Attitudes towards tobacco control policies among smokers of menthol, other flavored and unflavored cigarettes: Findings from the EUREST-PLUS ITC Europe Surveys

Objective To assess the attitudes of flavored and unflavored cigarette smokers towards tobacco control policies, including the EU flavors ban and to explore the ban impact on smoking behaviors. Methods The research analysis include data from Wave 1 of the EUREST PLUS-ITC Europe Survey Project in Germany, Greece, Hungary, Poland, Romania, and Spain, and data from other ITC surveys conducted in England and the Netherlands. All cross-sectional data were collected in 2016 among 10,760 adult current smokers. The attitudes towards various tobacco control policies have been compared among menthol, other flavored and unflavored cigarette smokers. The univariate data analysis adjusted to few confounding factors was made with the use of SPSS Complex Samples Package. Results Findings show that menthol smokers are much less likely to support a ban on tobacco additives and flavors than other cigarette smokers but they are more supportive of smoking ban in public places. After the enforcement of the ban, 16% of menthol cigarette smokers and 10% of other flavored cigarette smokers reported the intention to quit smoking. However, the percentage of those menthol and other flavored smokers who declare quitting smoking after the ban implementation varies substantially with countries. Furthermore, almost one of three menthol cigarette smokers (27%) say they will find a way to get menthol tobacco product banned. Conclusions Attitudes of menthol and other flavored cigarettes towards various tobacco control policies differ substantially in the analyzed countries. Therefore, tobacco control and smoking cessation programs should be adapted to country needs. A special attention must be focused on smoking cessation offer addressed to those menthol cigarette smokers who intend to quit smoking after the flavors ban and on preventing the risk of illicit trade in menthol cigarettes.