Association of Ontario’s Ban on Menthol Cigarettes With Smoking Behavior 1 Month After Implementation

Chaiton, Michael; Schwartz, Robert; Cohen, Joanna E.; Soule, Eric K.; Eissenberg, Thomas

doi:10.1001/jamainternmed.2017.8650

Cited by 60 publications

(63 citation statements)

References 8 publications

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“…Consistent with other data from the USA (Dutra and Glantz 2017;Levy et al 2018), it appears as though the increase in youth e-cigarette use has not led to an increase in youth smoking. The availability of flavours of e-cigarettes may have increased their appeal over traditional cigarettes (Zhu et al 2014); for example, within Ontario as of January 1, 2017, menthol-flavoured cigarettes were banned (Chaiton et al 2018), leaving e-cigarettes as one of the few a Ever use of e-cigarettes was not assessed prior to 2015; non-current users include those who have never used e-cigarettes and those who did not use e-cigarettes in the last 30 days b Students who identified as "off-reserve Aboriginal" are also included in this category flavoured tobacco products available. Other evidence suggests that promotion on social media may have also contributed to the increased appeal of e-cigarettes over traditional cigarettes (Allem et al 2018;Laestadius et al 2018).…”

Section: Discussionmentioning

confidence: 99%

Trends in youth e-cigarette and cigarette use between 2013 and 2019: insights from repeat cross-sectional data from the COMPASS study

Cole

Aleyan

Battista

et al. 2020

Can J Public Health

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Objectives E-cigarettes are an increasingly popular product among youth in Canada. However, there is a lack of long-term data presenting trends in use. As such, the objective of this study was to examine trends in e-cigarette and cigarette use across various demographic characteristics between 2013 and 2019 among a large sample of secondary school youth in Canada. Methods Using repeat cross-sectional data from a non-probability sample of students in grades 9 to 12, this study explored trends in the prevalence of ever and current e-cigarette use and cigarette smoking between 2013–2014 and 2018–2019 in British Columbia, Alberta, Ontario, and Quebec. Trends in ever and current e-cigarette use and cigarette smoking were studied across demographic variables among students in Ontario. Results The prevalence of e-cigarette ever and current use was variable across province and increased over time, particularly between 2016–2017 and 2018–2019. In contrast, the prevalence of current cigarette smoking was relatively stable over the study period, decreasing significantly in Alberta and Ontario between 2017–2018 and 2018–2019. In Ontario, the prevalence of ever and current e-cigarette use increased among all grades, both genders, and all ethnicities. Conclusion Consistent with data from the United States, the prevalence of e-cigarette use among our large sample of Canadian youth has increased substantially in a short period of time. Surveillance systems should continue to monitor the prevalence of tobacco use among youth. Additional interventions may be necessary to curb e-cigarette use among Canadian youth.

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Section: Discussionmentioning

confidence: 99%

Trends in youth e-cigarette and cigarette use between 2013 and 2019: insights from repeat cross-sectional data from the COMPASS study

Cole

Aleyan

Battista

et al. 2020

Can J Public Health

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“…Chaiton et al [17,18], conducted two studies analyzing the impact of the 2017 Ontario, Canada ban on menthol cigarettes. Both studies used random-digit dialing to identify a sample of smokers aged 16 and older prior to the menthol ban's implementation.…”

Section: Individual Behaviormentioning

confidence: 99%

“…Both studies used random-digit dialing to identify a sample of smokers aged 16 and older prior to the menthol ban's implementation. The first study, with 324 smokers at one-month post-ban [18], found that 28% of menthol smokers switched to non-menthol cigarettes, 29% attempted to quit, and 29% used an alternative flavored tobacco or e-cigarette product. A second study [17] conducted one-year post-ban with a sample of 913 smokers (including non-menthol and menthol users) found that 56% of all smokers had made at least one quit attempt, and 19% reported no current tobacco use.…”

Section: Individual Behaviormentioning

confidence: 99%

“…Pacek et al [27] also surveyed participants regarding e-cigarette use, finding that approximately 30% of menthol cigarette dual users reported an intention to increase e-cigarette use following a menthol ban. Rose et al [29] examined responses among the Truth Initiative Young Adult Cohort from 2011 to 2016 (aged [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34]. They found that 32.3% of respondents would switch to non-menthol cigarettes, 23.5% would consider quitting, and 10.7% would switch to another tobacco product.…”

