Background:
Canada was one of the first countries to ban menthol cigarettes between 2015 and 2017. Tobacco companies argue that menthol bans increase the illicit cigarette market.

Objective:
This study examines illicit cigarette purchasing trends following implementation of menthol cigarette bans in seven Canadian provinces between 2016 and 2018 through analysis of cigarette brand purchasing among menthol and non-menthol smokers.

Methods:
Analyses compared pre- and post-ban purchases of illicit menthol cigarettes among 1098 non-menthol smokers and 138 menthol smokers in Canada who completed the ITC Four Country Smoking and Vaping Survey in 2016 (pre-ban) and 2018 (post-ban). Weighted survey logistic regression models generated population level estimates.

Results:
Among pre-ban menthol smokers (n=138), 19.5% reported still smoking menthols (n=36) after the ban. However, based on reports of brand smoked, nearly half were not actually smoking menthols; 7.5% were instead smoking a non-menthol brand and 1.5% were smoking a ‘menthol replacement’ brand (blue). Thus, only 10.5% (n=17) were smoking a verified menthol cigarette brand, and 7.9% (n=13) last purchased a menthol cigarette brand after the ban. Among those who purchased menthol cigarettes at both pre- and post-ban (n=9), there was no difference in purchasing from a First Nations reserve before versus after the ban (51.2% vs 51.2%). There was no change in First Nations purchases among non-menthol smokers at both pre- and post-ban (n=1024; 9.1% vs 8.7%, p=0.7), nor among all smokers who purchased cigarettes at both pre- and post-ban (n=1086; 9.7% vs 9.2%, p=0.6).

Conclusions:
Brand analysis demonstrated lower rates of post-ban menthol smoking compared to post-ban self-reports of smoking menthols. Purchasing illicit cigarettes did not increase among either menthol or non-menthol smokers after Canada’s menthol ban. These findings provide real-world evidence casting doubt on tobacco industry claims that a menthol ban will increase the illicit trade market.