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. Author manuscript; available in PMC: 2026 Sep 29.
Published before final editing as: Nicotine Tob Res. 2026 Sep 9:ntag185. doi: 10.1093/ntr/ntag185

Identifying key beliefs for anti-disinformation messaging for Black adults about proposed US bans on menthol cigarettes and flavored cigars

Ollie Ganz 1,2,*, Kymberle L Sterling 1,2, Charity Ntansah 1, Marisa Tomaino 1, Olivia A Wackowski 1,2, Aila Altunbilek 1, Jeannie Garmon 1,3, Amanda Johnson 1, Craig S Fryer 4, Andrea C Villanti 1,2
PMCID: PMC13617659  NIHMSID: NIHMS2211091  PMID: 42715155

Abstract

Introduction:

The goal of this study was to identify knowledge and beliefs held by Black adults that are associated with strongly favoring proposed menthol cigarette and flavored cigar bans in the United States.

Methods:

Eight hundred twenty-three US non-Hispanic Black adults (aged 18+) were surveyed in June 2024 through a nationally representative panel, oversampling people who currently smoke cigarettes. Participants completed items related to beliefs about and support for menthol cigarette and flavored cigar bans. Weighted bivariate analyses followed Hornik’s approach to message planning strategies, assessing the proportion of participants holding each belief, the relationship between each belief and policy support, and “percentage to gain” (ie, intention to support the bans if a perfectly effective campaign moved everyone to strongly agree with a belief).

Results:

Approximately 40% of respondents strongly favored menthol cigarette and flavored cigar bans. Seven beliefs had the largest potential percentage to gain (>30%) for building policy support, pertaining to: focus of the proposed policies on tobacco companies and retailers versus individuals, positive impacts of the proposed bans, addressing concerns that bans would do more harm than good in Black communities, and adult choice.

Conclusion:

Findings support the opportunity to develop messages for Black adults on potential positive impacts of menthol cigarette and flavored cigar bans, which in turn may impact policy support. Findings also highlight the need to address disinformation regarding the impact of these policies on Black individuals rather than on the manufacture, distribution, and sales of menthol cigarettes and flavored cigars.

Implications:

This study identified several beliefs that have the potential to influence policy support for bans on menthol cigarettes and flavored cigars. Findings from this study support the opportunity to message to Black adults on potential positive impacts of menthol cigarette and flavored cigar bans and to correct misperceptions about the bans, and that changing these beliefs may impact support for these policies.

Keywords: tobacco control, tobacco industry, menthol cigarettes, flavored cigars, tobacco regulatory science

Introduction

While cigarette smoking has declined dramatically in the United States over the past 20 years, the prevalence of menthol cigarette use among adults who smoke has increased,1,2 with menthol cigarettes comprising 40% of the cigarette market share in 2024.3 The availability of these products has implications for health disparities, with national data from 2020 showing that among adults who smoke cigarettes, 80.9% of non-Hispanic Black individuals smoke menthol cigarettes, compared to 43.4% of those who smoke overall.1 Data also show that non-Hispanic Black individuals may be more susceptible to initiation and continued use of menthol cigarettes over time, compared with non-Hispanic white individuals.4 The prevalence of flavored cigars is also disproportionately high among young, non-Hispanic Black individuals.5 Indeed, data from the Population Assessment of Tobacco and Health Study found that among young adults (ages 18–34) who used cigars in the past 30 days, 40.4% of Black/African American individuals used flavored cigars and in multivariable models, Black/African young adults had higher prevalence of using flavored cigars than their white counterparts.5 These differences are notable given that menthol cigarettes and flavored cigars carry disproportionate population-level harms.6,7 A systematic review of the scientific literature identified a positive relationship between menthol cigarettes and increased youth smoking initiation, increased nicotine dependence, and decreased cessation among adults.6 Additionally, national data has shown that use of flavored cigars was associated with greater odds of daily cigar smoking and nicotine dependence, compared with non-flavored cigar use.8 Initiation with a flavored cigar product was also associated with subsequent use (including regular use) among young adults and adults ages 25 and older.9