Section: Hypothetical Menthol Banmentioning

confidence: 99%

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The actual and anticipated effects of a menthol cigarette ban: a scoping review

et al. 2020

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Background: The United States (US) Food and Drug Administration (FDA), under the 2009 Family Smoking Prevention and Tobacco Control Act, banned characterizing flavors in cigarettes; however, mentholated tobacco products were exempt. Since 2009, over 20 US jurisdictions and numerous countries around the world have extended this restriction to menthol. Currently, the FDA is reconsidering its position on a nationwide menthol cigarette ban. However, the effects of such a ban remain unclear. We conducted a scoping review to explore the impact of a menthol cigarette ban on individual behaviors (initiation, cessation, and product switching), sales, and compliance. Methods: We conducted a search of the international literature using PubMed, EBSCO, and Web of Science (to November 25, 2019). We retrieved articles relevant to the impacts of an implemented or hypothetical menthol ban. We also included studies of flavored tobacco product bans due to their potential relevance in gauging compliance and product substitutability. Results: The search identified 493 articles, of which 24 were included. Studies examined the effects of implemented menthol bans (n = 6), hypothetical menthol bans (n = 12) and implemented flavor bans that exclude menthol (n = 6). Menthol bans were found to reduce sales and increase smoking cessation with only partial substitution for non-menthol cigarettes. US smokers' reactions to a hypothetical ban indicate that about 25-64% would attempt to quit smoking and 11-46% would consider switching to other tobacco products, including 15-30% to e-cigarettes. Flavor ban studies indicate reductions in initiation of 6%. Ban compliance was high, but studies indicate that the tobacco industry and retailers have attempted to circumvent their impact via packaging changes and online sales. Conclusion: Our review finds that extending the US cigarette flavor ban to menthol products would promote smoking cessation and reduce initiation. This evidence supports further action by the FDA towards mentholated tobacco products. However, few studies have been conducted in the vaping era.

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“…Before the ban 14% thought they would quit smoking and, 1 month post-ban, 29% reported having quit. 20 A later Ontario study found that daily menthol smokers, compared with non-menthol smokers, were significantly more likely to self-report quitting 1 year after the ban. 21 There are no reports concerning how menthol bans may affect smoking among persons with substance use or mental health problems, but there is reason to think they may respond differently from general population smokers.…”

Section: Introductionmentioning

confidence: 98%

Menthol cigarette use in substance use disorder treatment before and after implementation of a county-wide flavoured tobacco ban

Guydish

Straus

et al. 2020

Tob Control

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IntroductionThis study examined the impact of a San Francisco City and County ban on all flavoured tobacco products, including menthol cigarettes, among clients in residential substance use disorder (SUD) treatment.MethodsWe conducted cross-sectional surveys of clients at two residential SUD programmes before the County began enforcing the ban (n=160) and twice after enforcement began (n=102, n=120). The samples were compared on demographic characteristics, smoking status, smoking behaviours and the proportion reporting menthol as their usual cigarette. Menthol smokers were asked whether they smoked only menthol cigarettes, mostly menthol, both menthol and non-menthol or mostly non-menthol. Post-ban samples were asked about awareness of the ban and access to menthol cigarettes.ResultsIn multivariate analyses, we found no evidence that the ban was associated with decreased number of cigarettes per day or increased readiness to quit among current smokers. However, odds were lower post-ban for reporting menthol as the usual cigarette (OR=0.80, 95% CI 0.72 to 0.90), and for smoking only menthol cigarettes (OR=0.19, 95% CI 0.18 to 0.19). Perhaps most importantly, and with the ability to influence all other findings, 50% of self-identified menthol smokers reported purchasing menthol cigarettes in San Francisco nearly 1 year after the ban was implemented.ConclusionIn subgroups where smoking has remained elevated, like those receiving SUD treatment, local menthol bans may have only modest impacts on smoking behaviour. Broader regional, state or national bans, that effectively restrict access to menthol products, may be needed to show stronger effects on smoking behaviour.

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Association of Ontario’s Ban on Menthol Cigarettes With Smoking Behavior 1 Month After Implementation

Abstract: Drs Lee and Fitchett had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Cited by 60 publications

References 8 publications

Trends in youth e-cigarette and cigarette use between 2013 and 2019: insights from repeat cross-sectional data from the COMPASS study

Trends in youth e-cigarette and cigarette use between 2013 and 2019: insights from repeat cross-sectional data from the COMPASS study

The actual and anticipated effects of a menthol cigarette ban: a scoping review

Menthol cigarette use in substance use disorder treatment before and after implementation of a county-wide flavoured tobacco ban

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