Cited references for this diagram
Smokers who did not make a quit attempt before bans were less likely than those who made a pre-ban quit attempt to make a quit attempt at follow-up
Chung-Hall, J., Fong, G. T., Meng, G., Cummings, K. M., Hyland, A., O’Connor, R. J., Quah, A. C. K., & Craig, L. V. (2022). Evaluating the impact of menthol cigarette bans on cessation and smoking behaviours in Canada: longitudinal findings from the Canadian arm of the 2016–2018 ITC Four Country Smoking and Vaping Surveys. Tobacco Control, 31(4), 556–563.
Smokers who did not make a quit attempt before bans were less likely than those who made a pre-ban quit attempt to make a quit attempt at follow-up
Chung-Hall, J., Fong, G. T., Meng, G., Cummings, K. M., Hyland, A., O’Connor, R. J., Quah, A. C. K., & Craig, L. V. (2022). Evaluating the impact of menthol cigarette bans on cessation and smoking behaviours in Canada: longitudinal findings from the Canadian arm of the 2016–2018 ITC Four Country Smoking and Vaping Surveys. Tobacco Control, 31(4), 556–563.
Smokers with no plans to quit before bans were also less likely than those with plans to quit before bans to make a quit attempt at follow-up.
Chung-Hall, J., Fong, G. T., Meng, G., Cummings, K. M., Hyland, A., O’Connor, R. J., Quah, A. C. K., & Craig, L. V. (2022). Evaluating the impact of menthol cigarette bans on cessation and smoking behaviours in Canada: longitudinal findings from the Canadian arm of the 2016–2018 ITC Four Country Smoking and Vaping Surveys. Tobacco Control, 31(4), 556–563.
Compared with smokers with lower nicotine dependence, those with higher nicotine dependence were less likely to be short-term quitters
Chung-Hall, J., Fong, G. T., Meng, G., Cummings, K. M., Hyland, A., O’Connor, R. J., Quah, A. C. K., & Craig, L. V. (2022). Evaluating the impact of menthol cigarette bans on cessation and smoking behaviours in Canada: longitudinal findings from the Canadian arm of the 2016–2018 ITC Four Country Smoking and Vaping Surveys. Tobacco Control, 31(4), 556–563.
Residents who smoked within 30 min of waking (OR 0.48, 95% CI 0.23 to 0.98) and daily smokers (OR 0.42, 95% CI 0.21 to 0.84) were less likely to say they would quit if menthol-flavoured products were no longer sold.
Dearfield, C. T., Horn, K., Crandell, I., & Bernat, D. H. (2022). Behavioural intentions in response to a potential menthol cigarette sales ban: a survey examining smokers in Washington, DC public housing. BMJ Open, 12(7), e059821.
daily smokers (OR 0.42, 95% CI 0.21 to 0.84) were less likely to say they would quit if menthol-flavoured products were no longer sold.
Dearfield, C. T., Horn, K., Crandell, I., & Bernat, D. H. (2022). Behavioural intentions in response to a potential menthol cigarette sales ban: a survey examining smokers in Washington, DC public housing. BMJ Open, 12(7), e059821.
Menthol smokers who said they would quit in the event of a ban were more likely to have attempted to quit in the previous 12 months than those who said they would not
D’Silva, J., Amato, M. S., & Boyle, R. G. (2015). Quitting and Switching: Menthol Smokers’ Responses to a Menthol Ban. Tobacco Regulatory Science, 1(1), 54–60.
Menthol smokers who said they would quit in the event of a ban were more likely to have attempted to quit in the previous 12 months than those who said they would not
D’Silva, J., Amato, M. S., & Boyle, R. G. (2015). Quitting and Switching: Menthol Smokers’ Responses to a Menthol Ban. Tobacco Regulatory Science, 1(1), 54–60.
Menthol smokers who said they would quit smoking if menthol were banned smoked an average of 3.8 fewer cigarettes per day compared to those who said they would continue smoking (t = 3.6, p
D’Silva, J., Amato, M. S., & Boyle, R. G. (2015). Quitting and Switching: Menthol Smokers’ Responses to a Menthol Ban. Tobacco Regulatory Science, 1(1), 54–60.
