Targeted Advertising and Adverse Outcomes: A Case Study of Menthol Cigarettes

Tobacco, but primarily cigarettes, remains the leading cause of preventable disease in the US, claiming 480,000 lives per year and affecting an additional 16 million smokers who suffer from smoking-related chronic diseases.1 Tobacco control efforts have resulted in an overall decline in cigarette smoking, but combustible cigarettes remain the largest cause of preventable death and disease in the United States (US).1,2 The overall decline in cigarette smoking masks the prevalence of menthol cigarette smoking, which has not decreased, and has either remained stable or increased in certain sociodemographic groups.3–7 In the US, menthol cigarettes are disproportionally used by certain segments of the population1,8. The historic failure to ban menthol in cigarettes has been considered, by some, to be a social justice issue.4,9–11 Advertising for menthol cigarettes has been targeted at minority, youth, women, LGBTQ, communities of color, particularly, Black, Hispanic, and other disadvantaged populations including low income and people with mental health issues resulting in higher percentages of use among these groups.3,5,8,12–20 Black communities, have much higher menthol cigarette usage rates.4,13,21,22 Of Black people that smoke, over 86% smoke menthol cigarettes as compared to 30% of whites who smoke and use menthol cigarettes.13,21,22 The disparate use of menthol cigarettes by smokers of different gender, race, or ethnicity is thought to contribute, at least, partly to the uneven distribution of…