The benefits of banning menthol cigarettes in Canada

The ban on menthol cigarettes in Canada increased the number of quit attempts, increased the chances of quitting, and reduced the risk of relapse among former smokers, and has not led to an increase in illicit trade, according to a new public policy evaluation study conducted by the University of Waterloo as part of the ITC, International Tobacco Control Project.

Canada was one of the first countries in the world to ban menthol cigarettes. Between May 2015 and July 2017, 7 out of 13 Canadian provinces (Alberta, Labrador, Nova Scotia, New Brunswick, Ontario, Prince Edward Island, Quebec) already banned menthol cigarettes. An even broader federal law banning menthol in cigarettes, most cigars and blunts (flavoured tobacco leaf) came into effect in October 2017. The study[1] analyzed the impacts of banning menthol cigarettes in these 7 provinces, representing 83% of the population. The study is based on longitudinal data from the Canadian component of the 2016 and 2018 ITC Smoking and Vaping Surveys.

Ban is associated with higher rates of quit attempts and success

Menthol smokers were significantly more likely than other smokers to attempt to quit after the menthol ban (58.7% vs. 49%). Daily menthol smokers were almost twice as likely as other daily smokers to quit after the ban (21% vs. 11.6%). Finally, menthol smokers who had quit before the menthol ban were significantly less likely to relapse than other smokers who had quit.

More specific research conducted in the Canadian province of Ontario (which banned menthol cigarettes on 1^er January 2017) show that daily menthol smokers in Ontario were also more likely than other smokers to attempt to quit (63% vs. 43%) and to quit smoking (24% vs. 14%).[2]-[3]

Positive results that should encourage the United States to implement the ban

For the authors, these results should pave the way for a ban on menthol products in the United States, which are widely consumed in the country.[4]. The tobacco industry has been using these products in particular for decades to attract new smokers and discourage quitting, particularly among the African-American community. The study estimates that banning menthol cigarettes in the United States would encourage an additional 923,000 smokers to quit, including 230,000 African-American smokers. A report by the US Food and Drug Administration advisory committee estimated that if measures to ban menthol cigarettes had been taken in 2010 in the United States, approximately 17,000 premature deaths could have been prevented and 2.3 million people would not have started smoking during the decade 2010-2020. By 2050, more than 320,000 deaths, including nearly a third in the African-American community, could be prevented if a ban were implemented today.[5].

Tobacco industry's illicit trade argument refuted

Contrary to tobacco industry claims, the ban on menthol in tobacco products in Canada did not lead to an increase in illicit trade. A minority of respondents reported still smoking menthol products after the ban. The majority of menthol products consumed were legal purchases made before the ban came into effect, or replacement brands.[6]. A first study at the local level[7] had already refuted the tobacco industry’s claims. In May 2015, the Canadian province of Nova Scotia became the first jurisdiction in the world to ban menthol cigarettes. At the time, the tobacco industry claimed that “the primary effect of this legislation will be to increase the illegal tobacco market in Nova Scotia.” Data on the number of illicit cigarettes seized in Nova Scotia for the period 2007-08 to 2017-18 was obtained from the province’s Finance Commission to compare seizures before and after the ban was implemented. In the years following the ban in 2015, the volume of seizures remained stable. Nova Scotia tax authorities estimate that the share of tobacco products coming from illicit channels has declined from 30% of all tobacco consumed in 2006-2007 to less than 10% in 2016-2017. According to the results, illegal seizures of menthol products in the year following the ban were marginal and there were no seizures of menthol cigarettes thereafter.

Keywords: Canada, Menthol, Menthol cigarettes, ban, United States, Health Photo credit: ©Truth Initiative ©Tobacco Free Generation

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[1] Chung-Hall J, Fong GT, Meng G, et al. Tob Control Epub ahead of print:. doi:10.1136/ tobaccocontrol-2020-056259 [2] Chaiton MO, Nicolau I, Schwartz R, et al. Ban on menthol-flavored tobacco products predicts cigarette cessation at 1 year: a population cohort study. Tob Control 2020;29:tobaccocontrol-2018-054841–-2017. [3] Chaiton M, Schwartz R, Cohen JE, et al. Association of Ontario's ban on menthol cigarettes with smoking behavior 1 month after implementation. JAMA Intern Med 2018;178:710–1. [4] Generation Without Tobacco, Menthol: 10 million additional smokers in the United States, March 1, 2021, accessed April 8, 2021 [5] Generation Without Tobacco, United States: FDA called out for inaction on menthol, March 3, 2021, accessed April 8, 2021 [6] Generation Without Tobacco, Circumvention of menthol ban: public authorities open investigation, August 24, 2020, accessed April 8, 2021 [7] Stoklosa M No surge in illicit cigarettes after implementation of menthol ban in Nova Scotia Tobacco Control 2019;28:702-704. National Committee Against Smoking |