Perceptions of a Menthol Cigarette Ban: Focus Group Study With US Adults who Smoke Menthol Cigarettes
Department of Health Behavior, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Chapel Hill, NC, USA
Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
Department of Public Health Education, University of North Carolina at Greensboro, Greensboro, NC, USA
Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
Abstract
Purpose
This study examined perceptions of a proposed US menthol cigarette ban among adults who smoke menthol cigarettes.
Design
Focus group discussions.
Setting
Virtual focus groups with 7-9 participants each.
Participants
50 US adults (age 21+) who currently smoke menthol cigarettes participated in six focus groups: two with Black participants; two lesbian, gay, or bisexual participants; and two general population groups.
Methods
Each 90-minute session was audio-recorded and transcribed. We used qualitative thematic analyses to examine participants’ views on reasons for the ban and its potential impact on tobacco use, with a focus on differences across the three identity-based groups.
Results
Many participants, across all group types, believed the ban aimed to protect youth and future generations due to menthol’s appeal and higher addictiveness. Some viewed the ban as government overreach, racially targeted, and economically or politically motivated. Several indicated they would seek menthol cigarettes through illicit markets that might emerge post-ban. Some considered switching to non-menthol cigarettes, vapes, or marijuana. However, several felt the ban could help them reduce smoking and quit entirely, citing non-menthol cigarettes’ lower appeal and concerns about vaping’s addictiveness and harms. Black participants expressed specific concerns about over-policing, racial profiling, community safety, and potential increases in crime related to menthol access.
Conclusions
Concerns about over-policing and targeted enforcement align with tobacco industry narratives, illustrating the pervasiveness of negative industry messaging. Findings underscore the importance of proactive communication about the ban’s public health goals, while addressing community concerns about policing and racial equity.
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Keywords: policy, qualitative research, public health, tobacco control, menthol cigarettes, smoking
Article notes
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Received 2025 May 18; Revised 2025 Aug 15; Accepted 2025 Sep 25; Collection date 2026 May.
Purpose
Menthol cigarettes have a distinct cool and minty flavor with anesthetic properties that mask the harshness of tobacco smoke, making smoking more palatable, especially for beginners. 1 The addition of menthol in cigarettes is associated with increased smoking initiation, progression to regular use, and lower likelihood of smoking cessation.2,3 In the United States (US), menthol cigarettes account for a third of the cigarette market share.4,5 In addition, the share of menthol cigarettes smoked has been increasing. Among people who smoke cigarettes, the proportion using menthol cigarettes increased from 35% to 40% between 2008 and 2018. 3
Menthol cigarettes are a key driver of tobacco-related health disparities. 6 As a result of targeted marketing by the tobacco industry, Black Americans smoke menthol cigarettes at higher rates than any other racial or ethnic group. 3 Data from 2008-2020 show that 81% of Black people who smoked cigarettes used menthol, compared to only 34% of white people who smoked.7-9 Between 1980-2018, menthol cigarettes were responsible for an estimated 1.5 million life-years lost among Black Americans. 3 Similarly, lesbian, gay, and bisexual (LGB) people exhibit disproportionately high rates of menthol cigarette use, with 2020 data indicating that 51% of lesbian and gay people who smoke cigarettes and 46% of bisexual people who smoke cigarettes used menthol cigarettes, compared to 39% of straight people who smoked cigarettes. 3
Recognizing these public health harms, menthol cigarette bans have been enacted in several countries, including Canada and Turkey, and the European Union.8,10 Several US jurisdictions, such as California, the District of Columbia, and Massachusetts have also implemented menthol bans. 8 The US announced its intention to prohibit menthol in cigarettes and cigars nationally in 2021, 3 proposed administrative rules in 2022, and withdrew them in 2025. 11 Despite this withdrawal, menthol cigarette regulation remains a prominent topic in public health and policy discussions, particularly at local and state levels. Given the well-established harms of menthol cigarettes and their role in perpetuating inequities, future federal regulatory action remains plausible.
Previous qualitative research using individual interviews has provided important insights into public reactions to menthol bans, including concerns about regulation, government motives, and potential behavioral responses.12,13 Focus groups, in contrast, can capture social dynamics, peer influence, and collective meaning-making. To complement and extend existing research, we conducted focus groups with populations who use menthol cigarettes at disproportionately higher rates, particularly Black and LGB communities, to understand how they perceive a menthol cigarette ban with the goal of informing communication strategies and facilitating effective policy implementation.
