities.

The City of Cleveland Director of Public Health, Dr. Margolius, believes this proposed ban could save thousands of lives, and dramatically increase the life expectancy of Clevelanders. It would also put Cleveland in line with The City of Columbus, New York, New Jersey, California, and Canada, all of which have already passed similar legislation. The Center for Community Solutions supports this effort and urges Cleveland City Council to approve this legislation.

A common retort to this proposed legislation is that it won’t amount to much since menthol smokers will be able to just travel outside of the city to purchase their cigarettes. Obviously, that will be the case. But you know what made me stop vaping so much JUUL? They discontinued Mango, objectively the best flavor, in response to FDA plans to outlaw flavored vape cartridges. That helped me switch over to using nicotine cessation mints, the next step in my quitting process AND way more than I’d like to admit—I just hated the “tobacco” and “menthol” flavors. Added barriers to smoking can work.