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Tobacco Control

ACS CAN supports a comprehensive approach to reducing tobacco use and exposure to secondhand smoke, including increasing taxes on all tobacco products, implementing comprehensive smoke-free laws, fully funding and sustaining evidence-based, statewide tobacco control programs, ensuring access to clinical cessation services and working with the Food and Drug Administration to regulate tobacco products and their marketing.

Tobacco Control Resources:

High rates of menthol cigarette use is the result of deliberate actions by the tobacco industry to target certain populations. Decades of tobacco industry documents show how the tobacco industry targeted Black Americans, as well as LGBTQ+ and low-income communities with menthol cigarettes.

Cigars are tobacco wrapped in tobacco leaf or wrapped in a substance containing tobacco leaf. They can come in all shapes and sizes. One study found that the sales of cigarillos - which comprise most cigar sales - increased from 2016 to 2020 while their prices decreased. Lower prices can make tobacco products more attractive to youth because they are price sensitive. The study also found a significant increase in the sales of certain flavored cigarillos and large cigars.

Among adults who currently smoke cigars, those who used flavored products were more likely to be non-Hispanic Black individuals, younger, and have lower household incomes.

Flavors are a marketing ploy tobacco manufacturers use to target youth and young people to a lifetime of addiction. Adding flavors can improve the ease of use of a product by masking harsh effects, facilitating nicotine uptake, and increasing a product’s overall appeal.

This factsheet provides an overview of key activities by the FDA on menthol cigarettes and flavored cigars.

We write to urge you to respond to a new and growing threat to our nation’s youth: e-cigarette manufacturers’ use of synthetic nicotine to evade Food and Drug Administration (FDA) oversight. E-cigarette manufacturers, including the e-cigarette brand that is most popular with youth, are switching from using tobacco-derived nicotine in their products to synthetic nicotine in order to circumvent tobacco product regulations and to keep flavored e-cigarettes that are attracting and addicting youth on the market. We urge you to quickly address this serious public health situation by enacting legislation at the earliest possible opportunity that enables FDA’s Center for Tobacco Products to regulate synthetic nicotine products.

Whether Puff Bar is under the jurisdiction of the Center for Drug Evaluation and Research
(CDER) as a drug or the Center for Tobacco Products (CTP) as a tobacco product, it is critical that
FDA take action and not permit this company and this product to escape regulatory oversight.
Puff Bar has neither been approved as a drug nor received a premarket tobacco product order.
The agency should not allow any perceived regulatory “gap” to enable this company or any
other company to market new addictive nicotine products without going through the legally
required FDA review by either CDER or CTP.

Because JUUL’s products continue to have the largest share of the e-cigarette market, and therefore presumably are undergoing expedited review, we write at this time to express our conclusion that based on all of the publicly available evidence, no JUUL product currently on the market can meet the statutory public health standard. Therefore, they should not receive a marketing order.

The undersigned organizations submit this citizen petition supplement to update the administrative record for this citizen petition with the most recent information on the impact of menthol in cigarettes.

Regulation and Products Resources:

Implementation of graphic warnings in the U.S. has been thwarted by tobacco industry legal challenges. The American Cancer Society (ACS) and the American Cancer Society Cancer Action Network (ACS CAN), along with our partners, have fought back in the judicial system, using litigation to both compel the U.S. Food and Drug Administration (FDA) to issue graphic warning regulations and help the U.S. Department of Justice (DOJ) defend the regulations finalized by FDA.

Tobacco use has been found to be one of the primary drivers of cancer-related health disparities because its use disproportionately impacts people based on race, ethnicity, sexual orientation, gender identity, disability status, mental health, income level, education level, and geographic location. Achieving health equity relies heavily on eliminating tobacco use. ACS CAN is pursuing fact-based tobacco control policies at the local, state and federal levels that aim to reduce disparities and improve health outcomes for everyone.

