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8 <br />in Ontario was also associated with a significant <br />reduction in menthol cigarette sales and total <br />cigarette sales.34 <br /> <br />In the U.S., several surveys have asked menthol <br />smokers about their planned behavior should a <br />hypothetical menthol cigarette ban be <br />implemented, and they have consistently found <br />even more encouraging pre-implementation <br />results as compared to findings from Ontario. In <br />one longitudinal study using data from 2011 – <br />2016, 24% of young adult smokers said they <br />would quit menthol cigarettes. This response <br />did not vary greatly across time and African <br />Americans, females, and those with less than a <br />high school education were more likely to report <br />the intention to quit smoking. However, there <br />was a significant increase in respondents who <br />said they would switch to another tobacco <br />product if menthol cigarettes were no longer <br />available, from 7% in 2011 to 13% in 2016.35 Of <br />the cross-sectional surveys predicting the impact <br />of a menthol cigarette ban, a 2010 study with <br />adolescent and adult smokers found that 35% of <br />menthol smokers reported that they would quit <br />smoking and 25% reported that they “would find <br />a way to buy a menthol brand”.36 In a 2011 study <br />of young adults, ages 18 – 34, 66% of menthol <br />cigarette smokers reported the intention to quit <br />smoking, 18% of respondents reported that they <br />would switch to non-menthol cigarettes, and <br />16%said they would switch to some other <br />tobacco product. Intention to quit was most <br />prevalent among African American menthol <br />smokers (79%) and intention to switch to some <br />other tobacco product was more prevalent <br />among menthol smokers who also reported <br />currently using another tobacco product (35%).37 <br />To examine the impact a menthol cigarette ban <br />may have on future smoking prevalence and <br />tobacco caused deaths in the U.S, another study <br />used simulation modeling. Under different <br />scenarios assuming that 10%, 20%, or 30% of <br />smokers would quit in the event of a menthol <br />cigarette ban, researchers found that overall <br />smoking prevalence would decrease by 4 – 10% <br />(9% – 25% among African Americans) and <br />between 323,000 and 633,000 deaths would be <br />avoided in the United States over a 40 year <br />period (2011 – 2050), with almost one third of <br />lives saved being African American.38 <br />Finally, some research has examined the effect <br />of other tobacco control policies on menthol <br />cigarette use. One study using Nielsen <br />Homescan Data, a dataset where a national <br />panel of households scan their cigarette <br />purchases, explored the impact of taxes and <br />public smoking restrictions on menthol cigarette <br />smoking and found that neither higher prices nor <br />public smoking restrictions increase the <br />likelihood of quitting among menthol smokers.39 <br />Notably, much of the menthol cigarette policy <br />research found in our literature search was <br />conducted prior to the rise of e-cigarettes in the <br />United States and before JUUL went to market. <br />While there is still a gap in the literature with <br />regard to the number of US consumers who <br />might switch to menthol e-cigarettes in light of a <br />ban on combustible menthol cigarettes and with <br />regard to the consumer response to a ban on all <br />menthol tobacco products, it is clear that bans <br />on menthol cigarettes would result in higher <br />rates of quitting among smokers, particularly <br />African American smokers in the United States <br />who are disproportionately affected by menthol <br />cigarettes. Furthermore, the evidence shows <br />that existing tobacco control policies, such as <br />increased tobacco taxes and public smoking <br />restrictions, are not sufficient in reducing <br />menthol cigarette use. <br />Cigar Flavor Ban or Restriction <br />The Population Assessment of Tobacco and <br />Health Study, a national longitudinal study of <br />tobacco use, was used to model the potential <br />public health benefits of a hypothetical national <br />ban of flavored cigars by extending the known <br />benefits of local and state policies to the nation. <br />The authors indicate a national law equaling the <br />net effectiveness of the local and state policies <br />would prevent 15% of premature deaths from <br />exclusive and regular cigar smoking and reduce