Perceptions of a Menthol Cigarette and Flavored Cigar Ban in Black and White Adults in the United States who Smoke Menthol Cigarettes and Factors Associated with Ban Opposition or Ambivalence.

Objectives: Menthol flavoring is a critical public health issue, but prior work has largely represented the voices of White adults who smoke (AWS) menthol cigarettes who comprise a small subset of AWS menthol cigarettes in the US. This study compared perceptions of a hypothetical MC/FC ban among Black and White AWS menthol cigarettes. Methods: Participants were a convenience sample of 2,113 Black and 1,087 White AWS menthol cigarettes collected through Amazon Mechanical Turk between July 2023 and January 2024. Participants reported opinions about a MC/FC ban, likely public health outcomes, and hypothetical impact of the ban on their smoking behavior. Stepwise logistic regression modeled factors associated with ban opposition/ambivalence. Results: Over one-third of menthol cigarette users supported a MC/FC ban (Black, 37.2% vs White, 34.5%, p=.13], but Black AWS were more likely to endorse public health benefits of a ban assessed via agreement with 5 statements of FDA rationale [3.0 (SD=1.7) versus 2.4 (SD=1.8), p<.001]. Smoking more cigarettes per day, belief that menthol cigarettes are more addictive/harder to quit, and intent to continue using nicotine under a ban increased odd of opposition/ambivalence. Conclusions: Compared to White AWS, Black AWS were more likely to believe that a MC/FC ban would benefit public health and showed no statistical difference in overall support for a ban. Targeted outreach to those who consume more menthol products and those who do not intend to quit nicotine could increase ban support among menthol users. Summary Box: