Menthol ban in Ontario Canada increased smoking cessation

The tobacco companies (including e-cig companies) work through surrogates to claim that bans on the sale of flavored tobacco products limits freedom, the case just got stronger that flavor bans help people quit smoking (which improves lives and reduces tobacco company profits).

Specifically, Michael Chaiton and his colleagues followed smokers beginning before Ontario Canada ended the sale of menthol cigarettes until a year later and found that more menthol smokers quit than smokers who did not use menthol cigarettes.  Because the tobacco companies have not pushed menthol as hard in Canada than the US, menthol use is lower, so the benefits of a ban on menthol would be even higher in the US than in Canada. 

As they point out in their paper,

The results from our study suggest that the ban on the sale of menthol tobacco products was associated with a higher level of quitting or attempting to quit smoking at 1-year follow-up among daily menthol smokers. In the USA, where no national menthol ban has been implemented, cross-sectional studies showed that menthol users were less successful in quitting than non-menthol users despite increased quit attempts or intentions to quit. Considering that menthol smokers may be more nicotine dependent and have reduced cessation success,  our findings that daily menthol smokers were significantly more likely to reporting smoking cessation relative to non-menthol smokers after the ban suggest that the menthol ban could have tremendous public health impact at the population level in Canada and in other jurisdictions as well from a overall reduced level of cigarette smoking. [citations removed]

This is particularly important for African Americans in the US, who, after decades of targeting by cigarettes companies, almost exclusively smoke menthol cigarettes because they would particularly benefit from local laws ending the sale of flavored tobacco products (including menthol) or the FDA finally ending the sale of menthol cigarettes, something the FDA has been considering for 10 years.

This evidence makes the fact that Black leaders like Al Sharpton, who has been on a road show fighting menthol bans, and the NAACP, which is back to opposing menthol bans, are helping cigarette companies kill the very people they claim to represent.

Another important point is that the Ontario law only applied to cigarettes, not e-cigarettes.  A comprehensive flavor ban that applied to all tobacco products would have an even bigger effect.

Here is the abstract for their paper, “Ban on menthol-flavoured tobacco products predicts cigarette cessation at 1 year: a population cohort study”:

OBJECTIVES: The province of Ontario, Canada, banned the use of menthol-flavoured tobacco products as of 1 January 2017. The long-term impact of a menthol ban on smoking behaviour has not been previously evaluated.

METHODS:  Population cohort study with baseline survey conducted September-December 2016 and follow-up January-August 2018 among residents of Ontario, Canada, 16 years old and over who reported current smoking (past 30 days) at baseline survey and completed follow-up (n=913) including 187 reporting smoking menthol cigarettes daily, 420 reported smoking menthol cigarettes occasionally, and 306 were non-menthol cigarette smokers. Relative rates of making a quit attempt and being a non-smoker at follow-up were estimated with Poisson regression controlling for smoking and demographic characteristics at baseline.

RESULTS:  At follow-up, 63% of daily menthol smokers reported making a quit attempt since the ban compared with 62% of occasional menthol smokers and 43% of non-menthol smokers (adjusted relative rate (ARR) for daily menthol smokers compared with non-menthol smokers: 1.25; 95% CI 1.03 to 1.50). At follow-up, 24% of daily menthol smokers reported making a quit since the ban compared with 20% of occasional menthol smokers and 14% of non-menthol smokers (ARR for daily menthol smokers compared with non-menthol smokers: 1.62; 95% CI 1.08 to 2.42).

CONCLUSIONS:  The study found higher rates of quitting among daily and occasional menthol smokers in Ontario 1 year after the implementation of a menthol ban compared with non-menthol smokers. Our findings suggest that restrictions on menthol may lead to substantial improvements in public health.

The full citation is Chaiton MO, Nicolau I, Schwartz R, Cohen JE, Soule E, Zhang B, Eissenberg T.  Ban on menthol-flavoured tobacco products predicts cigarette cessation at 1 year: a population cohort study.  Tob Control. 2019 May 30. pii: tobaccocontrol-2018-054841. doi: 10.1136/tobaccocontrol-2018-054841. [Epub ahead of print].  It is available here.