Should menthol e-cigarettes be banned? Reaction of adult smokers and users of e-cigarettes to hypothetical bans

Abstract

IntroductionThis study examines how current smokers using menthol cigarettes or flavoured cigars, and current users of flavoured e-cigarettes may respond to three hypothetical flavour-ban scenarios: (1) banning only menthol cigarettes and flavoured cigars; (2) also banning e-cigarettes with any non-tobacco flavours except menthol; and (3) also banning e-cigarettes with any non-tobacco flavours, including menthol.MethodsRecruited from mTurk, respondents were asked if they would quit all tobacco-nicotine use or continue or start using products that were still legally available. The patterns of responding to each ban scenario, for both flavoured smokers and users of non-tobacco flavoured e-cigarettes, were summarised. Multinomial logistic regressions were used to estimate associations between demographics, smoking or e-cigarette use status and reactions to a ban.ResultsA ban on menthol cigarettes and flavoured cigars would lead to 12%–20% of flavoured smokers trying to quit all tobacco use and 32%–52% switching to non-flavoured smoking, with the remaining switching to e-cigarettes or other products. Compared with a ban on only menthol cigarettes and flavoured cigars, also banning flavoured e-cigarettes would increase the likelihood of quitting all tobacco-nicotine use (OR=2.58) but also increase the likelihood of switching to non-flavoured smoking (OR=1.74).ConclusionsOur results indicate that a ban on menthol cigarettes and flavoured cigars would decrease smoking. However, it is unclear if adding a ban of menthol e-cigarettes would lead to additional benefits because without menthol e-cigarettes as an alternative, some smokers and e-cigarette users may switch to non-flavoured tobacco smoking, rather than quit all tobacco use.

Tobacco control policy and regulation from diverse perspectives and contexts

“…Gendall and Hoek 13 analysed tobacco company returns to the New Zealand Ministry of Health over 11 years and found that they hold a modest but significant share of tobacco sales in the country. Yang et al 14 surveyed people who currently smoke menthol or flavoured tobacco products and/or use non-tobacco flavoured e-cigarettes about how they would respond to three different scenarios of menthol and other flavoured tobacco product bans, with or without including flavoured and menthol e-cigarettes. They found mixed potential public health impact, with both the highest proportion of people likely to quit in a full flavoured tobacco and e-cigarette ban, but also the highest proportion of people who currently use flavoured products likely to switch to non-flavoured smoking.…”