The proportion of packs with green as a prominent pack colour declined in the postban sample (pre: 87.5% vs post: 17.4%; p≤0.001), whereas the proportion with blue as a prominent colour increased (pre: 6.3% vs post: 43.5%; p=0.012)

Similarly, postban secondary filter tip colours were less likely to be green (pre: 93.8% vs post: 13%; p≤0.001) and more likely to be blue (pre: 6.3% vs post: 47.8%, p=0.006).

Postban brands were more likely to have a colour descriptor as part of their variant name (pre: 6.3% vs post: 52.2%, p=0.003), with blue being the most common descriptor.

Postban brands were more likely to have a colour descriptor as part of their variant name (pre: 6.3% vs post: 52.2%, p=0.003), with blue being the most common descriptor.

‘Menthol’ was not observed on postban packs, however, it was found on the cellophane of four (12.1%) packs, labelling them as non-menthol alternatives (‘Smooth taste redesigned without menthol’).

‘Menthol’ was not observed on postban packs, however, it was found on the cellophane of four (12.1%) packs, labelling them as non-menthol alternatives (‘Smooth taste redesigned without menthol’).

Postban brands ​​were also more likely to have ‘Smooth’ as a taste descriptor (pre: ​​6.3% vs post: 56.5%, p=0.002).

Consistent with traditional menthol findings, postban brands were more likely to have colour descriptors as part of their variant name (pre: 7.1% vs post: 64.3%, p=0.002), with blue the most common

Consistent with traditional menthol findings, postban brands were more likely to have colour descriptors as part of their variant name (pre: 7.1% vs post: 64.3%, p=0.002), with blue the most common

Postban, neither ‘menthol’ nor ​​‘capsule/convertible’ was observed on packs, with the exception ​​of three products identified as non-capsule alternatives via their ​​cellophane (‘Your Pall Mall. Now without convertibles’).

Similarly, descriptors highlighting freshness or cooling sensation were not observed on postban packs; only one pack highlighted the consumer’s ‘choice’ to change the cigarette’s taste.

In both samples, the majority of postban packs and secondary filter tip colours were blue and blue/silver, respectively.

In both samples, the majority of postban packs and secondary filter tip colours were blue and blue/silver, respectively.

Pack designs and brand descriptors insinuating ​​menthol-like qualities Cigarette pack designs serve as a marketing tool for ​​tobacco companies to influence consumers’ percep​tions of taste. Despite a characterising flavour ​​ban, pack design may manipulate smokers’ expe​rience of menthol/non-menthol flavour. After the ​​ban, one pack from Japan Tobacco International ​​(JTI) retained insinuating menthol-like qualities. ​​It retained the brand descriptor ‘Activate’ and an ​​illustration on the package, indicating that the ciga​rette still had a click-function (figure 3A).

We categorised packs as ‘menthol replacements’ if ​they largely maintained the same colour and design ​as menthol packs sold preban. Among the packs ​collected preban, all packs labelled as menthol fea​tured green as a prominent colour. Menthol ​replacement packs continued to display green as a ​prominent colour. The only change across all ​menthol replacement packs, when compared to ​menthol packs purchased preban, was the substitu​tion of the word ‘menthol’ with the descriptor ​‘green’

. Additionally, 87.3% of menthol ​replacement packs were wrapped in cellophane dis​playing the phrase ‘smooth taste [redesigned] ​without menthol’

Table 3 shows the sources of purchase among those who smoked ​​menthol cigarettes compared with those only smoking non-flavoured cigarettes (unweighted data in online supplemental ​​table S5). The main sources were newsagents/off-licence/corner ​​shops and supermarkets. There were no noteworthy differences ​​between the two groups. Most participants reported purchasing ​​through licit sources (for menthol cigarette smoking: 93.9%, ​​95%CI 92.2% to 95.5%; for non-flavoured cigarette smoking: ​​93.5%, 95%CI 92.7% to 94.2%).