Participants
Participants who smoked menthol cigarettes were recruited between February and March 2024 through advertising on Craigslist by the study team in 3 major US cities (New York City, Chicago, and Atlanta). Potential participants completed an online screener that assessed eligibility and demographic characteristics, including self-identified race and ethnicity and sexual orientation. Eligibility criteria included current predominant use of menthol cigarettes (defined as smoking on most or all days, having smoked at least 100 cigarettes in their lifetime, and preferring menthol-flavored cigarettes), being age 21 years or older, living in the United States, being able to speak English, and being willing to participate in a video conference.
Approach and Setting
A staff member contacted eligible participants to confirm their interest, obtain verbal informed consent, and schedule their participation. We conducted six semi-structured virtual focus groups in two rounds (three in February 2024 and three in March 2024). Each round included one group with only Black or African American participants, one with only LGB participants, and one general population group. Separate groups were held to encourage open discussion about social identity related to menthol cigarette use. Each group included 7-9 participants and was conducted via Zoom, lasting about 90 minutes. Three study team members were present at each focus group. After the focus group, participants received an electronic gift card for $110 and a list of smoking cessation resources.
We followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) to enhance transparency and completeness. 14 Study procedures were approved by the University of North Carolina at Chapel Hill Institutional Review Board.
Method
The moderator of the focus group used a semi-structured interview guide to explore perceptions of the proposed national menthol cigarette ban and its anticipated impact on smoking behaviors. The guide examined why participants thought the government would consider banning menthol cigarettes, how a ban would affect their tobacco use, and the potential impact of a ban on Black and LGB communities. The guide also assessed participants’ reactions to efficacy and motivation-based smoking cessation messages, which we plan to report on in a separate publication.
Analyses used Dedoose software (version 9.0.107). Our analytic approach followed Braun and Clarke’s six-phase method of thematic analysis. 15 We first familiarized ourselves with the transcribed data and notes taken during the focus groups. We then created deductive codes for an initial codebook based on the study’s research questions. 16 Three authors (RNV, MS, SF) used the initial codebook to independently code the first focus group transcript, adding inductive codes as they arose, followed by a collaborative discussion to refine the initial codebook and add new codes as needed. MS and SF independently coded each of the remaining five transcripts using the same process and met afterwards to reconcile codes. We revised the codebook iteratively during the coding process, with input from the larger study team as needed. We grouped related codes into thematic categories to reflect key patterns in the data. 15 Six focus groups were sufficient, as data saturation was reached; by the final group, no new themes or substantive insights emerged.
Results
Participant Characteristics
Forty-eight percent of participants were Black or African American, and 38% were LGB. In addition, 88% of participants smoked cigarettes every day. The mean age of study participants was 40 years (Table 1). Black groups included participants who self-identified as Black or African American and identified their sexual orientation as straight or heterosexual. LGB groups included participants of any race or ethnicity who identified as lesbian, gay, or bisexual. General population groups included participants who identified as any race and ethnicity and sexual orientation.
| Characteristic | n (%) |
|---|---|
| Age, mean (SD) | 40 (11.8) |
| Gender | |
| Male | 25 (50) |
| Female | 24 (48) |
| Nonbinary | 1 (2) |
| Race and ethnicity | |
| American Indian or Alaska native | 2 (4) |
| Asian | 2 (4) |
| Black or African American | 24 (48) |
| Hispanic | 6 (12) |
| White | 16 (32) |
| Another race or ethnicity | 3 (6) |
| State | |
| New York | 18 (36) |
| Illinois | 18 (36) |
| Georgia | 10 (20) |
| Massachusetts | 1 (2) |
| Texas | 1 (2) |
| New Jersey | 1 (2) |
| Cigarette use | |
| Some days | 6 (12) |
| Every day | 44 (88) |
| Preferred cigarette brand(s) | |
| Newport | 26 (52) |
| Marlboro | 17 (34) |
| Newport 100 | 10 (20) |
| Camel | 5 (10) |
| American spirit | 4 (8) |
| Kool | 4 (8) |
| Camel crush | 3 (6) |
| Parliament | 2 (4) |
| Other | 1 (2) |
Perceived Reasons for a Menthol Cigarette Ban
Protecting Youth From Tobacco Initiation and Harm
Across the general, Black, and LGB groups, participants commonly believed the menthol ban aimed to prevent youth from initiating tobacco use. Participants viewed menthol’s smooth taste and cooling sensation as especially appealing to beginners, making smoking more palatable, similar to flavored vapes or candy. They saw the menthol ban as a continuation of broader efforts to reduce flavored tobacco use among youth. One participant expanded on this belief, likening the appeal of menthol cigarettes to that of candy:
“I think that the menthol does attract a younger crowd because it’s like candy. That sort of thing. You know?”