In Canada, menthol or capsule smoking was more common among participants who reported being a little or very addicted to cigarettes than those who reported not being addicted (3.1% vs 1.3%; AOR, 1.02; 95% CI, 1.00-1.03; P = .01) (Table 2)
East, K. A., Reid, J. L., Burkhalter, R., Kock, L., Hyland, A., Fong, G. T., & Hammond, D. (2022). Evaluating the Outcomes of the Menthol Cigarette Ban in England by Comparing Menthol Cigarette Smoking Among Youth in England, Canada, and the US, 2018-2020. JAMA Network Open, 5(5), e2210029.
In England, there was little evidence for any associations between cigarette consumption or dependence and menthol or capsule smoking (Table 2).
East, K. A., Reid, J. L., Burkhalter, R., Kock, L., Hyland, A., Fong, G. T., & Hammond, D. (2022). Evaluating the Outcomes of the Menthol Cigarette Ban in England by Comparing Menthol Cigarette Smoking Among Youth in England, Canada, and the US, 2018-2020. JAMA Network Open, 5(5), e2210029.
In the US, menthol or capsule smoking was more common among those who smoked on at least 20 of the past 30 days vs otherwise (38.1% vs 32.7%; AOR, 1.07; 95% CI, 1.01-1.13; P = .03)
East, K. A., Reid, J. L., Burkhalter, R., Kock, L., Hyland, A., Fong, G. T., & Hammond, D. (2022). Evaluating the Outcomes of the Menthol Cigarette Ban in England by Comparing Menthol Cigarette Smoking Among Youth in England, Canada, and the US, 2018-2020. JAMA Network Open, 5(5), e2210029.
In the US, menthol or capsule smoking was more common among those ... who smoked 2 to 5 (37.9%) or more than 5 (38.5%) cigarettes per day than those who smoked 1 or fewer (29.8%) (2-5 vs 1 cigarettes per day, AOR, 1.09; 95% CI, 1.02-1.15; P = .006; >5 vs 1 cigarettes per day, AOR, 1.10; 95% CI, 1.03-1.18; P = .007) [C1] United States [/C1]
East, K. A., Reid, J. L., Burkhalter, R., Kock, L., Hyland, A., Fong, G. T., & Hammond, D. (2022). Evaluating the Outcomes of the Menthol Cigarette Ban in England by Comparing Menthol Cigarette Smoking Among Youth in England, Canada, and the US, 2018-2020. JAMA Network Open, 5(5), e2210029.
In the US, menthol or capsule smoking was more common among those ... who reported urges to smoke every or most days vs less often (38.0% vs 30.3%; AOR, 1.08; 95% CI, 1.02-1.14; P = .006) (Table 2) [C1] United States [/C1]
East, K. A., Reid, J. L., Burkhalter, R., Kock, L., Hyland, A., Fong, G. T., & Hammond, D. (2022). Evaluating the Outcomes of the Menthol Cigarette Ban in England by Comparing Menthol Cigarette Smoking Among Youth in England, Canada, and the US, 2018-2020. JAMA Network Open, 5(5), e2210029.
Any menthol or capsule smoking in the past 30 days was also associated with a greater number of consumption and dependence indicators in all 3 countries than the usual brand measure (Table 2).
East, K. A., Reid, J. L., Burkhalter, R., Kock, L., Hyland, A., Fong, G. T., & Hammond, D. (2022). Evaluating the Outcomes of the Menthol Cigarette Ban in England by Comparing Menthol Cigarette Smoking Among Youth in England, Canada, and the US, 2018-2020. JAMA Network Open, 5(5), e2210029.
Any menthol or capsule smoking in the past 30 days was also associated with a greater number of consumption and dependence indicators in all 3 countries than the usual brand measure (Table 2).
East, K. A., Reid, J. L., Burkhalter, R., Kock, L., Hyland, A., Fong, G. T., & Hammond, D. (2022). Evaluating the Outcomes of the Menthol Cigarette Ban in England by Comparing Menthol Cigarette Smoking Among Youth in England, Canada, and the US, 2018-2020. JAMA Network Open, 5(5), e2210029.
Any menthol or capsule smoking in the past 30 days was also associated with a greater number of consumption and dependence indicators in all 3 countries than the usual brand measure (Table 2).