Method: “Menthol Ball' key word was Google searched. Out of 45,500 data retrieved ​1696 relevant ones were further investigated. Web sites of the products, e-commerce ​websites, social media accounts were detected. Their promotional activities, methods of ​trading were noted. Results: 37 brands of menthol balls were detected. All brands ​promote their products through videos describing the injection of the tiny menthol balls ​into the classical cigarettes. Only 12 have their individual website, the other 25 use main ​e-commerce outlets to reach to the customers. Two menthol ball brands market their ​products in one-kilogram bags at e-commerce sites. One brand market a 'menthol ball ​liquid' for roll-your-own tobacco. Three major e- commerce sites sell 1485 different ​flavored menthol balls under the category of air refresher. One other e-commerce site ​sold 88 various menthol balls under the category of tobacco bags.

Results: Out of 198 POS visited 31 ​sell a product called 'menthol ball'. These were tiny colorful balls of menthol mixed with ​other various aromas that are sold together with an instrument that stab the end of a ​standard cigarette and insert the ball into the cigarette.

Participants in the green (OR=1.74, 95% CI 1.13 to 2.70), menthol cigarette ban (OR=3.40, 95% CI 2.14 to 5.41) and all menthol ban conditions (OR=3.14, 95% CI 1.97 to 5.01) were more likely to purchase a cigarette brand different from their usual than participants in the no ban condition (table 4).

Participants in the green replacement condition (OR=1.75, ​​95% CI 1.23 to 2.51) were more likely to think cigarettes ​​labelled as green contained menthol than participants in the no ​​ban condition

Correct recall of green versus menthol cigarette ​​ads in the green and no ban conditions, respectively, did not ​​differ between the two conditions (OR=0.83, 95% CI 0.60 to ​​1.17).

Participants in the green (OR=1.74, 95% CI 1.13 to 2.70), menthol cigarette ban (OR=3.40, 95% CI 2.14 to 5.41) and all menthol ban conditions (OR=3.14, 95% CI 1.97 to 5.01) were more likely to purchase a cigarette brand different from their usual than participants in the no ban condition (table 4).

All participating countries reported a range of flavour acces​sories on their markets, regardless of their different levels of ​​tobacco product flavour regulation (table 2).

As tobacco accessories sold separately are excluded ​​from the legislation, companies have been intro​ducing various menthol-flavoured accessories. ​​Imperial launched menthol34 and capsule35 RYO ​​filter tips in mid-2017 and January 2019, respec​tively.

Extracts of Newport ​Non-Menthol Green and Newport Non-Menthol EXP ciga​rettes activated cold/menthol receptors at higher dilutions (33X ​each) than extracts of reference Newport menthol cigarettes ​(10X), and with higher efficacies (24% and 54%, respectively) ​(Figure, A). Camel Crisp–branded cigarettes also produced cool​ing activity, whereas Kool non-menthol cigarettes did not ​(Figure, B and C). Chemical analysis identified WS-3 (1.0-2.4 ​mg per cigarette) in 4 of the 9 non-menthol brands (Table). ​No other cooling agents or menthol was detected in any of the ​non-menthol products. Filter capsules of all Camel Crush non-menthol varieties contained vanillin (0.14 ± 0.02 mg), ethyl ​vanillin (0.25 ± 0.02 mg), and smaller amounts of anethole, ​linalool, acetophenone, and γ-octalactone. Discussion|These results suggest that some tobacco products ​marketed in California and Massachusetts after a ban on men​thol cigarettes contained a synthetic cooling agent,WS-3.WS-3 ​was restricted to non-menthol brands (Newport, Camel) mar​keted by R.J. Reynolds. Extracts ofWS-3–containing brands ac​tivated cold/menthol receptorswith higher efficacies thanmen​thol reference products, indicating these cigarettes can generate ​strong cooling sensations.

Zyn Chill extract robustly activated the cold/menthol ​​receptor TRPM8, even at 20-fold dilution, indicating the pres​ence of a cooling agent (figure 1A).