In addition to their appeal, participants across all group types perceived menthol cigarettes as more addictive and harmful than non-menthol cigarettes. This perceived addictiveness was seen to increase smoking, especially among youth. One participant articulated this perspective, saying:
“In comparison to the natural raw tobacco cigarettes, like your reds or your Marlboro cigarettes, they're much more addictive because they're less harsher.”
Another participant echoed this view, adding that menthol cigarettes’ flavoring contributes to a greater tendency for addiction:
“There's a tendency for addiction because of the flavoring and stuff. So I'm guessing there's some sort of higher level of, uh—what word do I use? There's a high level of, uh, tendency to want to—to – for- for high consumption, yeah.”
These observations collectively underscore the perception around health risks associated with menthol cigarettes, often citing their potential to be more harmful than regular cigarettes due to the presence of additional chemicals and additives. Participants believed that menthol cigarettes might contribute to higher rates of addiction and cancer, which they attributed to the flavoring agents that make smoking more appealing and less harsh.
Exercising Control, Targeting, and Hidden Agendas
While many participants acknowledged the public health rationale for banning menthol cigarettes, significant skepticism emerged across all group types about the government’s true intentions. Participants touched on issues of control, and participants particularly in Black and LGB groups voiced concerns about targeting specific social groups. Most focus groups revealed a belief that the menthol ban represented government overreach, with the intention to limit their personal freedom and control. Participants questioned whether the government should have the authority to regulate personal choices, particularly for adults. One participant expressed their frustration with what they perceived as an unnecessary level of control:
“I feel like the, uh, government is trying to ban them now as a form of control, to control what people are doing, how they're consuming it and, basically, for them to tell you what you can and can't do.”
Another participant similarly emphasized personal choice:
“It’s something that I believe is our choice, and I mean, if you’re already selling, you know, tobacco products as it is, um, it’s not anybody’s responsibility to, um, you know, stop children from smoking, but, you know, their parents or - or, you know, who’s - who’s around them. Um, I believe, as a consumer, we should be able to buy a product depending on the flavor or not the flavor, or, you know, it’s—that’s - that’s our choice.”
Participants from both the Black groups and one LGB group questioned why the ban targeted menthol cigarettes specifically rather than all tobacco products, interpreting it as selective and unfair. Concerns about racial targeting were also prevalent. Participants noted that menthol cigarette use is disproportionately high among Black communities and suggested the ban was racially motivated. As one participant explained:
“Statistically more Black people smoke menthol than Whites. You know? I’m a radical Black person. I personally believe if they are going to, in some way, make it illegal, menthol, because why wouldn’t then cigarettes in general be illegal? From my perspective, it would, like most things in America, have to do with ethnicity.”
These concerns contributed to the perception that the ban was a selective intervention against a specific product and community, rather than part of a broader, comprehensive health strategy. Participants also noted the government’s delayed action, questioning why menthol cigarettes were only now being addressed despite longstanding evidence of harm.
Black and LGB participants speculated that financial or political motivations, rather than public health concerns, were driving the menthol ban. One participant suggested that the government was motivated by public image and political interests:
“It's mainly due to his image. You know, bad publicity, bad image impacts their, um, re-election and so forth. And they want to have good standards and, you know, comments and everything—reviews. So that's why I think they're talking about takin' the cigarettes out. They've already gotten enough money, so it's not even a money issue right now.”
Another participant speculated that the ban is tied to economic strategies rather than addiction prevention:
“Um, I think we just getting ready for the next wave of something new. I don't think it has nothing to do with, um, the addiction. They don't care about that. And that's in my opinion. They—it's a margin thing. Everything's margin. Everything's system. It's just they're cooking up something new for the new market. And because they see that the new wave is vaping.”
