Menthol smokers' behavioural responses to the European Union ban on menthol: Findings from Wave 2 of the ITC Netherlands Survey with New Cohort
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Imperial College London, London, United Kingdom
University of Waterloo, Waterloo, Canada
Ontario Institute for Cancer Research, Toronto, Canada
Maastricht University, Maastricht, the Netherlands
Publication date: 2021-12-10
Tob. Prev. Cessation 2021;7(Supplement):43
Pre-Conference Event- 10 June 2021: ENSP Scientific Webinar “Effects and Challenges in Enforcing Ban on Flavoured Tobacco Products”

Menthol cigarettes threaten tobacco control efforts by increasing the palatability and attractiveness of smoking, which can facilitate initiation and sustain use. In May 2020, menthol was banned as a characterising flavour in cigarettes and roll-your-own-tobacco in the European Union (EU).

The aim of this study was to examine behavioural responses to the EU menthol ban among adults in the Netherlands who reported smoking menthol cigarettes prior to the ban.

Cross-sectional data came from the International Tobacco Control Policy Evaluation Project (ITC) Netherlands with New Cohort Wave 2 Survey conducted from September to November 2020 among a nationally representative sample of adult smokers and recent quitters (N=1,926) in the Netherlands. Respondents completed the survey using computer assisted web interviews (CAWI). Descriptive and bivariate analyses were conducted in STATA using weighted data.

14.2% (n=291) of respondents reported that they smoked menthol cigarettes before the menthol ban. After the ban, 10.2% of pre-ban menthol smokers quit smoking entirely and 20.8% reduced the amount they smoked. Three-quarters smoked non-menthol cigarettes (75.8%). Other product replacement behaviours included: smoking roll-your-own tobacco cigarettes with menthol filters (20.9%), using other menthol tobacco products such as cigars (9.5%), and using e-cigarettes (15.9%). One-third of respondents reported that they found a way to get menthol cigarettes (33.2%), while 18.9% reported that they did something else.

Findings suggest that the EU menthol ban increased quitting and reduced consumption among pre-ban menthol smokers in the Netherlands four to six months after its implementation. However, a majority of menthol smokers responded to the ban by using non-menthol cigarettes and one-third found a way to get menthol cigarettes. Results highlight the need for strategies to increase cessation support and ensure policy compliance.

G. T. Fong reports that he has been an expert witness/consultant for governments defending their country's policies/regulations in litigation.
C. N. Kyriakos is funded by the Imperial College London President's PhD Scholarships. Additional support is provided to G. T. Fong by the Ontario Institute for Cancer Research and the Canadian Cancer Society O. Harold Warwick Prize. The ITC Netherlands Project has received funding support from: Longfonds (Lung Foundation Netherlands), Hartstichting (Netherlands Heart Foundation), KWF Kankerbestrijding (Dutch Cancer Society), Trombosestichting Nederland (Thrombosis Foundation), Diabetesfonds (Diabetes Fund), and the Canadian Institutes for Health Research Foundation Grant (FDN-148477).
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