- Menthol-flavoured heated tobacco products (HTPs) are twice as effective at replacing cigarettes as regular tobacco flavour
- Smokers of menthol cigarettes cut their cigarette use by 80 per cent when switching to menthol-flavoured HTPs
- Those who switched to regular tobacco-flavoured HTPs cut cigarette use by only 37 per cent
- Researchers say flavour availability is a “key determinant” of substitution potential for menthol smokers
Menthol-flavoured heated tobacco products (HTPs) are a far more effective alternative for menthol cigarette smokers than regular tobacco flavours, new research suggests.
The findings come from a two-week pilot clinical trial in Richmond, Virginia, published in the American Journal of Preventive Medicine. The study tested Philip Morris International’s IQOS HTPs in Fresh Menthol and Regular Tobacco flavours.
Menthol cigarette smokers who switched to Fresh Menthol HTPs cut their cigarette consumption by 80 per cent, while those using Regular Tobacco HTPs cut theirs by just 37 per cent.
Thirty adult menthol cigarette smokers were randomly assigned to use one of the two flavours for a week, both in a lab setting and at home.
When both flavours were offered in a simulated purchasing environment – the Experimental Tobacco Marketplace (ETM) – smokers’ willingness to substitute cigarette with HTPs IQOS, measured by ‘cross-price elasticity’, was significantly higher for menthol (0.67) than for tobacco flavour (0.14).
The researchers wrote: “Access to menthol flavoured HTPs is an important determinant of potential substitution for people who smoke menthol cigarettes.”
Same nicotine, different impact
Nicotine delivery and puffing behaviour were similar for both flavours. “Differences in puff topography and nicotine delivery across IQOS flavours were not significant,” the study said, meaning the stronger cigarette reduction with menthol wasn’t due to higher nicotine intake.
This points to flavour as a major factor in encouraging smokers to switch from combustible cigarettes to less harmful products.
Why flavour matters
Menthol cigarettes have long been popular, with smokers reporting that menthol can enhance smoking satisfaction, reduce harshness, and make inhalation smoother. These same qualities may make menthol-flavoured HTPs more appealing to smokers who are considering switching.
However, menthol has been targeted for regulatory bans in many countries, including the U.S., due to concerns about youth uptake and reduced quitting rates.
This study adds to evidence that keeping menthol and other flavour options available in less harmful forms could help smokers transition away from cigarettes, which kill eight million people globally per year.
While the trial found that menthol-flavoured heated tobacco “may not be sufficient to promote complete substitution,” the 80 per cent reduction in cigarette use is a significant step toward harm reduction.
Policy implications
The findings highlight that offering flavours that align with smokers’ preferences can dramatically increase the likelihood they’ll cut down or switch. This means for menthol cigarette users, the right flavour could make the difference between halving cigarette use and reducing it by four-fifths.
Vapes and HTPs reduce toxins
A separate study earlier this month showed that HTPs and vapes reduce exposure to harmful chemicals by more than 90 per cent compared to cigarettes.
Published in the International Journal of Environmental Research and Public Health, the peer-reviewed analysis compared emissions from combustible cigarettes, HTPs, and vapes.
Drawing on real-world data from 15 independent studies, the review found HTPs and vapes cut exposure to toxic substances by up to 91 per cent and 98 per cent per puff, respectively.
