When I began medical school nearly two decades ago, tobacco use in the U.S. was declining rapidly, especially among young people. I was hopeful that once I completed my training as a cardiologist, I would see fewer patients suffering from heart disease caused by tobacco use and nicotine addiction. 

Nicotine is a dangerous and highly addictive drug that can damage the heart and other vital organs. It increases blood pressure, heart rate and blood flow to the heart, while narrowing and hardening arterial walls – a combination that can lead to heart attacks. 

Making cigarettes even more appealing is the slightly sweet minty menthol flavor added to some of the most widely used brands. For decades, combustible cigarette manufacturers have added menthol to their products to mask the harshness of cigarette smoke. This not only makes the products more palatable for beginners, but it can also strengthen nicotine addiction because the cooling sensation allows a person to inhale more deeply and quickly receive a greater amount of nicotine to their blood stream and brain. 

While cigarette smoking continues to decline, the rise of e-cigarettes in the mid-2010s – particularly those available in thousands of kid-friendly flavors – marked the beginning of a troubling new trend. E-cigarettes quickly took over the shelf space once dominated by traditional cigarettes and reversed the downward trajectory of tobacco use as a new, younger generation became hooked on nicotine.

I reiterate that these flavors are not just harmless additives; they are deliberate tools designed to mask the harshness of nicotine products, making it easier for people, particularly young people, to start using these products and become addicted. It also makes it more difficult for those who are currently experiencing nicotine dependence to break free from their addiction. 

This issue disproportionately impacts communities of color and other marginalized groups. For example, tobacco executives have aggressively marketed menthol cigarettes to Black communities for decades by offering deep discounts on products, advertising products in the places kids can easily see them and sponsoring community events like jazz festivals. This predatory marketing has resulted in nearly 85% of Black people who smoke reaching for menthols over other types of products. 

Tobacco companies have employed similar tactics to hook those who identify as LGBTQ+ by sponsoring pride celebrations and keeping product prices low in the places these individuals congregate. 

To address the public health crises of tobacco use and nicotine addiction, we must do more to reduce, and ultimately eliminate, the use of menthol cigarettes and all other flavored tobacco products. This effort is critical not only for preventing the next generation from becoming addicted but also for addressing the inequities that have allowed specific communities to become addicted and die prematurely at the hands of the tobacco industry.

“It is vital that Arizona lawmakers implement tobacco control policies to prevent kids from accessing flavored tobacco products, which are specifically designed to attract and hook them.”

“It is vital that Arizona lawmakers implement tobacco control policies to prevent kids from accessing flavored tobacco products, which are specifically designed to attract and hook them.”

As a member of the American Heart Association-Arizona board of directors, I am proud to spearhead and support our ongoing efforts to improve public health. With the help of a grant from the Centers for Disease Control and Prevention (CDC), the American Heart Association is working to inform the public about how, together, we can curb the use of these harmful products in Maricopa County and beyond.

We all have a role to play in protecting our children and our communities. Together, we can create a healthier future by supporting efforts that reduce the use of flavored tobacco products, including menthol, and by promoting broader public health initiatives that benefit the communities that call Maricopa County home.

Rachel M. Bond, MD, sits on the American Heart Association Greater Phoenix board of directors and is a national spokesperson for the “Go Red for Women” campaign. She works as the system director of Women’s Heart Health at Dignity Health in Chandler, Arizona.