Table 2 Studies that report results related to hypothetical menthol bans
From: The actual and anticipated effects of a menthol cigarette ban: a scoping review
Author, Year | Location | Age group | Study Design (Theme) | Sample Size | Ban Specifics (Implementation Date) | Data Sources | Main Outcomes | Results |
|---|---|---|---|---|---|---|---|---|
Buckell, J. 2019 [23] | US | 18–64 | Cross-Sectional (Individual Intentions) | N = 2031 smokers and recently quit smokers | Hypothetical national ban on menthol cigarettes and menthol/flavored e-cigarettes | Discrete choice experiment considering various combinations of menthol cigarette and menthol or fruit/sweet e-cigarette bans. | Change in product choice shares | Current and former smokers preferred cigarettes to e-cigarettes, but differences by age, race, and education exist. Banning menthol cigarettes would produce the greatest reduction in the choice of cigarettes (−5.2%), but with an accompanying increase in e-cigarette use (3.8%). Banning flavors, including menthol, in e-cigarettes without banning menthol cigarettes would result in an 8.3% increase in the use of combustible cigarettes and an 11.1% decline in e-cigarette use. Banning all flavors across all products would increase ‘opting-out’ the most (5.2%), but would also increase cigarette choice by 2.7%. |
D’Silva, J. 2015 [24] | Minnesota, US | 18+ | Cross-Sectional (Individual Intentions) | N = 1158 current menthol smokers (100+ cigarettes and smoked some or everyday with menthols as their usual brand) | Hypothetical ban on menthol cigarettes | Minnesota Adult Tobacco Survey | Cessation and product switching | Nearly half (46.4%, [37.9, 54.9]) of menthol smokers responded that they would quit smoking. Approximately one-fourth of menthol smokers (26.6%, [19.0, 34.1]) reported that they would switch to non-menthol cigarettes; 12.3% [6.3, 18.3] would switch to menthol e-cigarettes, 5.8% [1.8, 9.7] would buy menthol cigarettes online, 2.8% [0.4, 5.2] would switch to some other menthol tobacco product, 2.7% [0.0, 6.0] would buy menthol cigarettes from another country, and 1.5% [0.0, 3.8] would switch to some other non-menthol tobacco product. African-American menthol smokers were more than twice as likely to report an intention to quit in the event of a ban (76.0%, [57.6, 94.3]) compared to their white counterparts (30.3%, [21.7, 38.9]) (RR = 2.5, [1.7, 3.6], p < .001). |
Guillory, J. 2019 [25] | US | 18+ | Cross-Sectional (Individual Intentions) | N = 1197 menthol smokers | Hypothetical national ban on menthol cigarettes | RTI iShoppe virtual convenience store. Four types of virtual ban: a) no ban; b) replacement of menthol cigarettes and ads with green versions; c) menthol cigarette ban; d) all menthol tobacco products ban. | Consumer behavior in response to bans, brand loyalty, and perceived response. | Cigarette purchases were higher in the no ban (59%) and green conditions (59%) than the menthol cigarette ban (49%) and all menthol ban conditions (47%). Menthol cigarette purchases were highest in the no ban condition (50%). Other tobacco product (OTP) purchases were low across conditions, ranging from 16 to 17%, with 2–3% of all tobacco purchases being menthol e-cigarettes. Purchases of a substitute cigarette brand were highest in the menthol cigarette ban condition (61%) and the all menthol ban (60%).OTP purchases were similar across four scenarios, suggesting menthol bans may not increase OTP purchases. |
Hartman, A. 2011 [22] | US | 18+ | Cross-Sectional (Individual Intentions) | N = 10,441 (n= 2887 regular menthol smokers) | Hypothetical national ban on menthol cigarettes | Tobacco Use Supplement-current Population Survey 2010 | Cessation and product switching | 39% of usual menthol users (30% of the smokers’ sample) reported they would quit and not switch to an alternative tobacco product. This included 40.6% of the 18–44 year-olds and 36.7% of the 45+. Women and non-Hispanic blacks report less intention to quit compared to men and non-Hispanic whites. |
O’Connor, R. 2012 [26] | US | 14–65 | Cross-Sectional (Individual Intentions) | N = 417 (n = 170 menthol users). | Hypothetical national ban on menthol cigarettes | Global Market Institute, Inc. online survey panel, July 2010. Sample stratified smokers and non-smokers by age group | Cessation and product switching | More than 35% of menthol smokers reported the intention to quit smoking, 25% plan to seek out menthol cigarettes. Demand elasticity for non-menthol products in menthol smokers was 50% higher than for non-menthol smokers. |