Greater use of menthol cigarettes and flavored cigars among Black smokers is not happenstance; rather, it has been driven by decades of predatory marketing by tobacco companies in Black communities.10,11 Previously secret tobacco industry documents revealed decades of marketing practices originating in the 1960s that included menthol advertisements targeting Black television markets, publications (eg, Ebony, Jet), and advertising campaigns that promoted the supposed health benefits of menthol cigarettes.12 While overall cigarette marketing practices have shifted toward the retail environment since the 1998 Master Settlement Agreement,13 targeted marketing practices still exist today. Studies from the past 15 years show that retail advertising for menthol cigarettes and flavored cigars are more common in neighborhoods with more Black Americans, and several menthol cigarette and cigar brands have used hip-hop culture and music to target Black Americans.10,14

In the context of rising market share and popularity of menthol cigarettes and flavored cigars,3,15 and their disproportionate use among Black individuals and other historically marginalized groups,1 population-level strategies to reduce use of these products are urgently needed.10 A potential strategy would be to federally ban menthol cigarettes and all flavors in cigars, which studies show would have positive implications for public health and health equity (eg, promote smoking cessation, including among Black individuals who smoke).16,17 In 2022, the FDA issued proposed rules to ban menthol cigarettes and flavored cigars. These rules were originally scheduled to be finalized in August 2023, but in 2024 were delayed and ultimately abandoned in 2025.18 This was due in large part to tobacco industry interference, including the strategic use of disinformation campaigns with false information that deliberately misled the public and framed the bans as harmful to the Black community,16,19 meetings with White House officials,20 financial contributions to prominent Black leaders who advocated against the bans,21 and flooding of public comments with tobacco company form letters that sought to influence the opinion about the effects of the ban (eg, increases in illicit menthol cigarettes and flavor cigar markets).22 These widespread efforts may have resulted in misperceptions among Black adults about public health policies to reduce menthol cigarette and flavored cigar use.11 For example, a recent study using a convenience sample of US adults (ages 18–45) found that over half of Black adults were uncertain of tobacco company efforts to pay Black lobbyists to oppose public health policies.11

Public education campaigns can be effective tools for generating policy support, which has been important for advancing tobacco control policies.23,24 These campaigns have also been effective for correcting misperceptions and disinformation.25 The Theory of Planned Behavior,26 which has been utilized to examine smoking behavior and inform many communication campaigns,27-30 posits that beliefs, such as beliefs about tobacco companies and policies (eg, bans against menthol products), influence individuals’ subjective norms (eg, social norms related to tobacco policies), attitudes (eg, positive or negative evaluation of ban), and perceived behavioral control (eg, belief that individuals can influence ban adoption), which in turn predict behavioral intentions (eg, intention to support ban).31 Although the federal bans have been withdrawn, identifying inaccurate beliefs about the menthol cigarette and flavored cigar bans that can be intervened upon in health communication campaigns may increase support for future policy actions. Using the Theory of Planned Behavior as a conceptual guide, the goal of this study was to identify belief statements that could be addressed with a public education campaign for Black adults to increase support for policies to reduce menthol cigarette or flavored cigar sales and use. We utilized a national sample for this survey to inform campaign messages that would be generalizable to a broad sample of US Black adults.

Methods

We followed the approach developed by Hornik et al.,32,33 which has been used to guide many large-scale, anti-tobacco campaigns.34-36 This approach utilizes a cross-sectional survey to identify (1) belief statements that are associated with the desired outcome (intention to support menthol cigarette and flavored cigar policies) and (2) the proportion of people who do not already hold the belief (ie, “percentage to move” or number of people who can have their belief changed). These variables are then used to determine (3) “percentage to gain,” which projects intention to support the bans if a perfectly effective campaign moved everyone to strongly agree with a given belief.33 Longitudinal studies have shown that a belief’s “percentage to gain” predicts subsequent behavior change.33 While the Hornik approach does not guarantee a successful campaign, it can empower campaign planners to make data-informed decisions by guiding them toward beliefs that are associated with the behavior they want to change and are not already held by the majority of the target audience. “Percentage to gain” does not suggest that everyone who can be moved to agree with the belief will but rather brings together the first two pieces of the approach to give campaign planners a sense of whether targeting a specific belief is worth pursuing. Details on how these variables were operationalized can be found in the Analysis section.

