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

INTRODUCTION

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

Banning menthol cigarettes nationwide may substantially benefit the U.S. population, particularly Black and Hispanic individuals in high-tobacco-burden U.S. states.