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How Smokers of Menthol Cigarettes and Flavored Cigars Might Respond to FDA's Proposed Bans.

INTRODUCTION
We aimed to examine the response of current smokers to a hypothetical ban on menthol cigarettes and flavored cigars.


METHODS
Current smokers were recruited online and reported the alternative products that they may switch to under a hypothetical ban, if they would try to obtain the banned products from illicit channels, and their support to the ban.


RESULTS
51% of current smokers would use non-flavored cigarettes and cigars as alternatives, 45% would switch to flavored heated tobacco products or e-cigarettes or quit smoking. 17% would try to obtain the banned flavored products from illicit markets. A majority of menthol only smokers opposed the ban. Daily smokers would be more likely to switch to non-flavored smoking, to try illicit market products, and were less supportive of the ban. Black smokers would be less likely to switch to non-flavored smoking and were more supportive of the ban. Smokers who used menthol cigarettes only would be more likely to switch to non-flavored smoking, less likely to try illicit market sellers, and were the least supportive of the ban.


CONCLUSIONS
In response to a ban of all added flavors for cigarettes or cigars, nearly half of current smokers would quit smoking, largely by switching to non-smoking products. However, smokers with more chronic use and those who used only menthol cigarettes would be more likely to switch to non-flavored smoking, diminishing the harm reduction potential. The ban may decrease the relatively higher prevalence of menthol cigarette smoking among Blacks compared with other groups.


IMPLICATIONS
A ban on the sale of menthol cigarettes and flavored cigars may decrease the prevalence of smoking because some current smokers may quit smoking and switch to non-smoking products. However, smokers with more chronic use and those who used menthol cigarettes only were more likely to switch to non-flavored cigarettes or cigars, diminishing the harm reduction potential of the ban. Black smokers would be more likely to switch to products other than cigarettes and cigars thus decreasing their relatively higher prevalence of smoking compared with other groups.