In June 2024, we conducted a cross-sectional survey of 823 English-speaking, non-Hispanic Black adults aged 18 and older, oversampling individuals who currently smoke cigarettes every day or some days. Participants were recruited from the Ipsos KnowledgePanel®, the largest, nationally representative online panel of adults in the United States. KnowledgePanel® recruitment utilizes a rigorous address-based sampling methodology from the US Postal Service’s Delivery Sequence File, which contains full coverage of all delivery points in the United States.37 Eligible panel members were invited by IPSOS to participate via an email with a brief description of the survey, information about their rights as participants, and a survey link. Non-responders were sent up to two reminder emails to increase response rates. The survey was fielded for one week (N = 1506), with a study completion rate of 56% and a qualification rate of 97%, resulting in a final sample of 823 individuals. The median survey completion time was 9 minutes. Upon completion, qualified respondents received an entry into the KnowledgePanel® sweepstakes. This study was approved by the Rutgers Institutional Review Board (Pro 2 023 001 258).

Outcomes

The primary outcomes were perspectives of menthol cigarette and flavored cigar bans (eg, “What is your opinion about policies that would ban menthol cigarettes?”) with response options: “Strongly in favor”, “Somewhat in favor”, “Neither in favor nor against”, “Somewhat against,” “Strongly against,” “Don’t know”. Consistent with Brennan et al.,38 outcomes were coded as “strongly favor” vs. all other responses. This approach provides conservative estimates, as it posits what would occur if an individual agreed with the belief in the strongest terms.

Knowledge and beliefs

Knowledge about menthol cigarettes and flavored cigars was assessed using items that addressed the prevalence of menthol cigarette and flavored cigar use among Black adults who smoke, the role of menthol in cigarettes and flavors in cigars in becoming a regular smoker, and the role of menthol in making cigarettes harder to quit smoking, especially among Black adults (true, false, don’t know). These items were coded as “true” versus false/don’t know.

We also assessed beliefs about FDA’s proposed bans on menthol cigarettes and flavored cigars utilizing a Likert scale with “Strongly agree,” “Agree,” “Neither agree nor disagree”, “Disagree,” to “Strongly disagree,” and “Not sure.” These items asked whether the bans would make it illegal for: tobacco companies to manufacture menthol cigarettes and flavored cigars (true), stores to sell menthol cigarettes and flavored cigars (true), adults to buy menthol cigarettes and flavored cigars (false), and adults to use menthol cigarettes and flavored cigars (false). For the two true items, we coded the desired belief as “strongly agree” versus all other responses. For the two false items, we coded the desired belief as “strongly disagree” versus all other responses.

Beliefs about the impact of menthol cigarette and flavored cigar bans addressed positive effects based on public health impact as described in the FDA’s proposed rules39,40 (ie, help save lives and reduce disease in Black people; lower smoking rates in Black people; reduce tobacco use in Black youth and young adults) and negative effects based on tobacco company arguments22,41 (ie, do more harm than good in Black communities; hurt Black businesses; create an illegal market for these products in Black communities; put Black people who smoke at greater risk of police encounters). Two items addressed beliefs about adult choice: (1) Black adults who smoke cigarettes and/or cigars should be able to choose what products they use, flavored or not; and (2) Black youth who smoke cigarettes and cigars should be able to choose what products they use, flavored or not.

Other variables

Demographic characteristics were provided for participants from the KnowledgePanel (ie, age, gender, education, income, employment, and region). Current cigarette smoking was defined as use every day or some days. Current cigar use was defined as past 30-day use.