We detected the synthetic cooling agent, WS-3, in cigarettes of ​several of the newly California-marketed “non-menthol” cigarette brands.

Menthol smokers were less likely to support a ​​ban on menthol (aOR = 0.18, 95% CI: 0.08–0.43)

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)

According to public references, the bill proponent had received ​​campaign donations from Alliance One (R$100 000) and five ​​cars from Souza Cruz (British and American Tobacco in Brazil) ​​to donate to charities.

In 2011, the Getúlio Vargas Foundation (FGV for the name in ​​Portuguese) published a study,49 funded by TI and groups linked ​​to the TI90 (according to the publication—SINDITABACO— ​Interstate Tobacco Industry Union, FETAG—Federation of ​​Agricultural Workers in Rio Grande do Sul; FETAESC—Feder​ation of Agricultural Workers of the State of Santa Catarina; ​​STIFA—Union of Workers in the Tobacco and Food Industries ​​of Santa Cruz do Sul and Region; CNTUR—National Confed​eration of Tourism; ABRASEL—Brazilian Association of Bars ​​and Restaurants), concluding that the prohibition of additives ​​would bring no public health benefits while it would negatively ​​affect the production of burley-type tobacco and increase illicit ​​trade.49

While in itself this was not a concern, a story by ​​newspaper Folha de São Paulo50 suggested that such a large ​​number of comments aimed to delay the process of analysis of ​​public comments and, consequently, the release and implementa​tion of the proposed resolution. Analysis of documents obtained ​​through access of information law69 revealed that: 1. The TI printed its own form for submitting contributions, ​​containing filling instructions, to protest against the pro​posed regulation. Two thousand of these forms were blank ​​when delivered. 2. Thousands of forms were mailed from Rio de Janeiro, ac​cording to the postmark, however the addresses on the forms ​​were from other states. 3. Five hundred forms were sent without any identification and ​​only contained a statement against the proposed draft. 4. In some cases, ANVISA contacted the signatory to seek clar​ification on the comment submitted, and was told by the ​​supposed signatory that they had never participated in the ​​process. 5. In one case, the person indicated that they were at an event, ​​was requested to sign the public comment form, but indicat​ed that he was led to believe that the form was some type of ​​survey research. 6. Some of the addresses submitted on the forms were ​​non-existent. ​These finding indicate that these comments, and the massive ​​participation in the public consultation, were likely coordinated ​​by TI as a strategy to delay the conclusion of the process

While in itself this was not a concern, a story by ​​newspaper Folha de São Paulo50 suggested that such a large ​​number of comments aimed to delay the process of analysis of ​​public comments and, consequently, the release and implementa​tion of the proposed resolution. Analysis of documents obtained ​​through access of information law69 revealed that: 1. The TI printed its own form for submitting contributions, ​​containing filling instructions, to protest against the pro​posed regulation. Two thousand of these forms were blank ​​when delivered. 2. Thousands of forms were mailed from Rio de Janeiro, ac​cording to the postmark, however the addresses on the forms ​​were from other states. 3. Five hundred forms were sent without any identification and ​​only contained a statement against the proposed draft. 4. In some cases, ANVISA contacted the signatory to seek clar​ification on the comment submitted, and was told by the ​​supposed signatory that they had never participated in the ​​process. 5. In one case, the person indicated that they were at an event, ​​was requested to sign the public comment form, but indicat​ed that he was led to believe that the form was some type of ​​survey research. 6. Some of the addresses submitted on the forms were ​​non-existent. ​These finding indicate that these comments, and the massive ​​participation in the public consultation, were likely coordinated ​​by TI as a strategy to delay the conclusion of the process"

Differential packaging was observed only with the use of ‘non-menthol’ flavour descriptors among CA brands, rather than ​​‘menthol’ among NY brands (figure 1).

CA ​​Camel Crush-silver and blue logo types have replaced expressed ​​‘menthol’ with implied ‘oasis’ descriptors (figure 1E,F).

