Tobacco industry response to menthol cigarette bans in Alberta and Nova Scotia, Canada

Menthol cigarettes are associated with increased initiation and progression to regular smoking and decreased likelihood of smoking cessation.1–8 Menthol smokers are more likely to be women and adolescents in several countries.9 The Conference of the Parties to the Framework Convention on Tobacco Control recommend that Parties regulate ingredients that make cigarettes more palatable, including flavouring substances like menthol.10 The Canadian province Nova Scotia became the first jurisdiction to implement a ban on menthol tobacco products in May 2015, and the province of Alberta followed in September 2015.11 These regulations extended existing provincial bans on the sale of flavoured tobacco products to include menthol flavoured tobacco products, with the exception of pipe tobacco and some cigars. Additional Canadian provinces, Brazil, Ethiopia, Turkey and the European Union have passed regulations to ban menthol tobacco products.11 As jurisdictions (including cities, states/provinces and countries) consider bans on menthol tobacco products, real-life contextual data on the industry response to such bans can be helpful in formulating effective bans. For example, when misleading descriptors on tobacco packaging such as ‘light’ and ‘low tar’ were prohibited, the tobacco industry continued to communicate those same misleading health messages to the consumer using colour or other descriptors.12 ,13 Industry tactics to undermine the effectiveness of health warnings on tobacco packaging have included the use of promotional packaging and altered pack size.14 ,15 Drawing on a sample of cigarette packs …