Flavoured and Menthol Tobacco

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Key points

  • Menthol cigarettes make up 10% of the global cigarette market.
  • Using flavouring agents as additives is thought to establish and sustain tobacco use, particularly among young people.
  • Cigarettes with flavour capsules in the filter create novelty and interactivity and are more popular among young people. Sales of capsule cigarettes are high in some countries, including South Korea and Chile.
  • The tobacco industry is able to use its vast resources to extensively develop, market and promote flavoured products.
  • Regulation of flavour is recommended by the WHO.
  • Flavour bans have been found to reduce cigarette sales and smoking, and so are subject to industry interference. Tobacco companies advocate for bans on ‘characterizing flavours’ (rather than bans on additives) and can exploit them.
  • There is little evidence that menthol bans lead to an increase in the illicit tobacco trade.

Menthol cigarettes are key products in tobacco company portfolios, representing an estimated 10% of the global cigarette market according to the World Health Organization (WHO).1 Using flavouring agents as additives is thought to promote and sustain tobacco use, and therefore WHO recommends banning menthol and other flavours in cigarettes.2

Note that this page focuses on cigarettes. There are many other kinds of flavoured tobacco products, including waterpipe, smokeless tobacco, including snus.

Flavours are also used in newer, so called ‘next generation products’, such as e-cigarettes (ENDS), heated tobacco products (HTPs) and nicotine pouches.

Figure 1: Retail publication sponsored by JTI (Source: Scottish Local Retailer/Japan Tobacco International, “Making a Mint”, 2020, PDF supplied by Action on Smoking and Health)

Background

Cigarettes are produced and sold with a variety of flavours, including menthol, fruit, spice, herb, alcohol, sweet and floral.34 Menthol, a type of alcohol that can be obtained from mint plants or manufactured, is the most widely used cigarette flavour.567 Besides adding a flavour, menthol desensitises receptors that lead to irritant sensations from nicotine, making the experience of smoking less harsh.58. In the United States non-menthol cigarette consumption declined by 33%  from 2009-2018 but menthol cigarette consumption only declined by 8%.9

Smoking menthol may help establish smoking among young people,710111213 and reduce the likelihood of quitting.101114 Banning menthol should discourage sustained tobacco use.1015

Menthol cigarettes could contribute to health inequalities: in the USA they have been found to be disproportionately smoked by those with lower incomes,81617 those with a lower level of education,8 women,18 African Americans,1920 and young people.21

Menthol cigarettes are more commonly used by less-established or ‘novice’ smokers, and those who are experimenting with smoking.1721 Research shows that the tobacco industry has manipulated the menthol content of cigarettes to promote smoking initiation and sustain tobacco use.2223 Menthol was found to be key to industry strategy in Singapore, to both recruit and retain young smokers.24

Mass distribution and marketing of menthol did not start until the 1960s although a US patent for menthol flavouring was granted in the 1920s.6725 In 2007 a new innovation for adding flavour appeared on the Japanese market which has since become common elsewhere, often marketed as a ‘crushball’, in which flavour is added via crushing a small plastic capsule in the filter.2627 Tobacco companies have been developing flavour capsules since the 1960s and multiple innovations have been patented, but not yet marketed.28 Cigarettes with flavour capsules are popular with young people due to the interactivity, and the novelty of smoking a cigarette with two flavours.262729 Flavour capsule use is high in Chile, Mexico and South Korea.30 In some countries use is high among women.30 Some markets, such as the UK, only had menthol flavoured capsule cigarettes available, and not other flavours.31

Menthol can be present in tobacco products not labelled as menthol.3233 The tobacco industry has stated that this might occur as a by-product of processing, but that it is also added deliberately to improve the flavour.834

Regulation and Industry Interference

Regulation of flavours that make smoking more palatable is recommended by the WHO Framework Convention of Tobacco Control (FCTC).12 According to a review conducted by researchers at Johns Hopkins University, as of 2021, about 40 countries have active or pending policies on flavour.35 These policies differ according to whether the following are banned:

