Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK.
Department of Psychology, University of Waterloo, Waterloo, ON, Canada.
Eur J Public Health. 2023 Aug 1;33(4):619-626. doi: 10.1093/eurpub/ckad049.
The 2020 European Union (EU) menthol cigarette ban increased quitting among pre-ban menthol smokers in the Netherlands, but some reported continuing to smoke menthol cigarettes. This study examined three possible explanations for post-ban menthol use-(i) illicit purchasing, (ii) use of flavour accessories and (iii) use of non-menthol replacement brands marketed for menthol smokers.
Data were from the ITC Netherlands Cohort Surveys among adult smokers before the menthol ban (Wave 1: February-March 2020, N = 2067) and after the ban (Wave 2: September-November 2020, N = 1752; Wave 3: June-July 2021, N = 1721). Bivariate, logistic regression and generalized estimating equation model analyses were conducted on weighted data.
Illicit purchasing remained low from pre-ban (2.4%, 95% CI: 1.8-3.2, Wave 1) to post-ban (1.7%, 1.2-2.5%, Wave 3), with no difference between menthol and non-menthol smokers from Wave 1 to Wave 3. About 4.4% of post-ban menthol smokers last purchased their usual brand outside of the EU and 3.6% from the internet; 42.5% of post-ban menthol smokers and 4.4% of smokers overall reported using flavour accessories, with greater odds among those aged 25-39 years vs. 55+ (aOR = 3.16, P = 0.002). Approximately 70% of post-ban smokers who reported using a menthol brand were actually using a non-menthol replacement brand.
There was no increase in illicit purchasing or of smuggling outside the EU among menthol and non-menthol smokers in the Netherlands 1 year after the EU menthol cigarette ban. Use of flavour accessories and non-menthol replacement brands best explain post-ban menthol use, suggesting the need to ban accessories and ensure industry compliance.
2020 年欧盟（EU）对薄荷醇香烟的禁令增加了荷兰薄荷醇香烟禁令前薄荷醇烟民的戒烟率，但也有一些人报告称继续吸食薄荷醇香烟。本研究探讨了禁令后继续使用薄荷醇香烟的三种可能解释-(i) 非法购买，(ii) 使用调味配件，(iii) 使用针对薄荷醇吸烟者的非薄荷醇替代品牌。
数据来自 ITC 荷兰队列调查，调查对象为薄荷醇禁令前的成年吸烟者（第 1 波：2020 年 2 月至 3 月，N=2067）和禁令后（第 2 波：2020 年 9 月至 11 月，N=1752；第 3 波：2021 年 6 月至 7 月，N=1721）。对加权数据进行了双变量、逻辑回归和广义估计方程模型分析。
从禁令前（2.4%，95%CI：1.8-3.2，第 1 波）到禁令后（1.7%，1.2-2.5%，第 3 波），非法购买一直保持较低水平，且在禁令前后，薄荷醇和非薄荷醇吸烟者之间没有差异。约 4.4%的禁令后薄荷醇烟民最后一次购买他们惯用的品牌是在欧盟以外，3.6%是从互联网上购买的；42.5%的禁令后薄荷醇烟民和 4.4%的总体烟民报告说使用了调味配件，在 25-39 岁的人群中，这种情况更为常见，与 55 岁以上的人群相比，这一比例更高（调整后的比值比 aOR=3.16，P=0.002）。大约 70%的报告使用薄荷醇品牌的禁令后吸烟者实际上使用的是非薄荷醇替代品牌。
在欧盟薄荷醇香烟禁令实施一年后，荷兰薄荷醇和非薄荷醇烟民中并没有增加非法购买或在欧盟以外走私的情况。使用调味配件和非薄荷醇替代品牌是禁令后继续使用薄荷醇的最佳解释，这表明需要禁止使用配件并确保行业合规。