This quote reflects the belief that the government may be using the menthol ban to prepare for a shift towards other tobacco products, such as vaping. The participant’s reference to “everything’s margin” suggests they view the ban as part of the broader, profit-driven strategy rather than purely a public health initiative. Together these findings reveal a complex mix of perceptions around government motivations, ranging from genuine public health goals to control, targeting specific groups, and political or financial interests. These perspectives reflect the nuanced and conflicting ways in which participants interpret the menthol cigarette ban.
Perceived Impact of a Potential Menthol Cigarette Ban
Finding Ways to Obtain Menthol Cigarettes
Participants from all group types expressed strong intentions to seek alternative means if menthol cigarettes were banned. Participants anticipated informal sales networks and counterfeit products, with smoke shops illegally selling single menthol cigarettes at inflated prices by importing them from other states or countries. One participant explained their beliefs around the ease of illicit markets emerging in urban areas:
“Like, any like major metro area, seems like, will have like an underground market for anything. You know, like, if - if something’s been banned or whatever, like you could legitimately probably find, you know, a market for something that somebody’s running, you know, for it, if you really wanted it.“
Similarly, another participant speculated on the ingenuity of individuals in creating illicit menthol products:
“So there’s gonna be a group of people, you know, that are just gonna have, you know, stockpiles of it, you know, humidifier rooms or, you know, whatever, or they’re gonna start making some, you know—you know, street le—you know, street menthol cig - cigarettes.”
Not all participants shared this perspective; some doubted they would seek illicit products due to safety and quality concerns. These contrasting views reflect variability in participants’ likelihood of pursuing illicit sources, shaped by accessibility, cost, and perceived risk. While participants believed accessing menthol cigarettes post-ban would be costly and challenging, they still expressed defiance against government control, likening it to marijuana’s availability despite prohibition.
Switching to Other Products
Participants, particularly from the general and LGB groups, often said they would switch to non-menthol cigarettes or vaping if menthols were banned, while some mentioned heated tobacco products, or alcohol as alternatives. Participants from one of the LGB groups also discussed using menthol enhancers, such as menthol spray and menthol capsules, that add menthol flavors to non-mentholated products. A few participants from a Black group mentioned marijuana as an alternative. Many had previous experience with non-menthol cigarettes or vaping, making switching seem feasible, though some found non-menthol products less satisfying. A few also shared that they were concerned about their health and would rather switch to vaping. One participant who began smoking non-menthol cigarettes suggested they might revert to these if menthol cigarettes became unavailable:
“I did start off on regular cigarettes, so it didn’t, uh—it’s—I guess I would—if I—if it started being harder for me to find them, I’d just go back to the regular. It’s not that big of a deal.”
Vaping emerged as a popular alternative, though participants highlighted concerns about its health risks, such as addiction and “popcorn lung”. Those hesitant to switch to vaping described prior negative experiences, such as feeling that vaping had harmed their lungs. They also demonstrated awareness of vaping health harms, including perceived greater addictiveness compared to cigarettes. Additionally, some participants reported being advised by their doctors to avoid vaping, further reinforcing their reluctance. The variability in participants’ responses reflects complex decision-making processes participants anticipate if faced with a menthol ban.
Reducing or Quitting Smoking
Some participants from all three group types felt a menthol ban might help them reduce or quit smoking. Participants indicated that losing access to menthol cigarettes would prompt them to smoke less, switch to non-menthol cigarettes temporarily, or quit over time. While some saw this as an opportunity to improve their health and reduce consumption, others mentioned that smoking non-menthols lacked the same satisfaction, making quitting easier. One participant described how the absence of menthol cigarettes would diminish their enjoyment of smoking, potentially leading them to quit:
“I’ll smoke non-menthols for a little while, and - and then I’ll just—I’ll just stop because, I mean, I don’t enjoy it, you know, so—When I’m doing it, I don’t enjoy it, and if I’m not even getting the kick out it, it’s like, for what?”
A participant misperceived vaping to be as harmful as smoking and described that availability of such alternative products needs to be restricted to help people quit smoking altogether.
