YA recent increase in the number of GLBT youth smoking menthol cigarettes was the subject for a town hall meeting at Center on Halsted Sept. 17. The forum, presented by the Chicago Department of Public Health, was intended to generate discussion of possible local-level interventions that might reduce usage of menthol cigarettes amongst young people.
Bechara Choucar, commissioner of CDPH, said mentholated cigarettes present a serious public health problem for young people.
"Seventy-one percent of LGBT youth smokers use menthol-flavored cigarettes," according to Choucar. "These numbers are just as disturbing for other targeted populations—72 percent of African American youth, 51 percent of Asian youth, and 47 percent of Hispanic youths who smoke (also) use menthol-flavored cigarettes. Those figures should be a cause for alarm for all of us."
Only the FDA can ban menthol flavoring outright; the agency has already banned all cigarette flavorings except menthol, which is the most popular flavor. Menthol is intended as a cooling agent and makes smoking seem less harsh to people using cigarettes.
About 600,000 middle schoolers smoke, as do about three million high schoolers, said Alicia Matthews of the Health Systems Science department at University of Illinois at Chicago. The majority of those smokers—about 48 percent—are using menthol cigarettes.
She pointed out that cigarettes are more widely sold and advertised in African American communities, and thus in closer proximity to predominantly African American schools. Though the City cannot enact a ban of its own, "There is an opportunity for real leadership on the local level," Matthews said.
Smoking is also prevalent in the LGBT community, which has been targeted for a number of years by the tobacco industry, she added. Matthews recalled how the community reacted with a certain amount of pride when LGBT-focused cigarette ads appeared in the mid-1990s.
"I remember there was a billboard and it was one of the first time san advertisement like that was featuring LGBT couples," she said, adding that it was a vestige of the tobacco industry's targeting of cultures which were largely focused in urban areas, Project SubCulture Urban Marketing.
That engagement with the community has developed into what Matthews called "golden handcuffs, since Tobacco companies support LGBT events and organizations quite heavily.
"In a study, LGBT leaders of national organizations have gone on record as saying combating smoking could jeopardize funding for their organizations," she said. "So LGBT organizers, who are supposed to be leaders, are remaining mute and silent on the growing epidemic in our community."
Arthur Elster of the American Academy of Pediatrics said that about half of young people who become exposed to menthol with their first cigarette will eventually become addicted. About 59 percent of menthol cigarette smokers, he added, would like to see them banned.
"Widespread actions have not yet been enacted as far as we know in other cities, so Chicago has the opportunity to be a leader in implementing policies in protecting children and our community from tobacco and secondhand smoke," said Elster.
But Arvind Goyal, medical director for Ill. Health and Family Services, warned against the impulse to try to stem use with a new cigarette tax.
"We do not want to hurt the community whose public health interests we are looking at …There needs to be a local impact study related to mentholated cigarettes which is funded by the tobacco manufacturers, distributors, sellers and pushers," Goyal said.
Tom Elliott, communications director, Center on Halsted, spoke to the impact of beginning smoking at a young age; he started smoking mentholated cigarettes when he was 21, and has tried and failed to quit several times.
"Smoking cigarettes has not only had an impact on my physical health and well-being, but lung cancer has taken the lives of three of my grandparents and put my family through great emotional hardship," Elliott said. "The addictive qualities of cigarettes have also impacted my financial health …You can imagine that the financial burden of my addiction is not helping me get ahead in saving or investing in the future."
Aren Drehobl, program manager for Recovering with Pride at Howard Brown Health Center, said that persons with multiple stressors and multiple addictions sometimes underestimate the role that a tobacco addiction takes on their lives. She added that programs that can address specific communities have better long-term outcomes. But only five percent of smoking cessation programs in the country offer programming or material geared for LGBT participants.
Jim Ludwig, owner of Roscoe's, said that it was important to "get the education program as fully functional as we can." He added that work needed to be done with Center on Halsted and youth on Halsted; "almost all of the problem kids the bars are expected to somehow herd and handle—that are real problems for our businesses because of the crime that happens on the street—they're almost all smokers. I'm curious to know, is there the possibility of making it against the law for kids (who are) underage to possess cigarettes? If that was an enforceable thing, we could definitely get a lot of the smoking off the street."
Comments from the Sept. 17 meeting will be used to make specific policy recommendations regarding menthol use to Mayor Emanuel.
"One thing that's very clear is that it's going to take all of us working together," said Carolyn Lopez, president of the Chicago Board of Health. "But if we do work together, we'll be able to reduce menthol use among our youth and have a healthier Chicago."
