Cessation behaviours among smokers of menthol and flavoured cigarettes following the implementation of the EU Tobacco Products Directive: Findings from the EUREST-PLUS ITC Europe Surveys
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Health Promotion Foundation, Warsaw, Poland
European Observatory of Health Inequalities, President Stanisław Wojciechowski State University of Applied Sciences, Kalisz, Poland
Foundation ‘Smart Health - Health in 3D’, Warsaw, Poland
Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
Department of Psychology, University of Waterloo, Waterloo, Canada
Catalan Institute of Oncology, L’Hopitalet de Llobregat, Barcelona, Spain
Addictions Department, Kings College London, London, United Kingdom
Department of Health Promotion, Maastricht University (CAPHRI), Maastricht, Netherlands
German Cancer Research Center, Heidelberg, Germany
Medical School, University of Athens, Athens, Greece
University of Medicine and Pharmacy ‘Grigore T. Popa’ Iasi, Iasi, Romania
AER PUR Romania, Bucharest, Romania
School of Medicine, University of Crete, Heraklion, Greece
Publication date: 2020-10-22
Tob. Prev. Cessation 2020;6(Supplement):A28
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The European Tobacco Product Directive (TPD) banned the sale of cigarettes with characterizing flavours from May 2017, with an extension for menthol cigarettes until May 2020. This offers a unique opportunity to research the profiles and behaviours of menthol and flavoured cigarette (MFC) users in the European Union.

To evaluate population-level changes in the cessation behaviours of MFC smokers, and whether they have been modified following the 2016 ban on cigarettes with characterising flavours, and in anticipation of the 2020 ban on menthol cigarettes.

Longitudinal analysis of smoking status and cessation behaviour among adult smokers of menthol and other flavoured cigarettes between Wave 1 (2016, pre-TPD) and Wave 2 (2018) of the EUREST-PLUS ITC Europe Surveys.

There were significant but small declines in the weighted prevalence of menthol (by 0.94%; p=0.041) and other flavoured cigarettes (by 1.32%; p<0.001) use between Wave 1 and Wave 2, which tended to be driven by smokers switching to unflavoured tobacco, rather than quitting smoking. A narrow majority (51.6%) of menthol smokers did not change their preferred product, while 22.8% switched to unflavoured tobacco. Among other flavoured cigarette smokers, 11% did not change their preferred product, while 62.3% switched to unflavoured tobacco. Among smokers of menthol cigarettes, 14% quit smoking between Waves 1 and 2, compared with 9% among other flavoured cigarette smokers, and 12% among unflavoured tobacco smokers, but the differences were non-significant.

Continued monitoring is needed to ascertain the long-term impact of TPD, including if the MFC smokers who moved to unflavoured cigarettes will be more likely to quit as a next step. There remains an opportunity for tobacco control prior to the implementation of the 2020 ban on menthol cigarettes. Countries with high menthol use should strengthen stop-smoking campaigns alongside the menthol cigarette ban to aid cessation.

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