Assessing the Health and Economic Impact of a Potential Menthol Cigarette Ban in New York City: a Modeling Study

Abstract

Menthol in cigarettes increases nicotine dependence and decreases the chances of successful smoking cessation. In New York City (NYC), nearly half of current smokers usually smoke menthol cigarettes. Female and non-Latino Black individuals were more likely to smoke menthol-flavored cigarettes compared to males and other races and ethnicities. Although the US Food and Drug Administration recently announced that it will ban menthol cigarettes, it is unclear how the policy would affect population health and health disparities in NYC. To inform potential policymaking, we used a microsimulation model of cardiovascular disease (CVD) to project the long-term health and economic impact of a potential menthol ban in NYC. Our model projected that there could be 57,232 (95% CI: 51,967–62,497) myocardial infarction (MI) cases and 52,195 (95% CI: 47,446–56,945) stroke cases per 1 million adult smokers in NYC over a 20-year period without the menthol ban policy. With the menthol ban policy, 2,862 MI cases and 1,983 stroke cases per 1 million adults could be averted over a 20-year period. The model also projected that an average of $1,836 in healthcare costs per person, or $1.62 billion among all adult smokers, could be saved over a 20-year period due to the implementation of a menthol ban policy. Results from subgroup analyses showed that women, particularly Black women, would have more reductions in adverse CVD outcomes from the potential implementation of the menthol ban policy compared to males and other racial and ethnic subgroups, which implies that the policy could reduce sex and racial and ethnic CVD disparities. Findings from our study provide policymakers with evidence to support policies that limit access to menthol cigarettes and potentially address racial and ethnic disparities in smoking-related disease burden.

Addiction Potential of Combustible Menthol Cigarette Alternatives: A Randomized Crossover Trial

“…In April 2021, the FDA announced its intention to issue product standards banning menthol as a characterizing flavor in both cigarettes and cigars within a year. 14 While evidence from systematic reviews, 7 15-17 evaluations of Ontario's menthol cigarette ban, [18][19][20] and simulation studies strongly support the likely positive public health impact of a menthol ban on cigarette and cigars, [21][22][23] experimental evidence is also needed to bolster these findings to withstand tobacco industry lawsuits.…”

Addiction potential of combustible menthol cigarette alternatives: a randomised cross-over trial

“…In May 2022, the FDA issued proposed rules for product standards banning menthol as a characterising flavour in both cigarettes and cigars. 13 14 While evidence from systematic reviews, 7 15-17 evaluations of Ontario's menthol cigarette ban [18][19][20] and simulation studies strongly support the likely positive public health impact of a menthol ban on cigarette and cigars, [21][22][23] experimental evidence is also needed to bolster these findings to withstand tobacco industry lawsuits.…”