Title: The profile of menthol cigarette smokers in the months following the removal of these products from the market in England
Abstract: Abstract Introduction: In May 2020 the EU Tobacco Products Directive (TPD) ban on the sale of menthol cigarettes was implemented after a four-year transitional period. This study examined the prevalence of menthol cigarette smoking in the months following the ban, and according to sociodemographic and smoking characteristics. Methods: Cross-sectional data came from a representative survey of current smokers (18+) in England (unweighted n=1,577) during seven months (July-January) in 2020/2021. The weighted prevalence of menthol cigarette smoking as a proportion of total cigarette smoking was calculated, and chi-squared statistics assessed the relationship between menthol smoking, sociodemographic and smoking characteristics. Sources of purchase of menthol cigarettes were also explored. Results: The proportion of current smokers who smoked menthol cigarettes was similar in July to October 2020 (17.5%, 95% CI 15.3%-20.1%) compared with November 2020 to January 2021 (16.3%, 95% CI 13.9%-19.2%) (χ2(1)=0.38, P=0.56)). Menthol cigarette smoking was more common among younger age groups (16-24 = 29.0%; 25-34 = 23.3%) and women (21.1%). Menthol cigarette smokers showed lower cigarette dependence compared with other cigarette smokers. Purchases of menthol cigarettes from any illicit source in the past six months declined from 34.5% in July-October 2020 to 19.0% in November 2020–January 2021. Conclusions: A substantial proportion (just under a fifth) of current smokers in England reported menthol cigarette smoking between July-January 2020/2021 despite the ban. There was no decline in this proportion across the period, suggesting that smokers mitigated the impact of the ban by a variety of means, such as with legal menthol accessories.