East, K. A., Reid, J. L., Burkhalter, R., Kock, L., Hyland, A., Fong, G. T., & Hammond, D. (2022). Evaluating the Outcomes of the Menthol Cigarette Ban in England by Comparing Menthol Cigarette Smoking Among Youth in England, Canada, and the US, 2018-2020. JAMA Network Open, 5(5), e2210029.
Any menthol or capsule smoking in the past 30 days was also associated with a greater number of consumption and dependence indicators in all 3 countries than the usual brand measure (Table 2).
East, K. A., Reid, J. L., Burkhalter, R., Kock, L., Hyland, A., Fong, G. T., & Hammond, D. (2022). Evaluating the Outcomes of the Menthol Cigarette Ban in England by Comparing Menthol Cigarette Smoking Among Youth in England, Canada, and the US, 2018-2020. JAMA Network Open, 5(5), e2210029.
Menthol smokers were less likely to support a ban on menthol (aOR = 0.18, 95% CI: 0.08–0.43)
Kyriakos, C. N., Fong, G. T., De Abreu Perez, C., Szklo, A. S., Driezen, P., Quah, A. C. K., Figueiredo, V. C., & Filippidis, F. T. (2022). Brazilian smokers are ready for the ban on flavour additives in tobacco to be implemented. Preventive Medicine, 160, 107074.
Menthol smokers were less likely to support a ban on menthol (aOR = 0.18, 95% CI: 0.08–0.43) and on all additives (aOR = 0.24, 0.12–0.49)
Kyriakos, C. N., Fong, G. T., De Abreu Perez, C., Szklo, A. S., Driezen, P., Quah, A. C. K., Figueiredo, V. C., & Filippidis, F. T. (2022). Brazilian smokers are ready for the ban on flavour additives in tobacco to be implemented. Preventive Medicine, 160, 107074.
Those who reported that additive-free cigarettes are less harmful were more likely to support a ban on additives (aOR = 1.72, 1.18–2.50).
Kyriakos, C. N., Fong, G. T., De Abreu Perez, C., Szklo, A. S., Driezen, P., Quah, A. C. K., Figueiredo, V. C., & Filippidis, F. T. (2022). Brazilian smokers are ready for the ban on flavour additives in tobacco to be implemented. Preventive Medicine, 160, 107074.
In terms of experimental cigarettes, the LMM analysis indicated that a main effect of the presence of menthol emerged, such that menthol cigarettes were smoked significantly more than non-menthol cigarettes, regardless of nicotine content (see Figure 1, panel B, and Supplementary Table 2)
Oncken, C., Litt, M. D., Thurlow, S., Mead-Morse, E. L., Wang, L., & Hatsukami, D. K. (2023). Manipulation of Menthol and Nicotine Content in Cigarettes: Effects on Smoking Behavior and Toxicant Exposure in Women Menthol Smokers. Nicotine & Tobacco Research, 25(4), 665–673.
Using EC on a greater number of days during the past week (aRRR=1.51, 95% CI=1.11–2.07), intentions to quit EC use (aRRR=6.08, 95% CI=1.51– 24.46), and greater FTND scores (aRRR=1.42, 95% CI=1.03–1.97) were associated with increased likelihoods of quitting versus maintaining CC use (Supplementary Table 2b2).
Pacek, L. R., Oliver, J. A., Sweitzer, M. M., & McClernon, F. J. (2019). Young adult dual combusted cigarette and e-cigarette users’ anticipated responses to a nicotine reduction policy and menthol ban in combusted cigarettes. Drug and Alcohol Dependence, 194, 40–44.
Conversely, using CC on a greater number of days during the past week was associated with a decreased likelihood of quitting versus maintaining CC use
Pacek, L. R., Oliver, J. A., Sweitzer, M. M., & McClernon, F. J. (2019). Young adult dual combusted cigarette and e-cigarette users’ anticipated responses to a nicotine reduction policy and menthol ban in combusted cigarettes. Drug and Alcohol Dependence, 194, 40–44.
Menthol smokers with at least 1 recent quit attempt had twice the AOR as otherwise similar smokers who had not recently tried to quit of reporting they would rather quit than switch to a nonmenthol brand.
