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Profile of menthol cigarette smokers in the months following the removal of these products from the market: a cross-sectional population survey in England
  1. Loren Kock1,2,
  2. Lion Shahab1,2,
  3. Ilze Bogdanovica2,3,
  4. Jamie Brown1,2
  1. 1 Department of Behavioural Science and Health, University College London, London, UK
  2. 2 SPECTRUM Research Consortium, Edinburgh, UK
  3. 3 Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
  1. Correspondence to Dr Loren Kock, University College London, London, UK; l.kock{at}


Introduction In May 2020, the EU Tobacco Products Directive ban on the sale of menthol cigarettes was implemented in England. This study examined the prevalence of menthol cigarette smoking after the ban, according to sociodemographic and smoking characteristics.

Methods Cross-sectional data came from a representative survey of current smokers (18+) in England (unweighted n=2681) between July 2020 and June 2021. The weighted prevalence of menthol cigarette smoking as a proportion of total cigarette smoking was calculated, log-binomial regression explored trends over time, and χ2 statistics assessed the relationship between menthol smoking, sociodemographic and smoking characteristics. Sources of purchase of menthol cigarettes were explored.

Results Between July 2020 and June 2021, 15.7% (95% CI 14.5 to 17.1) of smokers reported smoking menthol cigarettes. The fitted non-linear trend supported no initial change followed by a possible reduction across April–June 2021 and fit the data better than linear and null (no change) models (χ2(2)=2519.7, p=0.06; χ2(3)=2519.7, p=0.006). Menthol cigarette smoking was more common among younger groups (16–24=25.2%; 25–34=19.9%) and women (19.4%). Menthol cigarette smokers showed lower cigarette dependence compared with other smokers. Past-6-month purchases of menthol cigarettes from any illicit or cross-border source declined from 30.1% in the last 6 months of 2020 to 17.5% in the first 6 months of 2021.

Conclusions A substantial minority of current smokers in England reported menthol cigarette smoking between July 2020 and June 2021, despite the ban, possibly reflecting mitigation of restrictions by a variety of licit means, such as legal menthol accessories. The reduction in menthol smoking across April–June 2021 warrants further monitoring.

  • surveillance and monitoring
  • public policy
  • illegal tobacco products

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  • Contributors LK, JB and LS conceived of the study. All authors contributed to the study analysis plan. LK conducted the analysis and write-up. All authors contributed to the final manuscript. LK is the guarantor of this work and, as such, had full access to all the data and take responsibility for the integrity of the data and the accuracy of the data analysis.

  • Funding Data collection for the Smoking and Alcohol Toolkit Studies is supported by Cancer Research UK (C1417/A22962). Authors are supported by the UK Prevention Research Partnership (MR/S037519/1), an initiative funded by UK Research and Innovation Councils, the Department of Health and Social Care (England), and the UK devolved administrations and leading health research charities.

  • Disclaimer No funders had any involvement in the design of the study, the analysis or interpretation of the data, the writing of the report or the decision to submit the paper for publication.

  • Competing interests Authors are members of the UK Prevention Research Partnership, an initiative funded by UK Research and Innovation Councils, the Department of Health and Social Care (England), and the UK devolved administrations and leading health research charities. JB reports receiving grants from Cancer Research UK during the conduct of the study and receiving unrestricted research funding from pharmaceutical companies who manufacture smoking cessation medications to study smoking cessation outside the submitted work. LS reports receiving honoraria for talks, receiving an unrestricted research grant and travel expenses to attend meetings and workshops by pharmaceutical companies that make smoking cessation products (Pfizer and Johnson & Johnson), and acting as a paid reviewer for grant-awarding bodies and as a paid consultant for health care companies. LK and IB have no competing interests to declare.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.