Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2022 Aug 6;24(9):1448-1457.
doi: 10.1093/ntr/ntac107.

Effect on Tobacco Use and Subjective Measures of Including E-cigarettes in a Simulated Ban of Menthol in Combustible Cigarettes

Michael Kotlyar  1   2   3 , Ryan Shanley  4 , Sheena R Dufresne  1 , Gretchen A Corcoran  1 , Dorothy K Hatsukami  2   3
Affiliations
Randomized Controlled Trial

Effect on Tobacco Use and Subjective Measures of Including E-cigarettes in a Simulated Ban of Menthol in Combustible Cigarettes

Michael Kotlyar et al. Nicotine Tob Res. .

Abstract

Introduction: Bans of menthol characterizing flavor in tobacco products have been proposed; however, there is limited data regarding the impact on current menthol cigarette smokers of including e-cigarettes in such bans.

Methods: In this six-week pilot study, 47 menthol smokers were randomized to receive all tobacco products from an experimental marketplace simulating either no menthol ban, a menthol ban for cigarettes but not e-cigarettes, or a ban for both ("total menthol ban").

Results: At the first visit, all but one participant selected cigarettes with e-cigarettes selected by 38%, 69%, and 40% of participants in the no ban, menthol cigarette ban, and total menthol ban groups, respectively. Over the study period, the total menthol ban group smoked more than the menthol cigarette ban group (estimated mean ratio [EMR] in cigarettes per day = 1.38; 95% CI: 1.1, 1.75; p = .006). Compared to the no ban condition, the menthol cigarette ban group smoked slightly fewer (EMR = 0.87; 95% CI: .68, 1.11) and the total menthol ban group smoked slightly more (EMR = 1.20; 95% CI: 1.00, 1.45) although neither difference reached statistical significance. In both menthol ban conditions, ratings were lower (vs. no ban) on several measures of craving and cigarette effects and liking.

Conclusions: Menthol bans that include e-cigarettes may result in different patterns of tobacco use than if only combustible cigarettes are included, although e-cigarettes were not extensively used in any group. Larger studies are needed to determine policies most likely to provide the largest public health benefit.

Implications: Bans of menthol characterizing flavor have been proposed, however, the effects on menthol cigarette smokers of including e-cigarettes in such bans are not clear. This study found that smokers randomized to a simulated ban on menthol in both cigarettes and e-cigarettes smoked more cigarettes per day over the 6-week study period than those randomized to a simulated ban on menthol in only cigarettes suggesting that smoking patterns among current menthol smokers differ depending on which products are included in a menthol ban. Larger studies are needed to determine the policies most likely to provide the largest public health benefit.

Trial registration: ClinicalTrials.gov NCT03402243.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Total Number (Raw Mean ± SD) of Cigarettes Smoked in Each Group.
See this image and copyright information in PMC

References

    1. TPSAC (Tobacco Products Scientific Advisory Committee). Menthol Cigarettes and Public Health: Review of the Scientific Evidence and Recommendations. 2011.
    1. FDA. Preliminary Scientific Evaluation of the Possible Public Health Effects of Menthol Versus Nonmenthol Cigarettes . https://www.fda.gov/media/86497/download. Published 2013. Accessed February 25, 2021.
    1. Smith PH, Assefa B, Kainth S, et al. . Use of mentholated cigarettes and likelihood of smoking cessation in the United States: A meta-analysis. Nicotine Tob Res. 2020;22(3):307–316. - PMC - PubMed
    1. Villanti AC, Collins LK, Niaura RS, et al. . Menthol cigarettes and the public health standard: A systematic review. BMC Public Health. 2017;17(1):983. doi:10.1186/s12889-017-4987-z. - DOI - PMC - PubMed
    1. Erinoso O, Clegg Smith K, Iacobelli M, et al. . Global review of tobacco product flavour policies. Tob Control. 2021;30(4):373–379. - PMC - PubMed

Publication types

Associated data