Public health impact of a US menthol cigarette ban on the non-Hispanic black population: a simulation study

Abstract

IntroductionWith the US Food and Drug Administration recently proposing to implement a ban on menthol cigarettes, it is critical to estimate the potential public health effects of such a ban. With high rates of menthol cigarette use and important smoking-related health disparity implications, the impact of the ban on the non-Hispanic black (NHB) population merits strong consideration.MethodsWe apply the previously developed Menthol Smoking and Vaping Model to the NHB population. A status quo scenario is developed using NHB-specific population, smoking and vaping initiation, cessation and death rates. Estimates from a recent expert elicitation on behavioural impacts of a menthol cigarette ban on the NHB population are used to develop a menthol ban scenario implemented in 2021. The public health impacts of the menthol ban are estimated as the difference between smoking and vaping attributable deaths (SVADs) and life years lost (LYLs) in the status quo and the menthol ban scenarios from 2021 to 2060.ResultsUnder the menthol ban scenario, overall smoking is projected to decline by 35.7% in 2026 and by 25.3% in 2060 relative to the status quo scenario. With these reductions, SVADs are estimated to fall by about 18.5% and LYLs by 22.1%, translating to 255 895 premature deaths averted, and 4.0 million life years gained over a 40-year period.ConclusionsA menthol cigarette ban will substantially reduce the smoking-associated health impact on the NHB population, thereby reducing health disparities.

Trends in US Adult Smoking Prevalence, 2011 to 2022

“… 10 A ban on menthol in cigarettes and cigars is associated with reduced racial disparities. 11 Increasing taxes on combustible tobacco products in low-taxing states may reduce disparities across states. 12 These targeted interventions would reduce health disparities and improve health equity by reducing smoking-attributable deaths among those with lower SES.…”

Smoking cessation prevalence by menthol cigarette use and select demographics among adults in the United States, TUS-CPS, 2003–2019

“…( National Center for Chronic Disease Prevention and Health Promotion, 1998 , Babb et al, 2017 , Sohn, 2017 , Delnevo et al, 2020 , Webb Hooper et al, 2020 , Nguyen et al, 2012 ) Population simulation modeling studies estimate that banning the sale of menthol cigarettes would avert more than 237,000 smoking-attributable deaths and result in relative reductions in menthol and non-menthol cigarette use of 35.7 % in 2026 and 25.3 % in 2060 among the non-Hispanic Black/African American population. ( Levy et al, 2011 , Issabakhsh et al, 2022 ).…”

Sociodemographic and Temporal Differences in Menthol Cigarette Use Among US Adults Who Smoke, 1999–2018

“…people and reduces the likelihood for successful cessation (2)(3)(4). Restricting the sale of flavored tobacco products in the US has been shown to reduce the proportion of youth who try or use tobacco products (5)(6)(7)(8). More than 18 million US adults smoked menthol cigarettes in 2019; it was estimated that prohibiting menthol cigarettes in the US would result in more than 1.3 million people quitting smoking, based on studies after menthol cigarettes were prohibited in Canada (9).…”