Pearson, J. L., Abrams, D. B., Niaura, R. S., Richardson, A., & Vallone, D. M. (2012). A Ban on Menthol Cigarettes: Impact on Public Opinion and Smokers’ Intention to Quit. American Journal of Public Health, 102(11), e107–e114.
. Menthol smokers were more likely than otherwise similar nonmenthol smokers to disagree with a menthol ban (50.5% vs 31.2%; P
Pearson, J. L., Abrams, D. B., Niaura, R. S., Richardson, A., & Vallone, D. M. (2012). A Ban on Menthol Cigarettes: Impact on Public Opinion and Smokers’ Intention to Quit. American Journal of Public Health, 102(11), e107–e114.
Menthol smokers with at least 1 recent quit attempt had twice the AOR as otherwise similar smokers who had not recently tried to quit of reporting they would rather quit than switch to a nonmenthol brand.
Pearson, J. L., Abrams, D. B., Niaura, R. S., Richardson, A., & Vallone, D. M. (2012). A Ban on Menthol Cigarettes: Impact on Public Opinion and Smokers’ Intention to Quit. American Journal of Public Health, 102(11), e107–e114.
Nearly 13% of menthol smokers would switch to a nonmenthol cigarette if menthol were banned. None of the demographic characteristics assessed predicted membership in this group, although we observed an inverse relationship with age that was marginally statistically significant in multivariable analysis. The AOR that these smokers were nicotine dependent was 5.6 times as high as the AOR among other menthol smokers
Pearson, J. L., Abrams, D. B., Niaura, R. S., Richardson, A., & Vallone, D. M. (2012). A Ban on Menthol Cigarettes: Impact on Public Opinion and Smokers’ Intention to Quit. American Journal of Public Health, 102(11), e107–e114.
Those who smoked sooner after waking had lower odds of endorsing quitting smoking.
Rose, S. W., Ganz, O., Zhou, Y., Carnegie, B. E., Villanti, A. C., Rath, J., & Hair, E. C. (2019). Longitudinal Response to Restrictions on Menthol Cigarettes Among Young Adult US Menthol Smokers, 2011–2016. American Journal of Public Health, 109(10), 1400–1403.
menthol in cigarettes increases initiation
Schroth, K. R. J., Villanti, A. C., Kurti, M., & Delnevo, C. D. (2019). Why an FDA Ban on Menthol Is Likely to Survive a Tobacco Industry Lawsuit. Public Health Reports®, 134(3), 300–306.
This study found that menthol bans likely have direct and indirect positive effects on smoking cessation among menthol smokers. Menthol bans may have the greatest impact on smoking cessation among those who are already motivated to quit before the implementation of a menthol ban.
Soule, E. K., Dubray, J., Cohen, J. E., Schwartz, R., & Chaiton, M. (2021). Smoking cessation strategies used by former menthol cigarette smokers after a menthol ban. Addictive Behaviors, 123, 107046.
These were reasons not only for preferring menthol cigarettes currently, but were also important when initiating smoking: “For me at least when I started smoking, they were easier to smoke, almost. Because it’s like you don’t even feel like you’re inhaling smoke. It’s like ice in your mouth, and I just like that.” (general YA group, male, age 19)
Wackowski, O. A., Evans, K. R., Harrell, M. B., Loukas, A., Lewis, M. J., Delnevo, C. D., & Perry, C. L. (2018). In Their Own Words: Young Adults’ Menthol Cigarette Initiation, Perceptions, Experiences and Regulation Perspectives. Nicotine & Tobacco Research, 20(9), 1076–1084.
These were reasons not only for preferring menthol cigarettes currently, but were also important when initiating smoking: “For me at least when I started smoking, they were easier to smoke, almost. Because it’s like you don’t even feel like you’re inhaling smoke. It’s like ice in your mouth, and I just like that.” (general YA group, male, age 19)
Wackowski, O. A., Evans, K. R., Harrell, M. B., Loukas, A., Lewis, M. J., Delnevo, C. D., & Perry, C. L. (2018). In Their Own Words: Young Adults’ Menthol Cigarette Initiation, Perceptions, Experiences and Regulation Perspectives. Nicotine & Tobacco Research, 20(9), 1076–1084.
