摘要：Objectives. We assessed support for a ban by the Food and Drug Administration on menthol in cigarettes and behavioral intentions among menthol smokers in the event of such a ban. Methods. We surveyed 2649 never, former, and current smokers and used ordinal logistic regression to calculate weighted point estimates and predictors of support for a menthol ban among the adult population and menthol smokers only. For menthol smokers, we also calculated weighted point estimates and predictors of behavioral intentions. Results. Overall, 28.2% of adults opposed, 20.0% supported, and 51.9% lacked a strong opinion about a menthol ban. Support was highest among Hispanics (36.4%), African Americans (29.0%), never smokers (26.8%), and respondents with less than a high school education (28.8%). Nearly 40% of menthol smokers said they would quit if menthol cigarettes were no longer available, 12.5% would switch to a nonmenthol brand, and 25.2% would both switch and try to quit. Conclusions. Support for a menthol ban is strongest among populations with the highest prevalence of menthol cigarette use. A menthol ban might motivate many menthol smokers to quit. In 2009, the passage of the Family Smoking Prevention and Tobacco Control Act gave the US Food and Drug Administration (FDA) the authority to regulate tobacco products in the United States. 1 Three months after passage of the law, the FDA banned cigarette flavorings such as clove and chocolate as a measure to reduce smoking initiation. The law excluded menthol from this ban, but mandated that the FDA’s new Center for Tobacco Products consider a menthol ban as one of its first actions. Convened in 2010, the Center's Tobacco Products Scientific Advisory Committee was tasked with assessing the scientific evidence regarding the public health impact of menthol in cigarettes. The committee’s report to the FDA in March 2011 stated, “removal of menthol cigarettes from the marketplace would benefit public health in the United States.” 2 (p208) Even before the 2009 cigarette-flavoring ban, menthol was the most popular characterizing flavor in the United States. 3 Although most cigarettes contain some menthol, about one third of all adult smokers smoke cigarettes with menthol as their characterizing flavor. 3,4 Smoking prevalence has decreased since the mid-20th century, but the proportion of menthol smokers has increased in recent years, 4 with menthol smoking higher among youths, women, African Americans, and those making less than $50 000 a year. 3 Proposed reasons for this increased market share include menthol’s role in facilitating initiation and decreasing cessation, as well as cigarette companies’ targeted marketing of African Americans. 5–8 Research by Winickoff et al. showed that public support for a ban is high when menthol cigarettes are framed as a type of flavored cigarette. 9 Our study adds to existing research assessing public support for a menthol ban, with special attention to the role of smoking status, gender, race/ethnicity, and education. We also report here the first peer-reviewed data on menthol smokers’ predicted behavioral responses in the event of a menthol ban. 10,11 Information about consumer sentiment and predicted behavioral reaction to a menthol ban could inform the FDA’s decision-making and help the agency plan what type of mass media educational campaign and smoking cessation resources are needed to maximize the public health benefit of a menthol ban.