“Yeah, me—I think it would be easier for, um, people to quit if they didn't have the option to smoke. And, um, I mean, uh, the vape pens, are a problem also. So it's not just menthol. It's the vape pens too. So they need to, like, get rid of everything and not just s-s-s—be s—like, choosing to select one thing when it's, um, vape pens too. So vape pens are harmful just as well as menthol is.”
Impact on LGB Communities
When asked about how a menthol ban would affect LGB communities, participants in LGB groups did not believe the menthol ban would affect their communities differently. They felt its impact would mirror that experienced by other individuals who smoked menthol cigarettes and that they would face similar challenges in response to the ban. For example, one participant stated:
“Menthols don’t discriminate. It doesn’t discriminate. It doesn’t make any difference. Black, White, gay, straight, woman, man. It doesn’t matter.”
Impact on Black Communities
When asked about how a menthol ban would affect Black communities, participants in the Black focus groups expressed skepticism about the motivations behind the ban, reporting it disproportionately targets Black communities. They questioned why public education on menthol’s harms was delayed despite long-standing evidence of targeting by the tobacco industry. For instance, one participant reflected:
“If you've known this has been affecting my community for at least the last 40 or 50 years—because I'm f—getting ready be 43 myself. And I've been smoking for over 20-something years. My siblings are in their 50s and early—uh, late 50s, mid-50s. They've been smoking forever too. Why didn't you guys start with this education process when you seen that to—big tobacco was going after inner-city and mostly Black people or people of color? Why not then? Why now? And why keep making it about us? We're the reason why menthol needs to stop. That's where it kinda makes me feel weird.”
Many feared banning menthol cigarettes would lead to increased policing in Black communities. They worried law enforcement would exploit the ban to justify arrests and harassment, exacerbating systemic inequities. Participants also believed that people would circumvent the ban by seeking alternatives or illicit menthol cigarettes, raising concerns about increased criminalization. One participant feared heightened police surveillance and enforcement in Black neighborhoods:
“And, because of the ban, they would, you know, find reasons to arrest, uh, people from the Black community. You know, try to get them, uh, arrested, or something like that, or just, you know, try to use their force—the police force, you know, to, um—could I say, bully them or something like that? And, yeah, I-I feel that would increase the crime rates in the Black community because, even though they ban it, people would also, you know, still try to lay their hands on it or get other products that are just like it, you know, just to, you know, get the same feel or something like that.”
Discussion
Participants expressed complex and at times conflicting views about a potential menthol cigarette ban, shaped by identity, trust, and lived experiences. They voiced support for protecting future generations from tobacco use, skepticism toward the rationale for government involvement, and intentions to circumvent the ban by obtaining menthol cigarettes through illicit channels. Participants also described a variety of ways a ban might change their tobacco use that ranged from quitting smoking altogether to switching to alternative tobacco products.
A dominant narrative across all group types was that a menthol ban could safeguard future generations from smoking by preventing initiation of a product that is appealing to youth and more addictive than non-menthol cigarettes. Messaging that highlights these protective motives, particularly toward youth, may resonate strongly with broader audiences and improve public support for the policy,17,18 creating a more favorable environment for policy implementation and acceptance. However, public health communication must also caution against misinterpreting the ban as suggesting that non-menthol cigarettes are safer. Clear messaging that all combustible tobacco products are harmful is critical to avoid unintended switching.
Concerns about government overreach, mistrust, and racial targeting, particularly among Black adults, echo longstanding tensions about menthol ban regulation.12,13,19 Such narratives may be shaped by the tobacco industry’s targeted marketing towards Black communities, contributing to disproportionately high menthol cigarette use, 20 as well as lobbying efforts engaging Black leaders and legislators that frame menthol bans as discriminatory.21,22 The tobacco industry has provided financial incentives to civil leaders and officials to propagate these narratives. 23 For instance, RJ Reynolds reportedly offered $250,000 to a pastor to oppose the menthol ban 24 and paid Black community leaders to claim it would increase police brutality. 24 Given the influence of these industry-driven narratives, there is a pressing need for nuanced, culturally tailored, and community-driven health communication interventions to address negative perceptions while emphasizing the public health goals of the ban. It is critical to clarify that enforcement efforts related to the ban will target manufacturers and retailers, not individuals possessing or using menthol cigarettes. 25 Furthermore, targeted cessation campaigns, developed in collaboration with trusted community partners, including community leaders, clinicians, and organizations familiar with Black and LGB populations, could address nicotine addiction, promote Black longevity, and engage credible and culturally resonant voices to improve message receptivity. 26 Alongside communication campaigns, culturally-relevant cessation resources should be made readily available.