“males, older adults, Blacks and Hispanics, those with higher levels of educational attainment, those with lower levels of household income, those with a shorter history of smoking, those who used nonmenthol cigarettes or nonflavored cigars, those who smoked less than daily, those who had moderate or high levels of dependence on smoking, and those who did not obtain cigarettes or cigars solely from local retailers were all more likely to be supportive of both bans compared with their counterparts.”
Yang, Y., Lindblom, E. N., Ward, K. D., & Salloum, R. G. (2022). How Smokers of Menthol Cigarettes and Flavored Cigars Might Respond to FDA’s Proposed Bans. Nicotine and Tobacco Research, 24(10), 1645–1653.
Non-daily smokers would be more likely than daily smokers to quit all tobacco-nicotine use (OR=3.57, 95% CI 2.97 to 4.28).
Yang, Y., Lindblom, E. N., Ward, K. D., & Salloum, R. G. (2024a). Should menthol e-cigarettes be banned? Reaction of adult smokers and users of e-cigarettes to hypothetical bans. Tobacco Control, 33(e1), e125–e127.
Across the surveyed countries, menthol cigarette smokers tended to be younger, more likely to be female, better educated, living with a higher household income, and smoking fewer cigarettes.
Zatoński, M., Herbeć, A., Zatoński, W., Przewoźniak, K., Janik-Koncewicz, K., Mons, U., Fong, G., Demjén, T., Tountas, Y., Trofor, A., Fernández, E., McNeill, A., Willemsen, M., Hummel, K., Quah, A., Kyriakos, C., & Vardavas, C. (2018). Characterising smokers of menthol and flavoured cigarettes,their attitudes towards tobacco regulation, and the anticipatedimpact of the Tobacco Products Directive on their smoking andquitting behaviours: The EUREST-PLUS ITC Europe Surveys. Tobacco Induced Diseases, 16(2).
All groups were predominantly supportive of a smoking ban in restaurants, with highest support reported by menthol smokers (73.5%), and lowest by other flavoured cigarette smokers (63.3%). Almost half of all smokers supported the ban on smoking in bars and pubs, with the support varying significantly by the type of cigarette smoked (56.1% among menthol, 45.4% among other flavoured cigarette smokers).
Zatoński, M., Herbeć, A., Zatoński, W., Przewoźniak, K., Janik-Koncewicz, K., Mons, U., Fong, G., Demjén, T., Tountas, Y., Trofor, A., Fernández, E., McNeill, A., Willemsen, M., Hummel, K., Quah, A., Kyriakos, C., & Vardavas, C. (2018). Characterising smokers of menthol and flavoured cigarettes,their attitudes towards tobacco regulation, and the anticipatedimpact of the Tobacco Products Directive on their smoking andquitting behaviours: The EUREST-PLUS ITC Europe Surveys. Tobacco Induced Diseases, 16(2).
The most divisive issue between menthol smokers and other smokers was that of banning additives, including flavourings, in cigarettes, with only 25.1% of menthol smokers supporting such a law, compared to 49.9% of other flavoured cigarette smokers.
Zatoński, M., Herbeć, A., Zatoński, W., Przewoźniak, K., Janik-Koncewicz, K., Mons, U., Fong, G., Demjén, T., Tountas, Y., Trofor, A., Fernández, E., McNeill, A., Willemsen, M., Hummel, K., Quah, A., Kyriakos, C., & Vardavas, C. (2018). Characterising smokers of menthol and flavoured cigarettes,their attitudes towards tobacco regulation, and the anticipatedimpact of the Tobacco Products Directive on their smoking andquitting behaviours: The EUREST-PLUS ITC Europe Surveys. Tobacco Induced Diseases, 16(2).
Higher nicotine dependence scores were associated with a reduced odds of intention to discontinue cigarillos.
Pike Moore, S., Osborn, C., Koopman Gonzalez, S., Quisenberry, A., Klein, E. G., Kaur, M., Suratkal, J., & Trapl, E. (2022). Flavour loyalty may predict cessation or substitution following a cigarillo flavour ban among young adults in the USA. Tobacco Control, 31(Suppl 3), s206–s213.
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