Analysis

All analyses accounted for survey weighting. Descriptive analyses examined the composition of our study sample by current cigarette use. Guided by Hornik et al.32,33 and Brennan et al.,38 belief items were dichotomized at the point representing the strongest belief (ie, “strongly agree” or “strongly disagree”) versus all other responses. We calculated three quantitative indicators of campaign message promise for each belief item: (1) the association between each belief and our outcome (ie, strongly favoring policy) using unadjusted logistic regression models; (2) the proportion of respondents who do not already hold the desired belief, meaning they can potentially be influenced to change their belief by a campaign that targets this belief (“percentage to move”); (3) accounting for the first two indicators, we estimated the additional proportion of respondents who would strongly favor the policy if 100% of respondents endorsed the belief and the belief perfectly predicted the outcome (ie, “percentage to gain”). This was calculated by subtracting the total proportion of those strongly in favor of the outcome from the proportion of those who endorsed the belief and strongly favored the outcome.

Results

Overall, 55% of participants were female, and the mean age was 46.3 (SD 17.5); more than half of the participants reported having at least some college education, and 50% worked full-time (Table 1). A large proportion of the sample resided in the South. A total of 14% of the sample reported currently smoking cigarettes and 8% reported currently smoking cigars (data not shown). Compared with those who did not smoke cigarettes, a greater proportion of participants who currently smoked cigarettes were older, male, and not working; they also reported lower education and income. Overall, 29% of the sample was strongly in favor of a menthol cigarette ban and 29% were strongly in favor of a flavored cigar ban. Support for the menthol (32% vs. 14%) and flavored cigar (32% vs. 12%) bans was more prevalent among those who do not smoke cigarettes versus those who do (data not shown).

Table 1.

Weighted sample characteristics (unweighted n = 823).

No current
cigarette
use		 Current
cigarette
use		 Total P-value
% % %
Overall 86.3% 13.7% 100.0%
Age (4 categories) <.001
 18–29 24.7% 6.5% 22.2%
 30–44 26.5% 33.2% 27.4%
 45–59 23.0% 32.3% 24.3%
 60+ 25.8% 28.0% 26.1%
Gender .008
 Male 42.9% 55.5% 44.6%
 Female 57.1% 44.5% 55.4%
Education (4 categories) <.001
 No high school diploma or GED 10.8% 22.4% 12.4%
 High school graduate (diploma or GED) 31.9% 40.2% 33.0%
 Some college or Associate’s degree 31.4% 30.1% 31.2%
 Bachelor’s degree or higher 25.9% 7.3% 23.3%
Household income <.001
 Less than $10 000 6.3% 22.6% 8.6%
 $10 000 to $24 999 9.6% 13.5% 10.1%
 $25 000 to $49 999 18.7% 28.5% 20.0%
 $50 000 to $74 999 18.5% 13.2% 17.8%
 $75 000 to $99 999 13.6% 12.6% 13.4%
 $100 000 to $149 999 15.7% 5.3% 14.3%
 $150 000 or more 17.5% 4.2% 15.7%
Current employment status .045
 Working full-time 51.6% 41.7% 50.3%
 Working part-time 13.3% 11.8% 13.1%
 Not working 35.1% 46.6% 36.6%
Region 4 (Based on State of Residence) .231
 Northeast 16.0% 9.9% 15.1%
 Midwest 13.7% 16.9% 14.1%
 South 61.3% 65.9% 61.9%
 West 9.1% 7.3% 8.8%
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Current cigarette smoking was defined as use every day or some days. Northeast includes: Massachusetts, Connecticut, New York, New Jersey, Pennsylvania. Midwest includes: Ohio, Indianna, Illinois, Michigan, Wisconsin, Minnesota, Iowa, Montana, Nebraska, Kansas. South includes: Delaware, Maryland, Washington DC, Virginia, West Virginia, North Carolina, South Carolina, Georgia, Florida, Kentucky, Tennessee, Alabama, Mississippi, Arkansas, Louisiana, Oklahoma, and Texas. West includes: Wyoming, Colorado, New Mexico, Arizona, Nevada, Washington, Oregon, California.