Some participants said that they would seek alternative ways to access menthol cigarettes, such as turning to illicit markets, if a ban were implemented. These findings are consistent with prior studies that find people who smoke menthol commonly say they will find menthol cigarettes through illicit sources.12,27,28 The tobacco industry has propagated similar narratives about an increase in the illicit sale of cigarettes. 29 However, our findings stand in contrast to real-world studies that tend to show very little illicit trade in the setting of menthol bans. 8 For example, one study found no increase in illicit cigarettes sales following the implementation of a ban in a Canadian province in 2015. 30 This discrepancy between stated intentions and actual behavior suggests that, while concerns about illicit markets are frequently voiced, they may not materialize to the extent anticipated. Public health messaging should acknowledge these concerns while also emphasizing real-world evidence showing minimal illicit trade post-ban.
Our study found that some participants expected to quit smoking altogether, whereas others said they would switch to other tobacco or nicotine products if menthol cigarettes became unavailable. Prior studies have documented a range of behavioral responses to a menthol ban.31-33 For instance, in some prior studies, people who smoke menthol have acknowledged that a ban might help them reduce consumption or quit altogether, 34 especially those with greater intentions to quit. 27 Population cohort studies from Canada found that after a menthol ban menthol smokers had higher quit rates, increased quit attempts, and greater success in quitting compared to non-menthol smokers.35,36 Studies in the US found that awareness of local policy banning menthol cigarettes was associated with motivation to quit smoking, and total cigarette sales 8 and smoking prevalence declined after the statewide menthol ban in Massachusetts. 37 While some smokers may switch to non-menthol cigarettes, observed increases in quit attempts and successful quitting suggests a menthol ban could reduce overall smoking prevalence. Findings from the present study highlight the importance of health communication campaigns that emphasize that the goal of a menthol ban is to encourage complete tobacco cessation.
Strengths of our study include a diverse sample, with meaningful representation of Black and LGB individuals, providing insights into populations disproportionately impacted by menthol cigarette use. Limitations include that findings rely on a hypothetical menthol ban scenario, as participants’ stated intentions to switch or quit may not align with actual real-world post-policy outcomes, and limited generalizability due to the sample’s demographic and regional composition.
Conclusions
Our study findings offer insight into potential reactions to a menthol cigarette ban, underscoring both support for the policy and concerns about unintended consequences. Findings suggest that effective policy implementation will require proactive public health messaging that addresses mistrust, counters industry narratives, and ensures equitable access to cessation support. Engaging community leaders, addressing enforcement concerns, and emphasizing the ban’s role in reducing health disparities may help increase support for the ban and facilitate implementation.
Boxed Text
So What?
What is Already Known on This Topic?
Menthol cigarettes are more appealing and addictive than non-menthol cigarettes, contributing to greater smoking initiation and lower cessation rates. Their disproportionate use among Black and LGB populations has exacerbated tobacco-related health disparities. However, fewer studies have explored how these communities collectively interpret and may respond to menthol cigarette bans, especially through the lens of group dynamics and shared lived experiences.
What Does This Article Add?
This study draws on focus group discussions with a geographically diverse sample of Black and LGB individuals who smoke menthol cigarettes to examine their perceptions of a potential menthol cigarette ban. Findings highlight key themes, including support for youth protection, distrust of government motives (e.g., economic or political agendas), and concerns about racial targeting and selective enforcement.
What are the Implications for Health Promotion Practice or Research?
Public health campaigns should be designed with a clear, community-informed messaging strategy to address both support and skepticism toward a menthol cigarette ban. Efforts should emphasize health equity and youth protection while directly engaging with concerns about government overreach, targeting and trust, particularly with historically marginalized communities.
Footnotes
Footnote Group
ORCID iD
Mayank Sakhuja https://orcid.org/0000-0001-8688-1985
Ethical Considerations
Study procedures were approved by the University of North Carolina at Chapel Hill Institutional Review Board.
Data Availability Statement
The data cannot be shared due to data use restrictions*.
References
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Associated Data
Data Availability Statement
The data cannot be shared due to data use restrictions*.