An Estimation of the Prevalence of Smoking and e-Cigarette Use among U.S. Adults If Menthol Cigarettes and Flavored Cigars Are Banned

Abstract

Introduction

People’s reaction to the FDA’s ban on flavored cigarettes and cigars may be modified by a concurrent ban on flavored e-cigarettes. We aim to estimate the prevalence of smoking and e-cigarette use among U.S. adults under various ban scenarios.

Methods

We collected the reactions of people who used cigarettes, cigars, and e-cigarettes reactions to three hypothetical ban scenarios, (1) restricting menthol cigarettes and flavored cigars only, or (2) further restricting e-cigarettes with any flavors except menthol or tobacco, or (3) further restricting e-cigarettes with all flavors. The above data were analyzed to identify determinants of reactions and to estimate and calibrate the probabilities of quitting and switching to non-flavored cigarettes and cigars. Afterward, the probabilities were applied to 2018–2019 TUS-CPS respondents to estimate the prevalence of smoking and e-cigarette use.

Results

Compared with the baseline, the prevalence of smoking decreased from 12.6% to 10.5%, and e-cigarette use increased from 2.6% to 3.8% in Scenario No.1. In Scenario No.2 and No.3, the prevalence of smoking was 10.5% and 10.7%, and the prevalence of e-cigarette use were 3.1% and 2.4%, respectively. For black people, the prevalence of smoking decreased from 14.2% in baseline to 8.1%-8.8% in three scenarios.

Conclusions

The result indicated that for a ban on menthol cigarettes and flavored cigars, a concurrent ban on flavored e-cigarettes with an exemption of menthol flavor could be more effective in encouraging people to quit smoking. Black people may see a disproportionate benefit from all ban scenarios compared with other race/ethics groups.

KEY MESSAGES

• What is already known on this topic: ban menthol in cigarettes and flavored cigars increases quitting among people who currently smoke.

• What this study adds: For a ban on menthol cigarettes and flavored cigars, a concurrent ban on flavored e-cigarettes could be complementary if menthol flavor was exempted.

• How this study might affect research, practice or policy: For flavor bans, inventions to mitigate the increasing use of e-cigarettes and alternative tobacco products are needed, also the interventions should be tailored to various population segments.

ONE SENTENCE SUMMARY

In a study that examined how flavor bans may affect smoking and the use of e-cigarettes, we found for a ban on menthol cigarettes and flavored cigars, a concurrent ban on flavored e-cigarettes with an exemption of menthol flavor could be more effective in encouraging people to quit smoking.

ABSTRACT IN PLAIN LANGUAGE

We wanted to see how people would react if the government banned certain types of flavored cigarettes and cigars, and also e-cigarettes with flavors. We surveyed people who used cigarettes, cigars, and e-cigarettes and found that if they banned menthol cigarettes and flavored cigars, more people might quit smoking, but some might switch to non-flavored products. This effect was even more noticeable when menthol e-cigarettes were also banned. Our study suggested that if menthol flavor is exempted, banning flavored e-cigarettes alongside menthol cigarettes and flavored cigars could work together. Interestingly, the benefits of these bans might be more significant for Black people compared to other racial groups.

Keywords:

• Flavor
• menthol
• cigarettes
• cigars
• e-cigarettes
• ban

Declaration of interest

The authors declare that they have no conflict of interest. The authors alone are responsible for the content and writing of the article.

Human rights

The surveys were exempted by the University of Memphis’s Institutional Review Board.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Funding

Supported by NIH’s National Institute on Drug Abuse (R03DA048460)