Public health impact of a US ban on menthol in cigarettes and cigars: a simulation study

Abstract

IntroductionThe US Food and Drug Administration most recently announced its intention to ban menthol cigarettes and cigars nationwide in April 2021. Implementation of the ban will require evidence that it would improve public health. This paper simulates the potential public health impact of a ban on menthol in cigarettes and cigars through its impacts on smoking initiation, smoking cessation and switching to nicotine vaping products (NVPs).MethodsAfter calibrating an established US simulation model to reflect recent use trends in cigarette and NVP use, we extended the model to incorporate menthol and non-menthol cigarette use under a status quo scenario. Applying estimates from a recent expert elicitation on the behavioural impacts of a menthol ban, we developed a menthol ban scenario with the ban starting in 2021. We estimated the public health impact as the difference between smoking and vaping-attributable deaths and life-years lost in the status quo scenario and the menthol ban scenario from 2021 to 2060.ResultsAs a result of the ban, overall smoking was estimated to decline by 15% as early as 2026 due to menthol smokers quitting both NVP and combustible use or switching to NVPs. These transitions are projected to reduce cumulative smoking and vaping-attributable deaths from 2021 to 2060 by 5% (650 000 in total) and reduce life-years lost by 8.8% (11.3 million). Sensitivity analyses showed appreciable public health benefits across different parameter specifications.Conclusions and relevanceOur findings strongly support the implementation of a ban on menthol in cigarettes and cigars.

The Public Health Impact of a US Menthol Cigarette Ban on the Non-Hispanic Black Population: A Simulation Study

“…The ban impact on the NHB population compares favorably to projections for the overall US population. 10 We found that the ban leads to relative reduction in NHB adult smoking prevalence of 35.1% compared to 14.7% for the US. 10 The percentage reduction in cumulative NHB averted deaths from 2021-2060 is 18.5% compared to 4.6% for the US, 10 with a 22.1% relative reduction in NHB cumulative LYLs compared to 7.9% for the US.…”

“…10 We found that the ban leads to relative reduction in NHB adult smoking prevalence of 35.1% compared to 14.7% for the US. 10 The percentage reduction in cumulative NHB averted deaths from 2021-2060 is 18.5% compared to 4.6% for the US, 10 with a 22.1% relative reduction in NHB cumulative LYLs compared to 7.9% for the US. 10 Thus, our analysis indicates that a menthol ban would also reduce smoking-related health disparities.…”

“…7,8 The Menthol Smoking and Vaping Model (SAVM) estimated the public health impact of a menthol ban on the total US population. 9,10 However, the model did not explicitly distinguish the impact of the ban on the non-Hispanic Black (NHB) population. Due to their high rates of menthol cigarette use 11,12,13 and important smoking-related health disparity implications, 14,15 we apply the previously-developed Menthol SAVM 10 to evaluate the impact of a menthol cigarette ban on the NHB population.…”

Evaluating the public health impact of partial and full tobacco flavour bans: A simulation study

“… 25 A 2021 study estimated an overall 15% decline in smoking prevalence, with over 11.3 million life years saved by 2060. 26 These simulation studies suggest that a tobacco flavours ban would reap substantial public health benefits, especially in countries such as the United States, Singapore, Malaysia and the Philippines where flavoured cigarettes comprise a large portion of the total cigarette market. However, no studies have, to our knowledge, quantified the potential impact of a tobacco flavours ban in a Western Pacific country.…”

Public support for policies to regulate flavoured tobacco and e-cigarette products in rural California

“…[12][13][14][15][16] Comprehensive action by policymakers and public health practitioners can help address youth e-cigarette use and existing disparities in tobacco use. 17 While the overall population has experienced decreases in flavoured tobacco product use, a menthol ban is estimated to have large reductions in smoking prevalence 18 with considerable benefits for populations who disproportionately smoke menthol cigarettes like African-Americans. 19 Limited research exists assessing public support for policies to regulate flavoured tobacco or e-cigarette products, particularly in rural regions.…”