  • all tobacco products
  • products with flavour additives
  • products with a noticeable or ‘characterising’ flavour
  • flavour descriptors and images on packaging

Tobacco industry documents show that the industry favours characterising flavour bans.36

Turkey was the first country to successfully introduce a ban on flavoured cigarettes, including menthol, in 2015, to be fully implemented in 2020.3738

In Africa, Ethiopia also banned menthol flavouring for cigarettes in 2015, effectively a pre-emptive move as Ethiopia had no significant existing use of menthol.139 Uganda, Senegal, Niger and Mauritania also had flavour policies in place by 2021, which prohibit fruits, vanilla and spice flavours.35 However, Niger made an exception for menthol, and details of flavours and ingredients were not specified in Mauritania and Uganda.35

While most flavour policies mention reducing youth use, only some restrict flavour descriptors on tobacco packaging.35

For up-to-date information on regulation of tobacco products around the world see the Tobacco Control Laws website, produced by the Campaign For Tobacco Free Kids (CTFK).

For countries that are parties to the FCTC, progress towards implementation of relevant articles (9 and 10) is detailed in the FCTC implementation database.

Brazil

Brazil was the first country in the world to pass a law banning menthol tobacco products in 2012, but was unable to enact it due to industry interference and a lengthy court battle.4041

Philip Morris Brasil (PMB) had challenged the ban through its membership of The National Industry Confederation (Confederação Nacional da Indústria, CNI), arguing that the ban was unconstitutional.4243 According to PMI’s 2018 annual report, “The tobacco union requested a stay of the enforcement of the ingredient ban while the appeal is pending”.43 The Brazilian government finally won the court case in February 2018, although the ban was not fully enacted due to ongoing interference.35414044

Chile

The Ministry of Health in Chile, a country with high use of menthol cigarettes, particularly among women, tried to introduce a menthol ban under an existing law in 2013.145 After lobbying from the tobacco industry, the ban was rejected due to claims of a lack of evidence of increased addiction or harm from menthol products.146 A new bill was introduced in 2015, supported by data showing very high use of menthol-flavoured cigarettes by young people (66% for smokers under 18).

In response to the new bill, British American Tobacco (BAT) threatened to withdraw its operations from Chile.4748 Despite passing the law in the Senate, as of February 2020 the law had yet to be implemented.49 Although the bill stalled, BAT went ahead with the closure of some of its factories. According to the Campaign for Tobacco Free Kids, this “can be interpreted as a decision to consolidate based on cost efficiency and not on local tobacco-control laws”.48 BAT continues to manufacture and market menthol cigarettes in Chile, with sales of capsule cigarettes increasing (see below).

Canada

Menthol cigarettes were initially exempted from a flavour ban in Canada in 2010. Evidence showed that menthol cigarettes were used by nearly a third of high school aged smokers.50 The tobacco industry lobbied against extending the ban to non-cigarette products (cigarillos and smokeless tobacco).51 After implementation tobacco companies developed new variations on existing products, including small menthol cigars, to get around the ban.13552

A series of menthol bans were implemented in Canadian provinces, starting with Nova Scotia in May 2015, and by October 2017 menthol cigarettes had been banned across Canada.15354

Canadian legislation bans menthol’s use as an ingredient because menthol’s presence at subliminal levels reduces the negative sensations of smoking.555657

United States

In the US, menthol represented nearly one third (27%) of the cigarette market when it was excluded from a cigarette flavour ban in 2009.5859 A proposed federal (nationwide) ban in 2016 led to a drop in the value of tobacco companies’ shares, although it was not implemented.6061 By 2018, 36% of cigarettes sold were menthol, and less than 1% of the US population lived in areas where menthol cigarettes were banned.259

In 2020, Massachusetts passed state-wide legislation banning all flavoured tobacco products, including menthol. Later the same year California passed a similar law, although some cigars and pipe tobacco were exempt.62 There are multiple other local bans and restrictions in place across the country – for more information see the factsheet produced by the Campaign for Tobacco Free Kids.63

