Likely Response to a Hypothetical Menthol Cigarette Ban Among Adults with Mood Disorders Who Smoke Menthol Cigarettes and Have No Current Plans to Quit Smoking

Background: There is limited evidence on how the United States Food and Drug Administration’s (FDA) proposed ban on menthol cigarettes and flavored cigars will impact individuals with mood disorders who smoke menthol cigarettes. This study aimed to evaluate how individuals with mood disorders who smoke menthol cigarettes might respond to a hypothetical ban on menthol cigarettes, explore the reasons for their current use, and examine how these reasons are associated with participants’ characteristics. Methods: Study data were collected at baseline from adults (18+ years) with mood disorders who participated in a randomized controlled trial evaluating the impact of gradual nicotine reduction. Participants were individuals who smoked and had no plan to quit in the next six months. They reported demographics and tobacco consumption patterns, interest in quitting, and responded to a hypothetical question on a potential ban on menthol cigarettes. The question asked participants which actions they would most likely take if menthol-flavored cigarettes were banned. Means and frequencies were used to describe the sample. Logistic regression was used to determine factors associated with each reason for menthol use (less harmful, better flavor, less harsh on the throat, and less harsh on the chest). Results: Participants ( n = 77) were an average age of 42.5 (SD 12.5) years, 61% ( n = 47) were female, 68.8% ( n = 53) identified as White, and 5.2% ( n = 4) identified as Hispanic. On average, participants reported currently smoking 18.1 (SD 9.9) cigarettes per day and had smoked for 23.9 (SD 13.6) years. About 58.4% of participants ( n = 45) expressed their intention to switch to non-menthol cigarettes, 19.5% ( n = 15) intended to transition to a different type of tobacco product, and 22.1% ( n = 17) intended to quit smoking entirely without substitution. The most endorsed reason for using menthol cigarettes was better flavor (89.6%, n = 69/77), followed by less harshness on the throat (41.3%, n = 31/75) and chest (40%, n = 30/75), and the belief that they were less harmful than non-menthol cigarettes (24%, n = 18/75). Older age was associated with the belief that menthol cigarettes were less harmful (OR = 1.06; p = 0.02). Conclusion: Among individuals with mood disorders and who smoke menthol cigarettes and have no plans to quit smoking, 22.1% may try to quit smoking if a menthol ban is implemented, while the majority (58.4%) stated that they would switch to non-menthol cigarettes. As the reasons for using menthol cigarettes included perceived lower harm, there is a need for targeted public awareness campaigns to correct misconceptions about the harms of menthol cigarettes.