A proposed U.S. federal ban on menthol cigarettes doesn't go far enough and needs to include other menthol products, from pipe tobacco to cigarette tubes, researchers say.
New evidence shows both the appeal and the addiction potential of these substitutes in adults who smoke menthol cigarettes, said scientists from Rutgers University Center for Tobacco Studies in New Brunswick, N.J., and Ohio State University.
"Tobacco companies have rebranded their roll-your-own cigarette tobacco as pipe tobacco, to avoid taxes, and rebranded flavored cigarettes as flavored cigars to skirt a federal ban," said co-lead investigator Andrea Villanti, deputy director of the Rutgers Center.
"We have already seen companies advertising pipe tobacco and cigarette tubes alongside cigarettes and filtered cigars," Villanti said in a Rutgers news release. "The products we tested in our study are likely to be products that tobacco companies will promote following a ban on menthol cigarettes."
The researchers looked at 98 adults who smoke menthol cigarettes in four sessions held over three weeks. Participants first smoked their usual brand of menthol cigarettes, and then they were randomized over three other tests.
These were smoking a preassembled roll-your-own cigarette using menthol pipe tobacco and a mentholated cigarette tube; smoking a menthol-filtered little cigar, and smoking a non-menthol cigarette.
None of these products are part of the proposed ban by the U.S. Food and Drug Administration, which is expected in the coming months.
The investigators measured how the smokers smoked each of the products, the exhalation of carbon monoxide and their craving and withdrawal symptoms. They also asked participants about their perceived effects.
Menthol filtered little cigars and non-menthol cigarettes were appealing substitutes, the researchers found. However, mentholated pipe tobacco and tubes in a roll-your-own cigarette were the most appealing. These resulted in the highest number of indicators for future nicotine addiction.
Therefore, these products should be included in the ban, Villanti said.
Menthol cigarette use is associated with increased smoking initiation, higher nicotine dependence and decreased adult cessation, particularly in vulnerable populations, past research has shown.
"The present findings suggest that components of menthol roll-your-own products, including menthol rolling papers, cigarette tubes and pipe tobacco, should be included in the menthol cigarette and flavored cigar product standards," said co-author Theodore Wagener, director of the Center for Tobacco Research at Ohio State's Comprehensive Cancer Center.
"Their absence from this restriction will result in a critical loophole that is already being exploited by the tobacco industry and has the potential to lessen the potential public health benefits of the proposed menthol ban," he said in the release.
The findings were published recently in the journal Tobacco Control.
The U.S. National Cancer Institute has more on the proposed FDA ban on menthol cigarettes.
SOURCE: Rutgers University, news release, Dec. 5, 2022