Introduction

Menthol, a type of alcohol (molecular formula C₁₀H₂₀O), can be obtained from mint plants or manufactured.1 2 In addition to flavouring, it has local anaesthetic properties that can conceal the negative sensations of smoking, due to desensitising receptors.1 3 Menthol cigarettes increase overall smoke intake, but mask early respiratory disease symptoms, reducing the chance of quitting.4–6 Smoking menthol cigarettes also may raise nicotine intake, promoting nicotine dependence and the establishment of smoking in youth.4 5 7–9 Thus, banning menthol should reduce smoking prevalence.4 Furthermore, menthol cigarettes are likely to contribute to health inequalities as sociodemographic groups more likely to be of low income (low education, women, African–Americans and young people) are more likely to smoke menthol.10–13

A process for flavouring tobacco with menthol was first patented in the USA in the 1920s,14 but mass distribution and marketing started in the 1960s when a version with a filter was developed.8 15 A more recent innovation for adding flavour is by the addition of a capsule, or ‘crushball’, a small plastic capsule in the filter activated by crushing16 (figure 1). These first appeared on the market in Japan in 2007 and are popular among young people due to the flavour and interactivity.16 17 In the UK the only cigarettes available with capsules are menthol-flavoured.18