Op-Ed: Why menthol must be included in ban on flavored tobacco

Op-Ed: Why menthol must be included in ban on flavored tobacco

By Shani “Kai” Carvalho, public relations director and certified tobacco treatment specialist, Hāmākua-Kohala Health

On Feb. 13, the Star-Advertiser printed an editorial that urged Hawaiʻi’s legislators to end the sale of flavored tobacco (“Let flavored vapes go up in smoke,” Feb. 13, 2025) but suggested that a menthol cigarette exemption would be an appropriate compromise to get this legislation passed. I’m here to offer a different perspective. To effectively address the toll of tobacco in Hawai‘i, we must include menthol in any ban on flavored tobacco. Exempting menthol creates a loophole that undermines public health efforts, perpetuates adult nicotine addiction, and will contribute to future youth addiction to nicotine.

Menthol is a chemical compound that creates a cooling sensation, making tobacco products more appealing, especially to young people. It numbs the throat, reducing the harshness of tobacco smoke, and enhances the addictive properties of nicotine, making mentholated products more addictive than regular tobacco.

Nearly 90% of smokers try their first cigarette during their teenage years. Menthol brands have long been promoted as “starter products” because they mask the harsh taste of tobacco. This marketing strategy has been used for decades, and now, e-cigarette and nicotine pouch companies use the same tactics to hook young people with menthol, mint, and other cooling flavors.

For example, as a Certified Tobacco Treatment Specialist, I have been working with a 6th grader in Waimea who started vaping regularly when she was in the 3rd grade. She started with a flavored vape and experimented with many different flavors, including mint and menthol flavors, during the three years she was using e-cigarettes. We supported her with one-on-one counseling and group counseling sessions. Thankfully, she has finally quit, but it wasn’t easy. She is now a vape-free, thriving 7th grader.

E-cigarette use among Hawai‘i’s youth is still a public health crisis. As of recent data, 13.2% of high school students and 10.3% of middle school students in Hawai‘i are current e-cigarette users, many showing signs of addiction. E-cigarettes can contain as much nicotine as 200 cigarettes, and menthol enhances the addictive properties of nicotine. Among youth e-cigarette users, 25.1% use mint flavors, and 15.1% use menthol; among youth nicotine pouch users, 53.3% use mint flavors, and 19.3% use menthol.

The tobacco industry has long used menthol to attract young users and marginalized groups. In Hawai‘i, 86.6% of Native Hawaiian and 83.6% of Filipinos smoke menthol cigarettes—a stark contrast to 42% among Caucasians. This targeted marketing has led to significant health disparities, with Native Hawaiians and Filipinos experiencing higher rates of lung cancer and other tobacco-related illnesses.

E-cigarette companies mirror these tactics by adding menthol to fruit flavors like “Frozen Raz” or “Pineapple Ice,” creating products that appeal to teens. After JUUL removed its mint-flavored pods in 2019 due to public pressure, sales of menthol-flavored e-cigarettes more than doubled within two months. This demonstrates that youth will gravitate toward whatever flavored options remain available, underscoring the need for a comprehensive ban.

Partial bans that exclude menthol have proven ineffective. For instance, when the FDA restricted certain e-cigarette flavors in 2020 but allowed menthol, sales of menthol products surged. Studies also show that partial bans may lead some users to switch to combustible cigarettes rather than quit. Including menthol in flavor bans is essential to prevent substitution effects and ensure people do not migrate to remaining flavored options. Research also indicates that banning menthol cigarettes could prompt nearly one million US smokers to quit within the first year. Such bans also address health inequities by reducing the disproportionate burden of tobacco-related diseases on communities of color.

Hawai‘i has an opportunity—and responsibility—to protect its youth from flavored tobacco products’ dangers. HB 756, which is a bill that could introduce a comprehensive ban on flavored tobacco statewide, would protect Hawai‘i’s youth and reduce health disparities. If our legislators can move this bill forward, Hawai‘i can safeguard its future generations from nicotine addiction and the long-term health consequences of tobacco use.

Note: HB 756, a bill that could end the sale of flavored tobacco, could die if it doesn’t get a hearing by March 20. If there’s no hearing scheduled by the end of day today (due to the 48-hour notice rule), the bill is dead.

*****Views expressed in Op-Ed pieces are those of the author’s alone and do not reflect or represent the opinions, policies or positions of Maui Now.*****