Overall, 29%–42% of participants correctly identified the impact of menthol cigarettes or flavored cigars on smoking progression or cessation, but only 20% reported correctly that the focus of the proposed policies was on tobacco manufacturers and retailers, not individuals (Table 2). A larger proportion of respondents who currently smoked cigarettes had knowledge about menthol cigarettes than those who did not smoke (eg, 38% vs 71% correctly identifying that among Black and African American people who smoke, more than more than 80% smoke menthol cigarettes), but the proportion with knowledge about cigars was lower (eg, statement with highest agreement about flavored cigars was 21%, versus 42% for menthol cigarettes) and did not differ by smoking status. Knowledge of the relationship between menthol cigarettes and flavored cigars and smoking progression or cessation were associated with strongly favoring a menthol cigarette (odds ratio [OR] range 1.58–2.44) or flavored cigar ban (OR range 1.62–2.32). Strong agreement that the focus of the proposed policies was on the tobacco companies or retailers was associated with favoring a menthol cigarette ban (OR range 7.22–8.63) or flavored cigar ban (OR range 8.23–8.35).

Table 2.

Weighted prevalence and odds of knowledge of menthol cigarettes, flavored cigars, and proposed bans of these products.

No current
cigarette
use		 Current
cigarette
use		 Total P-value Support for menthol
cigarette ban
 Support for flavored
cigar ban
 Potential
to move		 Potential percentage
to gain
% % % OR (95% CI) OR (95% CI) % Support for
menthol ban
%		 Support for
flavored
cigar ban %
Knowledge items
 Among Black and African American people who smoke cigarettes, more than 80% use menthol cigarettes 37.5% 71.2% 42.1% <.001 .80 (0.56–1.1.5) 0.70 (0.49–1.01) 57.9% −2.6% −4.2%
 Among people who smoke cigarillos or little cigars, about 50% use flavored cigars 29.1% 36.8% 30.2% .086 1.30 (0.89–1.90) 1.19 (0.81–1.74) 69.8% 3.8% 2.5%
 Menthol in cigarettes is linked to becoming a regular smoker 37.5% 55.1% 39.9% <.001 1.62** (1.12–2.33) 1.62* (1.12–2.33) 60.1% 6.1% 6.0%
 Flavors in cigars are linked to becoming a regular smoker 28.0% 31.5% 28.5% .426 2.44** (1.67–3.58) 2.32** (1.58–3.41) 71.5% 13.9% 13.1%
 Menthol in cigarettes makes it harder to quit smoking, especially among Black and African American people 34.0% 56.8% 37.1% <.001 1.58* (1.10–2.27) 1.74** (1.21–2.51) 62.9% 6.1% 7.3%
These bans would make it illegal for
 Tobacco companies to manufacture menthol cigarettes and flavored cigarsa 21.0% 18.9% 20.7% .578 7.22** (4.73–11.0) 8.23** (5.38–12.6) 79.3% 35.4% 37.4%
 Stores to sell menthol cigarettes and flavored cigarsa 20.6% 16.5% 20.1% .255 8.63** (5.53–13.5) 8.35** (5.38–12.9) 80.0% 38.8% 38.0%
 Adults to buy menthol cigarettes and flavored cigarsb 4.8% 15.0% 6.2% <.001 0.81 (0.38–1.74) 0.77 (0.36–1.66) 93.8% −3.9% −4.7%
 Adults to use menthol cigarettes and flavored cigarsb 5.3% 13.1% 6.3% .003 0.61 (0.26–1.42) 0.73 (0.32–1.64) 93.7% −8.8% −5.8%
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a

Strongly agree.

b

Strongly disagree. The menthol facts questions show the “true” responses; outcomes are “strongly favor;” only those with non-missing values for both the response and outcome were included in the percentage to gain calculations.