The US continues to be an important market for tobacco companies’ menthol brands. In its 2018 Annual Report, BAT said that after it acquired US tobacco company RJ Reynolds in 2017 “The sales of Newport, together with the other menthol brands of the Group’s operating subsidiaries, represent a significant portion of the Group’s total net sales”.64 In the same report it repeatedly noted the risk of any future flavour bans to impact negatively on its business.64 In September 2020, the Los Angeles Times reported that the tobacco industry was attempting to interfere with the implementation of the California ban through third party action.65

The tobacco industry claimed that stopping convenience stores selling menthol cigarettes in Minnesota (by restricting their sale to adult only tobacco and  stores selling alcohol) would lead to catastrophic financial and job losses.  However independent research suggested losses would be six times smaller: tobacco does not drive use of convenience stores as much as the tobacco industry claims.66

In June 2020, two US NGOs (African American Tobacco Control Leadership Council and Action on Smoking and Health) filed a lawsuit against the US Food and Drug Administration (FDA) to try to force it to introduce a ban on menthol cigarettes in order to reduce health inequalities, noting that 85% of African American smokers smoke menthol cigarettes.67 See also the STOP statement on this legal action. The same figure has been used by the tobacco industry to lobby against the ban, arguing that it is discriminatory: “giving special treatment to the rich, and singling out communities of color”.68 In September 2020, the American Medical Association (AMA) joined the lawsuit as co-plaintiffs.69 The president of the AMA said that “For generations, tobacco companies have promoted menthol cigarettes to the African American community, preying especially on African American youth… This action is long, long overdue”.6970 In April 2021, the FDA announced that it was “working towards” a full menthol and flavour ban in cigarettes and cigars, stating that:

“This decision is based on clear science and evidence establishing the addictiveness and harm of these products and builds on important, previous actions that banned other flavored cigarettes in 2009.”71

As the ban would cover “manufacturers, distributors, wholesalers, importers and retailers”, further legal challenges and protests from the tobacco industry and third party allies are likely.7172

Moldova

Moldova, a non-EU country in the lower middle-income category with a high smoking rate, was due to ban menthol cigarettes in May 2020 at the same time as the EU.3773 In 2019, PMI increased its lobbying efforts in Moldova, to try to gain influence over tobacco control policy in the country. For more information see Swiss Diplomats Lobbying for PMI.

European Union and UK

An EU-wide ban on the sale of flavoured cigarettes was introduced in May 2016, including menthol, under the 2014 revised European Tobacco Products Directive (TPD).74 After protests against the TPD from the tobacco industry, implementation of the ban on menthol cigarettes was postponed to 2020.7576

Do Bans Work?

Evidence from the US

The US flavour cigarette ban (with the exception of menthol) came into effect in September 2009. Survey data for the period up to 2017 suggested the ban reduced cigarette smoking long term among young adults (27%) and youth smokers (43%) but not older adults. Immediately post ban significant numbers of young adult and youth smokers of other flavours switched to menthol and non-flavoured cigarettes.77. However, by 2015 cigar sales had also increased, particularly flavoured cigars. Internet vendors, especially those based outside the US were found to be selling flavoured products in 2011, two years after the flavour ban.78

The 2009 ban only applied to cigarettes. In 2014, 61% of middle and high school smokers had recently used flavoured hookah and 64% had used flavoured cigars.79

In June 2017, the city of San Francisco, USA, banned the sale of all flavoured tobacco products including menthol. Retailers were given training, and shops were inspected. By December 2019, the comprehensive ban had reduced sales of flavoured products by 96%. Total tobacco sales declined significantly further than in neighbouring cities without bans.80

Evidence from Canada

The country wide Canadian ban was in place in October 2017, but several states implemented bans beforehand from 2015 onwards. In Ontario, a menthol cigarette ban was enacted in January 2017. Having a ban in place was associated with a reduction in menthol and total cigarette sales. This was despite 57% of menthol smokers switching to alternative tobacco products or e-cigarettes one month after the ban.  Quit attempts increased, and menthol smokers were more likely to successfully quit than non-menthol smokers in the year after the ban.7881

