The dangers of cigarettes have been known for decades. Numerous studies have established links between cigarette smoking and various cancers, coronary artery diseases, and respiratory infections, among other diseases. Cigarettes are also an environmental hazard, with five trillion butts being discarded every year, making them the world’s most common waste product.
Due to these risks, which also place a large burden on healthcare systems, healthcare officials and policymakers around the world have implemented a wide variety of policies to disincentivize cigarette smoking.
From banning all forms of tobacco-related advertising, to implementing tobacco taxes, to even a blanket cigarette ban for all future generations, governments have produced creative ways of tackling the smoking problem. The combination of these approaches has also likely played a role in smoking rates reaching all-time lows among adults in some countries.
Cool (mint) cigarettes
Another recent target of government regulators has been menthol cigarettes, whose flavour reduces the harsh taste of tobacco. In addition to targeted advertising campaigns, these properties have resulted in menthol cigarettes being disproportionately used by women, racialized minorities, and adolescents — widening preexisting health disparities.
Unsurprisingly, the use of menthol in tobacco products has been targeted by regulators, resulting in proposed or implemented menthol cigarette bans in Canada, the United States, and the European Union (EU), among dozens of other locations. This last ban is the focus of a new study in the journal Tobacco Control that was co-authored by researchers from the University of Waterloo.
As the authors of the study discuss, the European Union banned “characterising flavours” in tobacco products in 2016 — a ban that encompassed menthol cigarettes — with a grace period lasting until 2020. The researchers cite previous studies indicating that menthol bans may be linked to reduced tobacco use, increased smoking cessation, decreased smoking initiation, and decreased deaths and life-years lost due to tobacco.
To understand the effects of this menthol ban, the researchers recruited smokers from the International Tobacco Control Netherlands Surveys to obtain a representative sample of cigarette smokers in the Netherlands.
What did the study show?
Crucially, the group surveyed by the researchers included both menthol and non-menthol cigarette smokers. Additionally, the smokers were surveyed both before and after the menthol ban, allowing the researchers to understand the ban’s effect on menthol smoking rates.
After statistical adjustments, the study found that menthol cigarette use decreased significantly following the ban, dropping from 7.8% of all cigarette use to 4.0%. Quitting attempts were affected too, with nearly 67% of menthol smokers attempting to quit following the ban compared to nearly 50% of non-menthol smokers.
Successful quitting was also affected by the ban. By the end of the third survey wave, over a quarter (26%) of menthol smokers had quit smoking, whereas only 14% of non-menthol smokers had quit during this same time frame.
But it’s not all good news
Despite these promising results, the authors still remain cautious. While the menthol ban did result in decreased menthol cigarette consumption and increased attempted and successful quitting attempts, one-third (33%) of pre-ban menthol smokers reported that they continued to smoke menthol cigarettes, while 40% transitioned to non-menthol cigarettes.
Additionally, the authors warn that tobacco companies will attempt to lobby governments to weaken regulations including menthol bans. Yet there is room for action. As one co-author stated, “these tobacco industry actions undermine the effectiveness of the menthol ban. By tightening the regulations to include these menthol add-ons, the impact of the menthol ban on quitting could be even greater.”