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 nicotine and tobacco products, such as e-cigarettes (also known as electronic nicotine delivery systems, or 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,71011121314 and reduce the likelihood of quitting.101115 Banning menthol should discourage sustained tobacco use.1016

Menthol cigarettes could contribute to health inequalities: in the USA they have been found to be disproportionately smoked by those with lower incomes,81718 those with a lower level of education,8 women,19 African Americans,2021 the LGBTQ+ community,2223 and young people.24

Menthol cigarettes are more commonly used by less-established or ‘novice’ smokers, and those who are experimenting with smoking.1824 Research shows that the tobacco industry has manipulated the menthol content of cigarettes to promote smoking initiation and sustain tobacco use.2526 Menthol was found to be key to industry strategy in Singapore, to both recruit and retain young smokers.27

Mass distribution and marketing of menthol did not start until the 1960s although a US patent for menthol flavouring was granted in the 1920s.6728 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.2930 Tobacco companies have been developing flavour capsules since the 1960s and multiple innovations have been patented, but not yet marketed.31 Cigarettes with flavour capsules are popular with young people due to the interactivity, and the novelty of smoking a cigarette with two flavours.293032 Flavour capsule use is high in Chile, Mexico and South Korea.33 In some countries use is high among women.33 Some markets, such as the UK, only had menthol flavoured capsule cigarettes available, and not other flavours.34

Menthol can be present in tobacco products not labelled as menthol.3536 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.837

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.38 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.39

Turkey was the first country to successfully introduce a ban on flavoured cigarettes, including menthol, in 2015, to be fully implemented in 2020.4041

Also in 2015, Ethiopia banned menthol flavouring for all forms of tobacco to prevent appeal to children and adolescents, a pre-emptive move as Ethiopia had no significant existing use of menthol.142 The ban was comprehensive, covering manufacture, import, distribution, and  sale. It bans aroma as well as taste, effectively banning additions to packaging.43

While most flavour policies mention reducing youth use, only some restrict flavour descriptors on tobacco packaging.38

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

In 2012, in order to prohibit the addition of substances that enhance the attractiveness of tobacco products through flavour and taste, Brazil became the first country in the world to pass a law banning menthol tobacco products. However it was unable to enact the law due to industry interference and a lengthy court battle.4445

A review of academic, government and commercial documents found the tobacco industry used a range of strategies to interfere with the legislation, including instigating demonstrations by tobacco farming front groups, media articles, litigation, lobbying, and industry-commissioned studies questioning the rationales for legislation.44 Arguments used by the tobacco industry included that: a ban would threaten employment, increase illicit trade, or prevent successful growing of burley tobacco; there is a lack of evidence that a ban would reduce smoking; and that a ban would be illegal.44

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.4647 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”.47

The Brazilian government finally won the court case in February 2018, although the ban was not fully enacted due to ongoing interference.38454448 Researchers noted that these strategies had also been used elsewhere, and that the legislation was delayed for many years despite a lack of evidence to support industry arguments.44

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 2013.149 After lobbying from the tobacco industry, the ban was rejected. The industry argued that menthol products were no different to other tobacco products, and that there was a lack of evidence of increased addiction or harm.150 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.5152 Despite passing the law in the Senate, as of February 2020 the law had yet to be implemented.53 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”.52 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.54 The tobacco industry lobbied against extending the ban to non-cigarette products (cigarillos and smokeless tobacco).55 After implementation tobacco companies developed new variations on existing products, including small menthol cigars, to get around the ban.13856

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.1575859 First Nations reserves were included, removing a potential legal route for purchasing menthol after the ban, although products may still be available.5760

Canadian legislation bans menthol’s use as an ingredient because menthol’s presence at subliminal levels reduces the negative sensations of smoking.616263

United States

In 2019, 18.5 million people in the US were current smokers of menthol cigarettes.64 On 28 April 2022 the US Food and Drug Administration (FDA) announced proposed standards for banning menthol as a characterising flavour in cigarettes and cigars.6065 In 2009 the US had previously banned characterising flavours in cigarettes (see below) except menthol.

Characterising Flavour

Factors relevant for determining whether a product has a characterising flavour as stated by the FDA include, but are not limited to, presence and amount of flavour ingredients or additives, multisensory experience, implicit or explicit flavour representations (including descriptors) on the packaging.  Industry has commented that characterising flavour requires a clear and scientifically based definition for compliance.64

However, there is also evidence that tobacco companies have have undermined ‘characterising flavour’ bans implemented in other countries, notably the EU and UK.

