Intended Behaviors in Anticipation of a National Menthol Flavor Ban: Findings From a Multi-State Rapid-Response Survey in the U.S., 2023-2024.

Abstract

The U.S. Food and Drug Administration proposed a product standard to restrict menthol as a characterizing flavor in cigarettes in 2022. Evidence since this announcement on intended tobacco use behavior among individuals who currently smoke menthol cigarettes may inform further policy development. Data were from 2 years of a rapid-response survey of a probability sample of 12,300 adults (aged 18-65 years) in 13 high-tobacco-burden U.S. states and 4 low-tobacco-burden U.S. states collected in April-May 2023 and April-May 2024. In 2025, the authors analyzed intended tobacco-use behaviors in anticipation of an impending national menthol ban among 1,685 individuals (1,202 from high-tobacco-burden states and 483 from low-tobacco-burden states) who smoked menthol cigarettes. Weighted multinomial logistic regression examined which sociodemographic characteristics were associated with intended tobacco-use behaviors. Among respondents who smoked menthol cigarettes in high-tobacco-burden U.S. states, 25.2% reported intentions to quit all tobacco use or cigarette smoking, 15.2% reported intentions to quit menthol cigarette smoking or reduce cigarette smoking, and 53.0% reported intentions to switch to other tobacco products should menthol cigarettes become unavailable. In the low-tobacco-burden U.S. states, these percentages were 24.2%, 10.4%, and 62.0%, respectively. The multinomial logistic regression estimates indicated that in high-tobacco-burden U.S. states but not in low-tobacco-burden U.S. states, individuals of Black (RRR=2.4; 95% CI=1.6, 3.5; p<0.001) and Hispanic (RRR=2.8; 95% CI=1.6, 4.8; p<0.001) race/ethnicity were more likely to endorse quitting or reducing tobacco use relative to switching to other tobacco products than those of non-Hispanic White race/ethnicity. Banning menthol cigarettes nationwide may substantially benefit the U.S. population, particularly Black and Hispanic individuals in high-tobacco-burden U.S. states.