In Massachusetts, the ban on menthol cigarettes was reportedly followed by an increase in TNS sales.

A study estimates that sales of nicotine replacement products such as gum and lozenges may have benefited from the state's ban on menthol cigarettes. While the results are fragile, this trend suggests further investigation into individual reactions to the ban on menthol flavors in cigarettes.

The 1^er In June 2020, the ban on menthol cigarettes came into effect in the state of Massachusetts, the first to adopt such a measure in the United States. Following this ban, a team of researchers from Georgia had already observed that cigarette sales had declined in Massachusetts. The same team has since looked at sales of nicotine replacement therapy (NRT) to examine whether the menthol cigarette ban was also accompanied by an increase in attempts to quit smoking.[1].

Apparent impact on increased TNS sales

Using in-store sales surveys from the Nielsen Retail Scanner Data Index, the researchers were able to gather 1,664 observations of TNS sales volumes over four weeks collected between January 2017 and December 2021, before and after the menthol cigarette ban. The various points of sale (pharmacies, but also grocery stores, supermarkets, and other retailers) in 25 states were compared with those in Massachusetts.

The results show sales increases of 12.9 % for nicotine gum, and 17.9 % for lozenges (lozenges) of nicotine. Sales of nicotine patches, for their part, have increased only insignificantly. The ban on menthol cigarettes would therefore have been accompanied by an increase in sales of NRT, which would reflect an increase in attempts to quit smoking. If this effect were to be confirmed, it would imply better integration of smoking cessation interventions, at a time when measures to ban menthol flavors are being implemented.

Results too fragile to generalize this observation

These results, however, remain fragile, according to the authors themselves, and do not allow this conclusion to be extended to other situations. Only three forms of NRT were studied, which should call for further studies to validate the results obtained, including drug treatments to help people stop smoking (varenicline, bupropion), behavioral methods, hotlines, and the combination of these various methods.

The sales data used only included in-store sales and not online sales, which could present different profiles. These sales data also did not allow for the creation of user profiles or an understanding of their motivations. Finally, the period of the menthol cigarette ban also coincided with a new tax on e-cigarettes, which could have led to an indirect shift to NRT sales and led to biases in data interpretation. The study authors therefore suggest that the implementation of strong measures must be accompanied by monitoring of the possible effects of shifting consumption to other tobacco and nicotine products.

Keywords: Massachusetts, nicotine replacement therapy, smoking cessation, menthol.

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[1] Asare S, Xue Z, Bandi P, et al. Association of nicotine replacement therapy product sales with menthol cigarette sales restriction in Massachusetts. Tobacco Control Published Online First: 09 May 2023. doi: 10.1136/tc-2023-057942.

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