The rules were to come into effect one year after the final publication of the regulations (not yet provided).6466  The ban would also cover tribal lands.60

As the tobacco companies make ‘massive profits’ from menthol, legal challenges and protests from the tobacco industry and third party allies are likely.6768 30% of British American Tobacco’s operating profit is reported to come from the sale of menthol cigarettes in the US alone.69

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.4070 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).71 After protests against the TPD from the tobacco industry, implementation of the ban on menthol cigarettes was postponed to 2020.7273

Many of the brands assessed by the EU Commission advisory panel on characterising flavour have been found to have a chemical profile suggestive of having a characterising flavour, and noticeable odours.74

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.75 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.76

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.77

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.78

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.76

Across Canada, state menthol bans significantly increased quit success among menthol smokers compared with non-menthol smokers.79  The ban also prevented relapse among smokers who had quit pre-ban. 80 In 2015, even though some states had already passed legislation, 15% of 15 to 19 year olds reported smoking menthol cigarettes.81 Between 2018 and August 2020, 2-3% of  16-19 year olds were estimated to be smoking menthol or capsule cigarettes.82 Most menthol smokers switched to non-menthol cigarettes, and menthol accessories (which could provide a menthol flavour) remained on sale in Canada.80

In 2009, Canada had banned on all non-menthol flavour additives small cigars as well as cigarette. Despite an increase in non-flavoured cigars, there was a net reduction in cigar sales by 2015.76

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.83

The EU menthol ban came into force on 20 May 2020. An International Tobacco Control (ITC) study in 2020-2021 surveyed the same sample of adult smokers in the Netherlands before and after the EU menthol ban.84 This study found that menthol use significantly decreased from 8% to 4% post-ban. Compared to non-menthol smokers, menthol smokers had higher quit attempt rates (67% vs 50%). 40% of those who smoked menthol pre-ban switched to non-menthol cigarettes while just over a third continued to smoke menthol cigarettes after the ban.84 Over 40% of menthol smokers  reported using flavour accessories post-ban, including filters, flavour cards, marker pens, and drops, which were not banned.85 4% of all smokers used these accessories post-ban.85

The menthol ban was adopted into UK legislation before the UK left the EU. Results from evaluations have been mixed.  A study using the ITC Youth Tobacco and Vaping Survey found that in England, the percentage of youth smokers (age 16-19) whose usual cigarette brand was menthol declined from 12% in Feb 2020 to 3% in August 2020. This fall was not replicated in countries which did not have a menthol ban enacted during the study period. However, reported menthol smoking in the previous 30 days was still high post-ban at over 40%.82  Between July 2020 and June 2021, Smoking Toolkit Study data suggested 16% smokers in England reported smoking menthol cigarettes; women and younger smokers were more likely to report menthol smoking. There appeared to be a decline in reported menthol smoking in mid-2021.86 Some remaining reports of menthol smoking could be at least partly because menthol accessories and cigarillos were still available.87

The tobacco industry attempted to boost menthol sales after the ban was announced.88 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.89 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.89

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.90 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.76 In Romania there was no increase in tobacco confiscations after the EU ban.91 Both before and after the ban, about 2% purchases in the Netherlands were illicit.85 Despite English smokers continuing to smoke menthol cigarettes after the menthol ban, there was no reported rise in purchasing of cigarettes from illicit sources.86

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.92

From 2010 to 2020, capsule cigarettes experienced significant market growth, with an average increase of 0.7 percentage points per year.93   Growth occurred across all WHO regions, with the exception of Europe. Here there was an increase until 2019, then a decrease of 0.6 percentage points to 2020, likely due to the EU characterising flavour ban. Capsule cigarette market growth was most substantial for upper-middle income countries (with an average market share of 1.0% to 11.4) and the WHO region of the Americas (1.5% to 16.2%).93 The five countries with the highest average annual growth rates of capsule cigarettes  were: India (154%), Uzbekistan (122%), Uruguay (115%), Russia (84%), and Ukraine (84%). Four of these are middle-income countries.93 By 2019, capsule cigarettes made up a larger proportion of the global cigarette market than menthol flavoured cigarettes.  The overall market share of menthol cigarettes decreased by an average of 0.2 percentage points per year.93

According to Euromonitor, in 2020, capsules accounted for 3.3% of the market worldwide (by volume) and menthol flavoured cigarettes 2.4%. 94 However, regional distribution varies. Four of the five countries with the highest capsule market shares in 2020 were in Latin American: Chile (48%), Peru (35%), Guatemala (33%), Mexico (27%), and South Korea (25%).93

The market share of menthol flavoured cigarettes remained high in many countries, the highest being in the WHO Western Pacific region (15% in 2020) and Africa region (13%). The five countries with the largest menthol market shares in 2020 were: Singapore (47%), Dominican Republic (33%), Cameroon (30%), USA (29%) and Japan (28%).93 In contrast, in Europe the average market share for menthol flavoured cigarettes was only 1.5% across the region.

Both types of flavoured cigarette are equally popular in Nigeria and have over 40% of the tobacco market. Only two of the countries included in Euromonitor’s dataset, North Macedonia and Canada, had no measurable market for either.94

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

Relevant Links

Flavors (Including Menthol) in Tobacco Products, STOP resource (May 2022)

Case studies for regulatory approaches to tobacco products: menthol in tobacco products, World Health Organization advisory note (2018)

Partial guidelines for implementation of articles 9 and 10 of the WHO Framework Convention on Tobacco Control: regulation of the contents of tobacco products and of tobacco product disclosures, World Health Organization, WHO website (2012)

A global map of menthol bans is available on Tobacco Atlas: Product Sales

Public Health Law Center: Menthol and Other Flavoured Products, PHLC website (United States)

US Food and Drug Administration, Tobacco Product Standard for Menthol in Cigarettes (5 April 2022)

Centers for Disease Control and Prevention, Office on Smoking and Health Summary of Scientific Evidence: Flavored Tobacco Products, Including Menthol (United States, February 2021)

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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