The impact of Canada's Menthol Cigarette Ban on quitting among menthol smokers and projections of impact in the European Union: Findings from the ITC Project
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University of Waterloo, Waterloo, Canada
Ontario Institute for Cancer Research, Toronto, Canada
Imperial College London, London, United Kingdom
Publication date: 2021-12-10
Tob. Prev. Cessation 2021;7(Supplement):44
Pre-conference Event- 10 June 2021: ENSP Scientific Webinar “Effects and Challenges in Enforcing Ban on Flavoured Tobacco Products”

Menthol in cigarettes has been long-recognized as an additive that reduces harshness and enhances appeal, which results in greater uptake by youth and lower rates of quitting by adult smokers. Despite the extensive evidence supporting banning menthol in cigarettes, only in recent years have countries done so. Canada was one of the first countries to ban menthol cigarettes in 2015-17. The ITC Project recently published a pre-post evaluation of the impact of the menthol ban across provinces covering 83% of the Canadian population. The ITC evaluation study found that the Canadian menthol ban increased quit attempts (+9.7%) and quitting (+7.5%) among menthol smokers compared to non-menthol smokers, and reduced relapse among menthol smokers who had quit before the ban (-7.5%). Importantly, there was no significant increase in illicit purchasing. The EU banned menthol cigarettes in May 2020.

To use the effect size of the Canadian menthol ban on increased quitting (+7.5%) to estimate the possible impact of the EU's menthol ban.

The number of menthol smokers in each of the 28 EU Member States was obtained from the Eurobarometer 2017 Survey and multiplied by 7.5% to obtain the expected additional quitters due to the EU menthol ban.

From the 2017 Eurobarometer Survey, 7.67% of the 109,151,870 smokers (8,368,816) were menthol smokers. If the impact of the EU menthol ban was equal to Canada's menthol ban, there would be additional 627,661 quitters (95% CI: 550,248-714,945). The greatest number of additional quitters would be experienced in the former MS of UK (123,686), Poland (97,469), France (73,112), and Germany (67,957).

These projected estimates highlight the enormous potential of population-wide policies to significantly reduce smoking. The ITC Project is positioned to evaluate the actual impact of the EU menthol cigarette ban in Spain, The Netherlands, and England.

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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