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Should menthol e-cigarettes be banned? Reaction of adult smokers and users of e-cigarettes to hypothetical bans
  1. Yong Yang1,
  2. Eric N Lindblom2,
  3. Kenneth D Ward1,
  4. Ramzi G Salloum3
  1. 1 School of Public Health, University of Memphis, Memphis, Tennessee, USA
  2. 2 O'Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC, USA
  3. 3 Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, Florida, USA
  1. Correspondence to Dr Yong Yang, School of Public Health, University of Memphis, Memphis, TN 38152, USA; yyang15{at}


Introduction This study examines how current smokers using menthol cigarettes or flavoured cigars, and current users of flavoured e-cigarettes may respond to three hypothetical flavour-ban scenarios: (1) banning only menthol cigarettes and flavoured cigars; (2) also banning e-cigarettes with any non-tobacco flavours except menthol; and (3) also banning e-cigarettes with any non-tobacco flavours, including menthol.

Methods Recruited from mTurk, respondents were asked if they would quit all tobacco-nicotine use or continue or start using products that were still legally available. The patterns of responding to each ban scenario, for both flavoured smokers and users of non-tobacco flavoured e-cigarettes, were summarised. Multinomial logistic regressions were used to estimate associations between demographics, smoking or e-cigarette use status and reactions to a ban.

Results A ban on menthol cigarettes and flavoured cigars would lead to 12%–20% of flavoured smokers trying to quit all tobacco use and 32%–52% switching to non-flavoured smoking, with the remaining switching to e-cigarettes or other products. Compared with a ban on only menthol cigarettes and flavoured cigars, also banning flavoured e-cigarettes would increase the likelihood of quitting all tobacco-nicotine use (OR=2.58) but also increase the likelihood of switching to non-flavoured smoking (OR=1.74).

Conclusions Our results indicate that a ban on menthol cigarettes and flavoured cigars would decrease smoking. However, it is unclear if adding a ban of menthol e-cigarettes would lead to additional benefits because without menthol e-cigarettes as an alternative, some smokers and e-cigarette users may switch to non-flavoured tobacco smoking, rather than quit all tobacco use.

  • electronic nicotine delivery devices
  • nicotine
  • public policy

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  • Contributors YY designed the study, collected the data, conducted the analyses and drafted the manuscript. ENL, KW and RGS assisted in designing the study, interpreted the findings and critically reviewed the manuscript.

  • Funding This research was supported by the National Institute of Drug Abuse of the National Institutes of Health (award number: R03DA048460) and by the National Cancer Institute of the National Institutes of Health and FDA Center for Tobacco Products (award number: U54CA229974).

  • Disclaimer The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or the FDA.

  • Competing interests None declared.

  • 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.