Pacek, L. 2019 [27] | US | 18–29 | Cross-Sectional (Individual Intentions) | N = 240 (n = 126 menthol users) | Hypothetical national ban on menthol cigarettes (also considered low nicotine content cigarettes) | Amazon Mechanical Turk survey, 2017. Dual (combusted and e-cigarette) users. | Use of e-cigarettes in response to menthol cigarette ban | Approximately 25% (aged 18–29) would plan to quit and 32.5% would reduce the amount smoked. Approximately 30% of menthol cigarette/e-cigarette dual users reported an intention to increase e-cigarette use following a menthol ban. |
Pearson, J. 2012 [28] | US | 18+ | Cross-Sectional (Individual Intentions) | N = 2649 | Hypothetical national ban on menthol cigarettes | Data from the Knowledge Panel. Never, former and current smokers. Stratified by sex, ethnicity, age group, education, health status, intention to quit and quit attempts | Attitudes towards menthol bans; cessation and product switching. | Menthol smokers were more likely than non-menthol smokers to disagree with a menthol ban (50.5% vs. 31.2%; P < 0.001). 38.9% of menthol smokers said that they would quit, 13% would switch to a nonmenthol cigarette, 25% would switch to regular cigarettes and try to quit. |
Rose, S. 2019 [29] | US | 18–34 | Cohort (Individual Intentions) | N = 806 | Hypothetical national ban on menthol cigarettes | Truth Initiative Young Adult Cohort from 2011 to 2016 | Cessation and product switching | Switching to non-menthol cigarettes was most common post-ban intention (mean of 32.3% across multiple waves). 30.8% did not know what they would do in response to a menthol ban. 23.5% reported they would quit and 10.7% reported the intention to use an alternative tobacco product. |
Wackowski, O. 2014 [30] | US | 18–34 | Cross-Sectional (Individual Intentions) | N = 2871 (n = 619 menthol users) | Hypothetical national ban on menthol cigarettes | National Young Adult Health Survey, 2011. Menthol smokers | Cessation and product switching | 64% would try to quit smoking, 18% would switch to non-menthol cigarettes, 15.7% would switch to OTP, and 1% didn’t know. |
Wackowski, O. 2015 [31] | US | 18+ | Cross-Sectional (Individual Intentions) | N = 519 (n = 187 menthol users) | Hypothetical national ban on menthol cigarettes | Online survey panel, April 2014. Stratified by ethnicity. | Cessation and product switching | 28.4% would try to quit smoking; 45.9% switch to nonmenthol cigarettes; 3.9% would switch to OTP; 15.1% would switch to menthol e-cigarettes. |
Wackowski, O. 2018 [32] | New Jersey, US | 18–24 | Cross-Sectional (Individual Intentions) | N = 45 (in 6 focus groups) | Hypothetical ban on menthol cigarettes | Focus groups from Dec 2014 to Mar 2015 | Attitudes and perspective towards menthol cigarettes | 59.1% indicated that either all (34.1%) or most (25%) of their first few cigarettes were mentholated.Easy accesses to loosies influenced menthol use (particularly among African Americans). Several people noted that they were willing to smoke a friend’s non-menthol cigarette if they didn’t have their cigarettes. Many participants were highly skeptical that a ban could be effective, believing that people would still find a way to get menthol cigarettes, either on the “black market” or by making bootleg versions.Some stated that a ban would not make much of an impact on them because they would just switch to non-menthol cigarettes. However, others thought a ban might motivate them to quit and increase their likelihood of doing so. |
Zatoński, M. 2018 [33] | Europe | 18+ | Cross-Sectional (Individual Intentions) | N = 10,760 smokers (100+ cigarettes in their lifetime) | Hypothetical ban on menthol cigarettes | Smokers from 8 European countries from the International Tobacco Control Policy Evaluation | Cessation and product switching | When asked about their intended behavior following a hypothetical ban, most respondents reported intending to find menthol cigarettes regardless of the ban (27.3%; 95% CI 23.7–31.3), 20% reported an intention to switch to another product (95% CI 16.9–23.4), 17.6% reported an intention to reduce their smoking amount (95% CI 14.5–21.1), 16.0% reported an intention to quit (95% CI 13.3–19.2), and the remainder reported that they would ‘do something else’ or did not know. |