# Tobacco use behaviors in response to menthol restriction: A scoping review

## TL;DR

This review summarizes how people who smoke menthol cigarettes respond to menthol bans, highlighting differences in behavior between the US and other countries.

## Contribution

The study provides a comprehensive overview of behavioral responses to menthol bans, identifying research gaps and future directions.

## Key findings

- Most studies reported multiple behavior changes under hypothetical and actual menthol bans.
- US studies focused more on hypothetical bans, while non-US studies examined actual bans.
- Research gaps include geographical coverage, age-specific data, and racial/ethnic representation.

## Abstract

Understanding how menthol smokers change their behaviors in response to a menthol ban is important for public health and tobacco control. The goal of this scoping review is to summarize the up-to-date literature on this topic.

On 9 January 2024, we searched PubMed using the terms ‘menthol ban and responses’, ‘menthol ban and quitting’, and ‘menthol ban switching’, and performed forward citation tracking of recent review articles. We extracted data from each study regarding: 1) target population (US vs non-US); 2) type of ban (hypothetical or actual menthol ban); and 3) behavioral responses, including intended outcomes (quitting), harm reduction options (switching to e-cigarettes), and unintended consequences (continuing or switching to non-menthol products).

Our search resulted in 25 publications, including hypothetical bans (n=15), actual bans (n=6), and both scenarios (n=4); 95% and 73% of publications reported more than one behavior change under hypothetical and actual menthol bans, respectively. The majority of the US studies reported predicted behavior transitions under hypothetical bans (89%), while non-US studies have focused on actual menthol bans (73%).

Generally, the reported behavior transitions under hypothetical and actual bans largely vary in the US and non-US, identifying research gaps regarding geographical coverage, age-specific considerations, and racial/ethnic representation. This scoping review highlights a future research agenda to encourage the public health research community to collect historical data before and after a federal menthol ban.