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Introduction Since May 2020, the ban on production and sale of menthol and other flavored cigarettes will come into force in the European Union countries. Then millions of cigarette smokers can quit smoking or switch to other tobacco products, both conventional and novel. Study aim To assess the prevalence, socio-demographic characteristics, cessation behaviors and attitudes of menthol and other flavored cigarette smokers towards tobacco control policies and programs. Material and Methods Cross-sectional data were collected in 2016 among 10,760 adult current smokers from 8 European countries (EUREST-PLUS ITC Europe Project). Smokers of menthol, other flavoured, unflavored tobacco, or no usual brand were compared on smoking prevalence, socio-demographic characteristics, tobacco dependence, motivation to quit, self-efficacy, prior cessation behaviours, and attitudes towards tobacco control measures. The univariate data analysis adjusted to few confounding factors was made with the use of SPSS Complex Samples Package. Results Study results shows that around 7% of adults in all 8 analyzed European countries smoke menthol cigarettes and around 3% other flavored cigarettes. However, prevalence of menthol smoking substantially varies between countries (0.4% in Spain to 12.4% in England). Compared to other groups, menthol cigarette smokers are younger, more likely to be female, better educated, had higher household income, and smoked fewer cigarettes. In comparison to smokers of unflavored cigarettes, smokers of menthol and other flavoured cigarettes are less likely to smoke daily, tend to be less dependent and have higher quitting self-efficacy. In comparison to all other smokers, menthol smokers are less likely to support a ban on sale of flavored tobacco products, including menthol cigarettes. After enforcement of the ban, around a fifth of all menthol and flavored cigarette smokers intends to switch to another brand, and a third to reduce the amount they smoked or to quit smoking. Conclusions The EU TPD ban on sale of flavored cigarettes will affect one in ten smokers in the countries surveyed and provides an opportunity for targeting these groups with tobacco control policies and cessation programs. Lower tobacco dependence rates found in smokers of menthol and other flavored cigarettes may lead to greater success rates if quit attempts are strengthened by smoking cessation programs. However, smokers of different cigarette flavours in Europe differ on a range of smoking and cessation characteristics and may need different, target-tailored approaches.

Introduction Safety data on the chemical content of the electronic cigarette liquids depending on their flavors are scarce. Aims and objectives: This study aimed to identify and evaluate the content of e-liquids according to their flavor in the most common e-liquid products in the EU. Methods Within the Horizon2020, EUREST-PLUS study, 122 of the most commonly sold e-liquids in 9 European Countries (France, Poland, Germany, the Netherlands, United Kingdom, Spain, Romania, Hungary and Greece) were randomly selected and purchased. E-liquids were then divided into 7 groups according to their flavor. These groups are: Tobacco (35), Fruits (44), Menthol-mint (9), Non-alcoholic drinks (10), Alcohol (5), Desserts-sweets (11) and other flavors (8). A qualitative chemical analysis was performed using gas chromatography-mass spectrometry technique companied with solid phase microextraction (GC-SPME-MS), while the identification of the compound was done by NIST or Wiley library. Results After analyzing the total number of the samples, 232 compounds were detected in total. The 101 of these compounds were detected in Fruit flavor, 52 in the Tobacco flavor, 30 in the Non-alcoholic drinks flavor, 26 in the Desserts-sweets flavor, 24 in the alcohol flavor, 12 in the other flavors category and 15 in menthol-mint flavor. Of the detected compounds, Nonanal and Oxime-, methoxy-phenyl were the most frequently detected compound (15 and 14 times in tobacco flavor respectively) and also present in all flavors. These compounds are strong irritants to skin and eye. Additionally, banana oil, which was detected in 12 Fruit flavor samples and in most flavors, can cause skin, eye and respiratory irritation, narcotic effects and damage to organs through prolonged or repeated exposure Conclusions To our knowledge, this is the first study to examine the chemical content of the most common e-liquids in the EU depending on the flavor, indicating that several flavors could be more hazardous. Stricter strategies for these products are necessary. Funding This work was supported by a grant from the European Commission (Horizon2020 HCO-6-2015; EUREST-PLUS: 681109; Vardavas).