Community-Led Action to Reduce Menthol Cigarette Use in the African American Community

Abstract

Background. African Americans suffer a disproportionate burden of tobacco harm and researchers have posited that menthol cigarettes are a key contributor to this disparity. In 2015, a county health department and African American community-based organization (CBO) in Minnesota partnered to educate and engage the African American community on menthol and its role in tobacco-related health disparities. The following case study describes successes, challenges, and recommendations from this work. We focus on the role of a public health and community partnership in menthol policy adoption so others can more effectively implement a community-driven approach in their own communities. Methods. Interviews were conducted with local and state public health staff, leadership from the CBO, youth coordinators, and change agents—that is, leaders in the African American community recruited to educate and engage the community on menthol. Interviews were transcribed verbatim and analyzed in Atlas.ti using thematic analysis. Results. Participants identified several successes: (1) assessment data from community members helped inform policy decision making, (2) collaboration between local public health and CBO was powerful and a key to success, and (3) change agents were trusted communicators and effectively engaged and provided education to the community. Participants faced challenges related to stylistic and cultural differences in communication. Participants recommended engaging youth and incorporating cessation into the broader context of issues systemically affecting African American communities (e.g., economic inequity, police violence, incarceration). Implications. Menthol tobacco restrictions have the potential to reduce tobacco-related health inequities for African Americans. Findings highlight the role that public health and community partnerships can play in supporting this critical work to effect policy change.

Adoption of Tobacco 21: A Cross-Case Analysis of Ten US States

“…The themes identified in this case study are consistent with previous research on local, state, and national tobacco control policies that found that, among others, policy champions or change agents [ 7 , 42 , 43 , 44 ], engagement with youth advocates [ 7 , 45 ], supporting data, and other localities previously enacting the policy influenced adoption [ 42 ]. Past studies also suggest that the absence of supporting data may have hampered states which attempted to adopt T21 early [ 6 , 7 ], but in later years, the IOM report proved powerful enough to elevate the attention of T21 as a tool to reduce youth tobacco use.…”

A Comprehensive Qualitative Review of Studies Evaluating the Impact of Local US Laws Restricting the Sale of Flavored and Menthol Tobacco Products

“…Our review highlights the need for a comprehensive study of the association between policy mechanisms (e.g., policy provisions, exemptions, implementation actions, and challenges) and outcomes, which could provide evidence-based guidance for improving policy development and implementation, 51 , 52 especially to address endemic health inequities associated with target marketing of flavored and menthol tobacco products. 8 , 53 , 54 Indeed, few studies have specifically assessed the health equity impacts of sales restrictions among population groups who disproportionately suffer from tobacco-related disease and death, such as Black Americans. 55 Recent studies that have investigated health equity impacts of flavored and menthol sales restrictions reveal, for example, that: (a) the rationale for menthol tobacco sales restrictions was not well-understood or universally supported by African American smokers in Minneapolis and St. Paul, MN 56 ; (b) compared to White, non-Hispanic youth, Black, Hispanic, Asian, and LGBTQ youth in various California localities with flavor policies reported greater difficulty in accessing policy-restricted flavored tobacco products 57 ; and (c) Black young adults in San Francisco were more likely than other young adults to continue using flavored cigars after implementation of the flavored and menthol sales restriction in that city.…”

Public Perceptions of the Food and Drug Administration’s Proposed Rules Prohibiting Menthol Cigarettes on Twitter: Observational Study

“…Another similar publication has discussed how a menthol cigarette ban can protect African American communities [ 32 ]. In the real world, many community-based organizations in African American communities were also taking action to educate members of their communities about the risks of smoking menthol cigarettes and engaging community members to reduce the use of menthol cigarette [ 33 ]. The proposed menthol cigarette rules will further support community-based organizations’ efforts in reducing menthol cigarette smoking among African Americans.…”