Global Action Community Newsletter
Smart nicotine policy is a social justice issue.
Cigarettes harm everyone. But some populations have endured more of their negative effects than others.
In the United States, for example, Black Americans have been disproportionately harmed by menthol cigarettes. These cigarettes are just as deadly as their traditional tobacco counterparts, but the addition of menthol gives them a cooling, soothing taste. This masks the harsh sensation of inhaling smoke, making it easier for individuals to become addicted and harder for them to quit.
Historically, cigarette manufacturers aggressively promoted menthol cigarettes to Black Americans via strategic advertising and sponsorships. The specific commercial push to target Black Americans led to a dramatic increase in menthol cigarette use that persists long after those practices have been abandoned. Today, roughly 80% of Black Americans who smoke use menthol cigarettes.
For more than a decade, public health leaders and community advocates in the United States called for a federal ban on menthol cigarettes in response to the health disparities they caused. In fact, research requested by the U.S. Food and Drug Administration that I co-authored showed that banning these products could save as many as 650,000 deaths by 2060 through greater smoking cessation.
Submit a question on the latest quitting research, and we may answer it in an upcoming newsletter.
In 2022, the U.S. Food and Drug Administration formally proposed a plan to ban menthol cigarettes. Unfortunately, the Biden Administration did not finalize this ban, and in early 2025 the Trump Administration withdrew that proposal. It’s not clear that this area of public health will remain a priority.
There are still more tools available to support people who smoke menthol cigarettes in their journey to quit than ever before. In addition to the existing nicotine replacement therapies and pharmaceutical interventions that can help make quitting smoking easier, the FDA approved the marketing of four menthol e-cigarettes from NJOY late last year. Additionally, it authorized menthol, mint, and spearmint nicotine pouches under the brand name Zyn earlier this year.
E-cigarettes and nicotine pouches are not risk-free, but they are significantly less harmful than combustible cigarettes. Though these products are not approved as official smoking cessation tools, they have been shown to help many people quit who would otherwise not have done so.
To conclude this Black History month in the U.S., we reiterate that we are deeply concerned with the persistent health inequalities resulting from combustible cigarettes. We stand by our Black community members on their journeys to quit and hope to empower you to quit smoking however you choose.
All my best,
Cliff Douglas
President and CEO
Global Action to End Smoking
By the Numbers
The number of smoking-related premature deaths of African Americans related to menthol cigarettes between 1980 and 2018, according to research published in 2021 by scientists at the University of Michigan.
Despite the fact Black Americans make up about 12% of the U.S. population, estimates suggest that they have incurred about 41% of the premature deaths associated with menthol cigarettes.
“Removing menthol cigarettes from the market would benefit the overall US population but, particularly, the African American community,” the authors write. Read the full paper here.
Global Action to End Smoking has no affiliation with this work.
Get the facts
How risky are e-cigarettes (vapes) compared to cigarettes?
Global health authorities have concluded that e-cigarettes are significantly less risky than cigarettes. However, that does not mean these products are safe or risk-free.
E-cigarettes contain nicotine, the addictive stimulant in tobacco. But because they do not contain the roughly 70 known cancer-causing chemicals that cigarettes do, health authorities including the U.S. National Academies of Sciences, Engineering, and Medicine and the British Royal College of Physicians have concluded that e-cigarettes are less harmful than cigarettes.
It’s important to note that even if e-cigarettes are less harmful, it doesn’t mean that they’re safe. Nicotine should not be used by anyone who has never used it before – especially youth. Additionally, e-cigarettes contain other chemical components, including flavoring agents, whose health effects are unknown. Some may be dangerous, but we don’t yet have conclusive data.
Scientists know less about the long-term risks of e-cigarettes because they are relatively new compared to cigarettes, but also because the market is largely unregulated. Even though global health authorities have tried to regulate this large market, new types of e-cigarettes are being marketed every day. These unregulated e-cigarettes may contain chemicals public health authorities are unaware of, and therefore are unable to verify their safety.
In sum, e-cigarettes are relatively less harmful than cigarettes, and can offer adults who smoke an alternative to cigarettes that decreases their risk of tobacco-related disease and death. But they are still more dangerous than not using any form of nicotine at all.
More answers to common questions about nicotine and tobacco use can be found on Global Action’s Get the Facts page.
Tobacco and health around the world
Country snapshot: Indonesia
In 2022, 33.4% of Indonesia’s population used cigarettes, including 64.7% of men and 2% of women. Despite the Indonesia’s legal measures to control tobacco use, the country’s smoking prevalence has not markedly declined.
In 2022, an estimated 79.3 million people (75.9 million men and 3.5 million women) aged 15 years and older used tobacco in Indonesia. The vast majority of this use is combustible cigarettes.
This positions the country as the 3rd globally and the 2nd in the WHO South-East Asia Region in terms of number of tobacco users.
In 2021, 3.0% of people (5.8% men and 0.3% women) aged 15 years and older were current e-cigarette users in Indonesia.
In 2021, it was estimated that tobacco was the 2nd highest risk factor driving the most deaths and disability combined in Indonesia. Of tobacco-related deaths, 223,500 were due to smoking, and 52,700 thousand were due to secondhand smoke.
For references and to view other country profiles, visit our pages on
Thank you for your support
Give the gift of a healthier tomorrow.
We are taking bold action to find global solutions to end death and disease caused by tobacco, particularly combustible cigarettes. Access to cessation education and quitting tools isn’t just a health issue — it’s a matter of social and economic justice and a fundamental human right.
That’s why we’re partnering with the National Harm Reduction Coalition and the Studio of the Americas to fund two new projects. These initiatives will expand smoking cessation resources in marginalized communities, ensuring more people have the support they need to quit. Learn more about these life-saving projects here.
Your support makes this work possible. Together, we can build a future where no one suffers from tobacco-related disease.
Thank you for your support in the fight against smoking.
Get to Know Global Action
Global Action has awarded more than 175 grants to institutions that support the work of over 100 scientists, covering 46 countries on four continents.
Our organization is an independent, U.S. nonprofit 501(c)(3) grantmaking organization whose mission is to end combustible tobacco use, which remains the leading preventable cause of death globally. Through September 2023, Global Action received charitable gifts from PMI Global Services Inc. Global Action does not seek or accept funding from companies that produce tobacco or non-medicinal nicotine products.
To learn more about our work, visit our website.
Disclaimer: This newsletter does not provide medical advice. The information, including but not limited to, text, graphics, images and other material contained in this newsletter are for informational and educational purposes only and does not constitute providing medical advice or professional services. No material in this newsletter is intended to be a substitute for diagnosing or treating a health problem or disease. Those seeking personal medical advice should consult with a licensed physician or other qualified health care provider. Always seek the advice of your licensed physician or other qualified health care provider regarding a medical condition or with any questions you may have regarding treatment and before undertaking a new health care regimen. Never disregard professional medical advice or delay in seeking it because of something you read in this newsletter. No physician-patient relationship is created by this newsletter. Global Action doesn’t make representations, express or implied, with respect to the information provided here.