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Research reported in this publication was supported by the National Institute on Drug Abuse of the National Institutes of Health under Award Number FP00003667.
The US Food and Drug Administration concluded that a ban on menthol cigarettes would likely elicit a reduction in cigarette consumption, increased cessation and reduced initiation of smoking.1 Understanding how the tobacco industry prepared for a menthol ban in Ontario, Canada—a province with some 2 million smokers—can be useful to jurisdictions preparing similar bans. One previous menthol ban study2 found menthol replacement packs with the word ‘menthol’ replacing the word ‘green’ and with cellophane wrappers with the wording ‘smooth taste (redesigned) without menthol’.
Ontario’s ban on the sale of menthol cigarettes, first announced in May 2015, took effect on 1 January 2017. As the first phase of a pre–post ban study that aims to understand changes in cigarette packaging and product in response to the menthol ban, from mid-October to mid-November 2016, just prior to the ban, we purchased samples of every available menthol tobacco product in eight retail outlets in Toronto, Ontario (two chain, two independent, two gas stations) randomly sampled from an administrative list stratified by neighbourhood material deprivation index. To guide our purchases, we used a list of menthol cigarettes that were sold in Ontario as of May 2016, provided by Health Canada. Two research staff asked vendors for one of each type of menthol, capsule and green coloured or labelled packaged cigarette brands available. In total, we collected 30 unique packs.
We compared the packs collected to Health Canada’s 2016 list and to a similar 2014 Health Canada list to ensure that we had purchased all menthol packs available and to identify more recently introduced products. We conducted content analysis.
Results reveal substantial changes.
Capsules
In total, 14 of the 30 unique brands were capsules/convertibles. Capsule cigarettes, with menthol flavoured liquid-filled capsules inserted in filters, were first introduced to Ontario after the ban on menthol cigarettes was announced. From 2014 until May 2016, 10 new menthol brands emerged on Health Canada’s list—all capsules. Our stores did not sell three of the menthol capsule packs on this list. Moreover, we purchased seven additional capsule brands that did not appear on the May 2016 Health Canada list.
Colour
Menthol cigarette packages have traditionally had green as a prominent colour. While green predominated in most of the brands, 12 of the 30 brands were not predominantly green; all but one of these was a capsule brand. Dominant colours on these packs were blue, white and silver.
Words and images
Three packs included stickers on their cellophane wrappers that explicitly referred smokers to non-menthol alternatives. One of these, not a capsule, noted the date on which menthol products were to be discontinued and, ‘Coming soon: (brand), your smooth tasting non menthol alternative’. The other two were capsule brands.
Eight capsule brands had wording denoting choice. Examples are: ‘Fresh taste at your fingertips’, ‘Boost your menthol taste. It is your choice’, ‘choose to refresh your taste’, ‘create your refreshing taste experience’. Other common themes, included: smooth, fresh, refreshing and crisp. The capsule brands also depicted an image of a ‘power on’ button, sometimes in icy/silvery colour. One had two ‘power on’ buttons—green and blue. A previous study suggested that the power button may depict technology as relating to the crushable filter.3 We hypothesise that capsules were introduced to expose menthol smokers to the taste of non-menthol cigarettes and possibly to alternative technologies for choice to add flavour or coolant sensation.
Tobacco companies made substantial efforts to prepare smokers for the menthol ban in Ontario by introducing menthol-flavoured capsules, promoting the idea of choice and associating new colours with menthol. In some cases, they explicitly promoted ‘smooth tasting’ non-menthol alternatives, encouraging menthol smokers to switch to non-menthol cigarettes postban. These efforts may decrease the success of the menthol ban in encouraging cessation and decreasing initiation. Jurisdictions preparing for menthol bans may consider measures to prevent or mitigate these and other industry tactics that have been documented in regard to other tobacco control measures.
Footnotes
Contributors RS and MOC conceived the study and the analysis plan. TB and LD purchased the cigarette packages and did an initial data extraction. RS conducted the in-depth analysis and drafted the manuscript. MOC, TB and LD reviewed the manuscript and provided input to its finalisation.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Researchers wishing to view the actual cigarette packs may contact the corresponding author RS to arrange.