Effect of menthol bans on teen smoking rates

The sale of menthol cigarettes have been banned throughout Canada since 2017 and in England since May 2020. The US Food and Drug Administration may now make a similar move to try and reduce cigarette use among teenagers in the United States. A new report examines the outcome of the bans of menthol cigarettes and offers some information on adolescent smokers.¹

The investigators used data from online repeat cross-sectional International Tobacco Control Youth Tobacco and Vaping Surveys that were conducted in 2018, 2019, February 2020, and August 2020. The participants included people aged 16 to 19 years who were past 30-day smokers. The 3 countries represented a country where a menthol ban existed (Canada), was implemented during the study period (England), and did not exist (United States).

There were 7067 participants in the sample, 4129 were female and 5019 were White. The weighted percentage of smokers who report smoking either a menthol or capsule cigarette brand was stable in the first 3 survey waves in England before the ban (2018 to February 2020, 9.4% vs 12.1%; adjusted odds ratio [AOR], 1.03; 95% CI, 0.99-1.06; P = .15), but a decrease of 3% was found following the ban (February 2020 vs August 2020, AOR, 1.07; 95% CI, 1.04-1.10; P < .001). The decrease was overall similar across all of the demographic groups, but was found to be greater among adolescents who considered themselves addicted to cigarettes.(AOR, 0.37; 95% CI, 0.41-0.97; P = .04). In Canada and the United States, the rate of menthol or capsule smoking was the same across all of the waves 2018 to August 2020: US, 33.6%-36.9%; Canada, 3.1%-2.3%). In addition, it was more prevalent in the United States than in England (AOR, 5.58; 95% CI, 4.63-6.72; P < .001). It was also more prevalent among English female smokers than male (10.9% vs 7.2%; AOR, 1.04; 95% CI, 1.01-1.06; P = .002); US smokers who were Black than those who were White (60.6% vs 31.9%; AOR, 1.33; 95% CI, 1.23-1.44; P < .001).

The investigators concluded that the ratio of adolescents smothers who smoked menthol cigarettes saw a significant decrease after the ban of their sale was enacted and this dip was consisted across a variety of demographic groups. This could be indicative of how the use of menthol products would change after a similar ban in the United States.

Reference

1. East K, Reid J, Burkhalter R, et al. Evaluating the outcomes of the menthol cigarette ban in England by comparing menthol cigarette smoking among youth in England, Canada, and the US, 2018-2020. JAMA Netw Open. 2022;5(5):e2210029. doi:10.1001/jamanetworkopen.2022.10029