ACS CAN and 77 leading public health organizations urged the U.S. Food and Drug Administration (FDA), and its enforcement partners at the U.S. Department of Justice (DOJ) and the U.S. Customs and Border Protection (CBP), to use all the enforcement tools at their disposal against manufacturers, distributors, wholesalers and retailers to clear the market of unauthorized e-cigarette products, including flavored products that put young people at risk for nicotine addiction and other significant health harms.

All tobacco products, including heated tobacco products, are unsafe. Heated tobacco products involve heating rather than burning the tobacco leaf, which is why the tobacco industry refers to them as “heat-not-burn” or non-combustible cigarettes. These products differ from e-cigarettes which heat a liquid.

Increasing tobacco excise taxes is one of the best ways to reduce overall tobacco use. It is important that when considering an excise tax increase on any tobacco product, including e-cigarettes, that the tax should be increased on all tobacco products at an equivalent rate to encourage people to quit rather than switch to a cheaper product, and prevent youth from starting to use any tobacco product.

 

ACS CAN calls on the administration to finalize FDA’s rules to prohibit the sale of menthol cigarettes and flavored cigars immediately. There is no scientific rationale for permitting any flavored tobacco product to remain on the market. To end cancer as we know it for everyone, tobacco use must be addressed and cannot be done without prohibiting the sale of menthol flavors and all flavored cigars.

When faced with mounting evidence that tobacco tax increases effectively reduce tobacco use, tobacco manufacturers will try to distract policymakers from the material facts by invoking dire warnings of reduced revenue due to increased illicit activity including widespread smuggling and other organized crime that they claim will result from increased taxes on cigarettes and other tobacco products.

The U.S. Surgeon General declared youth e-cigarette use to be an epidemic. E-cigarettes are the most used tobacco product among youth and, like any tobacco product, are unsafe. E-cigarette use is also most common among younger adults. Action is urgently needed to reverse these dangerous trends.

Flavors are a marketing weapon the tobacco manufacturers use to target youth and young people to a lifetime of addiction. The use of any flavored tobacco product among youth is concerning because it exposes them to a lifetime of nicotine addiction, disease, and premature death.

Smoke Free Resources:

Smoke-free policies reduce exposure to secondhand smoke (SHS) in office and non-office worksites. This has been proven by reduced nicotine concentration levels in the bloodstream of the adults who work in these settings.

 

More than 40 years after former U.S. Surgeon General Jesse Steinfeld first exposed the potential health risks of secondhand smoke (SHS) in 1971, and nearly 30 years after a subsequent Surgeon General’s report stated that SHS causes lung cancer and other diseases, all U.S. workers still do not have the right to breathe smoke-free air.

ACS CAN advocates for everyone’s right to breathe smoke-free air so that no one is forced to choose between their health and a paycheck. ACS CAN urges state and local officials to pass and protect comprehensive smoke-free laws in all workplaces, including restaurants, bars and gaming facilities.

Research has repeatedly shown that there is no risk-free level of exposure to secondhand smoke (SHS). Smoke-free laws and policies provide immediate and long-term health benefits for both people who smoke and those who do not and are good for businesses and workers.

Exposure to secondhand smoke (SHS) is an occupational hazard for many casino workers – from dealers to security. But when smoking is permitted in casinos, no one – even patrons – is safe from SHS exposure. Job-related exposure to SHS is a significant, but entirely preventable, cause of premature death among U.S. workers.

 

Prevention and Cessation Resources:

Tobacco use has been found to be one of the primary drivers of cancer-related health disparities because its use disproportionately impacts people based on race, ethnicity, sexual orientation, gender identity, disability status, mental health, income level, education level, and geographic location. Achieving health equity relies heavily on eliminating tobacco use. ACS CAN is pursuing fact-based tobacco control policies at the local, state and federal levels that aim to reduce disparities and improve health outcomes for everyone.

Tobacco use causes about one-third of cancer deaths in the nation overall, but the burden varies by state.

Pharmacies can offer an additional opportunity to aid individuals wanting to quit tobacco by providing immediate support and access to FDA-approved cessation medications.