. Menthol smokers were more likely than ​otherwise similar nonmenthol smokers to dis​agree with a menthol ban (50.5% vs 31.2%; ​P

Retailers ​​were warned that they would be subject to permit suspension ​​and/or administrative penalties if they did not come into compli​ance and were offered the opportunity to self-certify compliance ​​by notifying the Department by text message when they had ​​eliminated flavoured tobacco product sales and display. Routine ​​inspections, which included the possibility of citations, started in ​​April 2019. The SFDPH issued 83 Notices of Correction and 4 ​​Notice of Violations between April 2019 and December 2019. ​​Between January 2019 and December 2019, compliance was ​​80%.

“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.”

Those who used menthol cigarettes tended to have a lower educational attainment, have a longer smoking history, were more likely to smoke daily, more likely to solely obtain their product from local retailers

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).

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.

While products with ambiguous flavor names were also ​significantly less prevalent in flavor ordinance jurisdictions compared to ​matched no-ordinance jurisdictions (cigarillo/cigar wraps: 53.9% vs. ​78.1%)

They did another round of data gathering in Minneapolis (but not St Paul) because compliance with new ban was so bad

In Minneapolis between rounds 1 and 3, there was a significant ​​reduction in the per cent of stores that sold tobacco with ambig​uous flavours names such as ‘TaTa’ and ‘Blue’ (80.5% vs 61.5%)

In Saint Paul, there was no significant change in the per cent of stores that sold products with ambiguous flavour names (67.6% vs 81.1%).

In addition, the NYC Department of Finance’s (DOF) ​​Sheriff’s Office regularly inspected tobacco retailers for ​​compliance with the city’s cigarette excise tax, including ​​searches of retailers’ premises for hidden packs of untaxed ​​cigarettes. Stakeholders reported that DOF found flavored ​​cigars hidden with untaxed cigarettes

No products with ambiguous names or replacement menthol tobacco were observed in the overall sample.

No products with ambiguous names or replacement menthol tobacco were observed in the overall sample.

During the ​​follow-up period, 85.5% of retailers reported that educational ​​visits and 62.2% reported that the MAHB flavoured product ​​guidance list were the most helpful for achieving compliance.

Since this policy was enacted, and with ample ​​time for a response, the tobacco industry began ​​extensively marketing cigarette varieties with ​​cooling features explicitly labelled such as ‘non-menthol’ at tobacco retailers in California.3 (Note ​​that the term ‘non-menthol’ in the remainder of the ​​manuscript refers to cigarettes explicitly labelled as ​​‘non-menthol’ vs broadly referring those that are ​​not mentholated.)

None of the 55 stores visited in December ​2018 were observed to have Game Blue cigarillos (the 4th and fi​nal round of store audits).

Between the first and last rounds of compliance checks, ​violations for sale of tobacco to a minor decreased by 12 percent​age points to 2%

In Providence, trends in the percentage of unique explicit-named flavoured cigarillo UPCs (‘sales share’) appear to drop from the prepolicy to the postpolicy period while trends in the share of concept-named and tobacco flavoured cigarillo UPCs appear to increase over these periods

The number of unique concept-named flavoured cigarillo ​​UPCs increased in both Providence and ROS in the week of ​​policy implementation. Although the total postpolicy difference ​​between Providence and ROS in the number of unique concept-named flavoured cigarillo UPCs was insignificant, the increase ​​in availability of these products from prepolicy to postpolicy ​​periods in Providence was 6.08 (±2.31) UPCs higher than the ​​comparable change in ROS (p

There was no significant difference in prepolicy share ​​of concept-named flavoured cigarillos between Providence ​​(9.44%,±0.49 percentage points) and ROS (9.68%,±0.99 ​​percentage points), but the postpolicy share of these products ​​was significantly different between Providence (27.32%,±1.77 ​​percentage points) and ROS (12.67%,±1.67 percentage points) ​​(p

When stratifying by store type, there was a statistically significant greater decrease in any FTP availability among policy-area convenience stores than among comparison-area convenience stores (p