Across Canada, state menthol bans significantly increased quit attempts and quit success among menthol smokers and prevented relapse among smokers who had quit pre-ban. However, most menthol smokers switched to non-menthol cigarettes, and menthol accessories are on sale in Canada.82 There was no change in youth smoking rates by 2017.83 Menthol cigarettes were also still available from First Nations reserves.83

In 2009, Canada banned on all non-menthol flavour additives in cigarettes and small cigars. Despite an increase in non-flavoured cigars, there was a net reduction in cigar sales by 2015.78

Evidence from the EU and UK

The European Union flavour ban (with the exception of menthol) came into force in May 2017. Survey data from eight EU countries suggested that between 2016 and 2018 only 11% of smokers of the banned flavours continued to smoke them, 62% moved to unflavoured cigarettes and 5% moved to menthol cigarettes. Only 9% quit completely.84

The European Union menthol ban was adopted into UK legislation before the UK left the EU. The tobacco industry attempted to boost menthol sales after the ban was announced.85 Between September 2019 and February 2020, before the ban, sales of menthol cigarettes fell by 57% in UK convenience stores (as reported by the Retail Data Partnership). However, under 2% of stores had stopped selling them.86 The analysts did not identify any significant rise in sales of RYO tobacco, cigarillos or e-cigarettes. Therefore, it was unclear whether customers were switching to products bought elsewhere (e.g. online), or were in fact quitting.86

Between July 2020 and June 2021, 16% smokers in England reported smoking menthol cigarettes; women and younger smokers were more likely to report menthol smoking. This could be at least partly because menthol accessories and cigarillos were still available.87 There appeared to be a decline in reported menthol smoking in mid-2021.88 

Flavour Bans and Illicit Tobacco

Where neighbouring countries do not implement a ban, it has been suggested that there is a risk that smuggling will increase.89 Tobacco companies have used this argument when lobbying against regulation, including the TPD.

However, the risk associated with the movement of illicit tobacco is often exaggerated by the tobacco industry. An evaluation of the 2015 menthol ban in the Canadian Province of Nova Scotia found no change in seizures of menthol or nonmenthol cigarettes after 3 years.78 Despite English smokers continuing to smoke menthol cigarettes after the menthol ban, there was no reported rise in purchasing of cigarettes from illicit sources.88 In Romania there was no increase in tobacco confiscations.90

The Global Market for Menthol Cigarettes

Euromonitor International produces data on cigarette market share by volume of capsule cigarettes (i.e. of any flavour, including menthol) and menthol flavoured cigarettes (i.e. without capsules) for up to 78 countries. Note that Euromonitor receives project funding from Philip Morris International.91

According to Euromonitor, in 2020, capsules accounted for 3.3% of the market worldwide (by volume) and menthol flavoured cigarettes 2.4%. However, regional distribution varies. Menthol flavoured cigarettes tend to have a larger share of the market than capsules in the lower income countries of the Western Pacific region (23.7% on average); in contrast, in Europe the average market share for menthol flavoured cigarettes was only 1.5% across the region.58

Sales of capsule cigarettes have in general tended to increase with growth in a country’s income (as defined by the World Bank).In Chile capsules made up 48.4% of the cigarette market in 2020, the highest globally. In South Korea, capsule cigarettes have a 24.7% share of the market; standard menthol flavoured cigarettes have just under 2.8%.58

Both types of flavoured cigarette are equally popular in Nigeria and have a large share (42.8%) of the tobacco market. Only two of the countries included in Euromonitor’s analysis, North Macedonia and Canada, had no measurable market for either.58

Company Market Shares

Tobacco companies do not share their sales figures for menthol tobacco products, so market share needs to be calculated from different data sources.

TobaccoTactics Resources

TCRG Research

For a comprehensive list of all TCRG publications, including research that evaluates the impact of public health policy, go to the Bath TCRG’s list of publications. 

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