Tobacco control partners provided comments on the Request for Information; Coverage of Over-the-Counter Preventative Services (CMS-9891-NC), including three nicotine replacement (NRT) products, which would increase access to effective tobacco cessation medications for adults who want to quit using commerncial tobacco products.

Tobacco use is one of the primary causes of cancer-related health disparities - disproportionately impacting people by race, ethnicity, sexual orientation, gender identity, disability status, mental health, income and education levels, and geographic location. Eliminating health disparities depends heavily on eliminating tobacco use. ACS CAN is pursuing evidence-based policies at the local, state, and federal levels that aim to reduce disparities and improve health outcomes for all individuals.

Big tobacco has a history of prioritizing corporate profits over people and communities burdened by tobacco-related illness and death. For decades, the tobacco industry has lied to specific communities and the public at large saying their products are not addictive, harmful or deadly. Tobacco manufacturers continue to create and flood the market with newly designed products they market as being less harmful and alternatives to quitting – a tactic that is not new.

While overall smoking rates have declined in recent years, smoking rates remain higher among specific populations, including people with limited incomes. These differences are in large part due to the tobacco industry’s targeted marketing through advertising, price discounting and other strategies. Every year the tobacco industry spends $9.1 billion in the United States marketing their deadly and addictive products. 

While overall smoking rates have declined in recent years, smoking rates remain higher among specific subpopulations, including African Americans. These differences are in large part due to the tobacco industry’s targeted marketing through advertising, price discounting and other strategies.

While overall smoking rates have declined in recent years, smoking rates remain higher among specific subpopulations, including the LGBTQ+ community. These differences are in large part due to the tobacco industry’s targeted marketing through advertising, price discounting and other strategies.

Tobacco Taxes Resources:

The American Cancer Society Cancer Action Network (ACS CAN) supports a comprehensive approach to tobacco control that includes significantly increasing excise taxes on all tobacco products to generate revenue, protect kids, and save lives. Significant tobacco tax increases are one of the most effective ways to prevent kids from starting to use tobacco and help adults quit.

Increasing tobacco excise taxes is one of the best ways to reduce overall tobacco use. It is important that when considering an excise tax increase on any tobacco product, including e-cigarettes, that the tax should be increased on all tobacco products at an equivalent rate to encourage people to quit rather than switch to a cheaper product, and prevent youth from starting to use any tobacco product.

 

When faced with mounting evidence that tobacco tax increases effectively reduce tobacco use, tobacco manufacturers will try to distract policymakers from the material facts by invoking dire warnings of reduced revenue due to increased illicit activity including widespread smuggling and other organized crime that they claim will result from increased taxes on cigarettes and other tobacco products.

The economic model developed jointly by the Campaign for Tobacco-Free Kids (TFK), the American Cancer Society Cancer Action Network (ACS CAN), and Tobacconomics (a program of the University of Illinois at Chicago) projects the increase in state revenues, public health benefits, and health care cost savings resulting from increases in state cigarette tax rates.  The projections are updated annually.  Calculations are based on economic modeling by Frank Chaloupka, Ph.D., and John Tauras, Ph.D., at the Institute for Health Research and Policy at the University of Illinois at Chicago, Jidong Huang, Ph.D., at Georgia State University, and Michael Pesko, Ph.D., at the University of Missouri.

The American Cancer Society Cancer Action Network (ACS CAN) supports a comprehensive approach to tobacco control that includes significantly increasing excise taxes on all forms of tobacco. Regular, significant excise tax increases of $1.00 or more per pack of cigarettes are one of the most effective ways to prevent kids from starting to use cigarettes and to help adults quit. Tobacco excise taxes can also reduce tobacco-related health disparities among people with limited incomes, pregnant persons and among racial and ethnic populations.

 

Tobacco excise taxes benefit people with limited incomes and reduce tobacco-related health disparities, especially when tobacco excise tax revenues are dedicated to cessation programs that serve people with limited incomes.