In May 2020, England banned menthol as a characterising flavour in cigarettes. However, the sale of menthol accessories (eg, filters, flavour cards) remains permitted. This study assessed the impact of England’s menthol ban on quit attempts and quit success.
Longitudinal data came from Waves 3 (2020, preban) and 4 (2022, postban) of the England arm of the International Tobacco Control Four Country Smoking and Vaping Survey. A nationally representative sample of 839 adults who smoke, were followed up, and provided sufficient data to derive menthol smoking (defined as smoking menthol cigarette brands/varieties) were included (n=112 smoked menthol, n=727 non-menthol, cigarettes preban). Logistic regressions examined associations between smoking menthol (vs non-menthol) preban and quit attempts and quit success postban. Menthol accessory use postban was also examined.
At baseline (preban), 12.8% of adults who smoked used menthol (vs non-menthol) cigarettes, compared with 6.3% postban (AOR 0.46, 95% CI=0.30–0.69, p<0.001). Quit attempts were similar between participants who smoked menthol (vs non-menthol) preban (29.5% vs 27.0%; AOR 0.72, 95% CI=0.31–1.67). Quit success was higher among participants who smoked menthol (vs non-menthol) preban, although wide CIs included the possibility of no difference (20.1% vs 14.2%; AOR 1.25, 95% CI=0.56–2.79). Among those who smoked menthol cigarettes preban, 43.4% continued smoking menthol and 32.1% reported using menthol accessories postban.
While quit success was higher among participants who smoked menthol, small sample sizes and wide CIs limited the ability to detect associations. Continued menthol use and widespread accessory use suggest regulatory loopholes may be undermining the ban’s effectiveness.