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Tobacco Use in the U.S.: A Call for Action Against Flavored Products

by Kaia

Nearly 20 years ago, when I started medical school, tobacco use in the U.S. was declining, particularly among young people. I hoped that by the time I completed my cardiology training, I would see fewer patients suffering from heart disease linked to tobacco and nicotine addiction.

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Nicotine is a harmful and highly addictive substance that damages the heart and other vital organs. It raises blood pressure and heart rate and narrows arteries. These effects can lead to heart attacks.

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Menthol flavoring in cigarettes enhances their appeal. For decades, cigarette manufacturers have added menthol to mask the harshness of smoke. This makes cigarettes easier to smoke for beginners and can increase nicotine addiction. The cooling sensation allows users to inhale more deeply, delivering more nicotine to their bloodstream and brain.

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Although cigarette smoking is still declining, the rise of e-cigarettes since the mid-2010s has created a concerning trend. E-cigarettes, often available in kid-friendly flavors, have taken over shelf space once dominated by traditional cigarettes. This has reversed the decline in tobacco use, as a new generation becomes addicted to nicotine.

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Flavored tobacco products are not harmless; they are intentional tools that make it easier for young people to start using and becoming addicted to nicotine. These products also complicate efforts for current users to quit.

This issue significantly affects communities of color and marginalized groups. Tobacco companies have historically marketed menthol cigarettes aggressively to Black communities. They offer discounts, advertise in easily visible locations, and sponsor community events, such as jazz festivals. As a result, about 85% of Black smokers choose menthol cigarettes.

Similar tactics target the LGBTQ+ community. Tobacco companies sponsor pride events and keep prices low in areas frequented by these individuals.

To combat the public health crises of tobacco use and nicotine addiction, we must work to reduce and ultimately eliminate menthol cigarettes and all flavored tobacco products. This action is crucial for preventing the next generation from becoming addicted and for addressing the inequalities that have led to addiction and premature deaths in specific communities.

Arizona lawmakers must implement tobacco control policies to prevent children from accessing flavored tobacco products. These products are specifically designed to attract and hook young users.

As a member of the American Heart Association-Arizona board of directors, I am proud to support our ongoing efforts to improve public health. Thanks to a grant from the Centers for Disease Control and Prevention (CDC), the American Heart Association is working to educate the public on how we can collectively reduce the use of harmful tobacco products in Maricopa County and beyond.

Everyone has a role in protecting our children and communities. Together, we can create a healthier future by supporting efforts to reduce the use of flavored tobacco products, including menthol, and by promoting broader public health initiatives that benefit all residents of Maricopa County.

Rachel M. Bond, MD, is a member of the American Heart Association Greater Phoenix board of directors and a national spokesperson for the “Go Red for Women” campaign. She serves as the system director of Women’s Heart Health at Dignity Health in Chandler, Arizona.

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