Study provides added evidence on positive public health impact of banning menthol cigarettes

A new study concludes that the 2020 European ban on menthol cigarettes made it more likely that menthol smokers would quit smoking, supporting previous Canadian research on the positive public health impact of banning menthol cigarettes.

Christina Kyriakos from Imperial College London led the study in collaboration with researchers from Maastricht University and the Trimbos Institute in the Netherlands and the International Tobacco Policy Evaluation Project (ITC Project) at the University of Waterloo in Canada.

This Dutch study is our second major national study to provide evidence of the powerful impact of banning menthol cigarettes on quitting, which supports proposed menthol bans in the U.S. and other countries."

Geoffrey T. Fong, Professor of Psychology and Public Health Sciences at Waterloo, and Principal Investigator of the ITC Project

The research team surveyed a national sample of adult smokers of menthol and non-menthol cigarettes in the Netherlands before and after the EU menthol ban. Of the menthol smokers surveyed before and after the ban, 26.1 per cent had quit smoking. This quit rate was higher than the control group of non-menthol smokers, of whom only 14.1 per cent had quit.

In fact, the increased quit rate of 12 per cent of menthol smokers after the European ban is greater than the increased quit rate of 7.3 per cent found in an ITC study of the menthol ban that was in effect across Canada in 2018.

For decades, tobacco companies have added menthol to cigarettes because it creates a cooling sensation that reduces the harshness of smoke. It makes it easier to start smoking, causing non-smoking youth to be more likely to progress to regular smoking and become addicted to nicotine.

For more than a decade, the World Health Organization and many other public health authorities have called on governments to ban menthol in cigarettes to reduce smoking, which kills 7.1 million smokers and 1.2 million non-smokers from second-hand smoke per year worldwide. The global tobacco control treaty, the WHO Framework Convention on Tobacco Control, calls upon countries to prohibit or restrict menthol and other additives that make smoking easier.

To date, 35 countries have banned menthol cigarettes. On April 28, 2022, the U.S. Food and Drug Administration announced a proposed rule to ban menthol in cigarettes and cigars. An ITC study published that day on the impact of the Canadian ban projected that a ban on menthol cigarettes in the U.S. would lead more than 1.3 million smokers to quit.

The Dutch study also found that one-third of menthol smokers reported continuing to smoke menthol cigarettes even after the ban. The tobacco industry markets a wide range of accessories to enable people to add menthol flavouring to tobacco products themselves.

"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," said Marc Willemsen, co-author of the Dutch study and professor in tobacco control research at Maastricht University and scientific director of tobacco control at the Trimbos Institute.

The study, Impact of the European Union's menthol cigarette ban on smoking cessation outcomes: Longitudinal findings from the 2020–2021 ITC Netherlands Surveys, appears in the journal Tobacco Control.