*

P<.0.5

**

P<.01.

Only 16%–26% of participants strongly agreed that menthol cigarette or flavored cigar policies had positive impacts, and only 4%–14% of participants strongly disagreed with the negative impacts of these policies (Table 3). Strong agreement with the positive impacts of these policies was associated with strongly favoring a menthol cigarette ban (OR range 5.28–6.89) or a flavored cigar ban (OR range 4.15–5.17). Strongly disagreeing with two of the four negative impacts of the ban was also associated with favoring the menthol cigarette or flavored cigar bans, specifically disagreeing with “do more harm than good in Black communities” (OR range 4.15–5.32) and “hurt Black businesses” (OR range 2.55–2.75). Few participants (6%) strongly disagreed that black adults who smoke should be able to choose the cigarettes or cigars they use, flavored or not, though this belief was associated with support for both bans (ORs 7.63 and 8.98). A larger proportion (24%) strongly disagreed that Black youth should be able to choose flavored or unflavored cigarettes and cigars, and this belief was associated with more modest support for the menthol cigarette (OR 3.28) and flavored cigar bans (OR 3.49).

Table 3.

Weighted prevalence and odds of beliefs about menthol cigarettes, flavored cigars, and proposed bans of these products.

No current
cigarette
use		 Current
cigarette
use		 Total P-value Support for menthol
cigarette ban
 Support for flavored
cigar ban
 Potential to
move		 Potential percentage to gain
% % % OR (95% CI) OR (95% CI) % Support for
menthol ban
%		 Support for
flavored cigar
ban %
Positive impactsa
 Help save lives and reduce disease in Black people 25.7% 24.1% 25.5% .690 6.89** (4.57–10.4) 5.17** (3.44–7.76) 74.5% 31.6% 27.1%
 Lower smoking rates in Black people 15.3% 18.5% 15.8% .368 5.29** (3.30–8.46) 4.47** (2.81–7.12) 84.3% 32.3% 29.1%
 Reduce tobacco use in Black youth and young adults 20.4% 18.9% 20.2% .692 5.28* (3.45–8.09) 4.15* (2.71–6.35) 79.8% 30.1% 25.7%
Negative impacts b
 Do more harm than good in Black communities 14.7% 11.7% 14.3% .346 5.32** (3.31–8.56) 4.15** (2.59–6.64) 85.7% 33.1% 28.1%
 Hurt Black businesses 11.6% 9.1% 11.2% .367 2.75** (1.65–4.60) 2.55** (1.53–4.26) 88.7% 20.7% 18.9%
 Create an illegal market for these products in Black communities 4.1% 1.7% 3.8% .096 1.96 (0.85–4.56) 1.98 (0.85–4.59) 96.2% 14.8% 15.0%
 Put Black people who smoke at greater risk of police encounters 7.7% 12.1% 8.3% .098 1.42 (0.79–2.53) 1.54 (0.87–2.74) 91.7% 7.0% 8.7%
Other beliefs b
 Black adults who smoke cigarettes and/or cigars should be able to choose what products they use, flavored or not 6.0% 1.9% 5.5% .011 7.63** (3.33–17.5) 8.98** (3.78–21.3) 94.5% 44.3% 47.2%
 Black youth who smoke cigarettes and cigars should be able to choose what products they use, flavored or not 25.4% 17.2% 24.3% .035 3.28** (2.20–4.89) 3.49** (2.33–5.21) 75.7% 20.0% 21.0%
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a

Strongly agree.

b

Strongly disagree. The menthol facts questions show the “true” responses; outcomes are “strongly favor”; only those with non-missing values for both the response and outcome were included in the percentage to gain calculations.

*

P<.0.5

**

P<.01.

For knowledge or beliefs that were positively associated with favoring a menthol cigarette or flavored cigar ban, the proportion of participants who did not hold the belief (ie, “potential to move”) ranged from 58% to 95%. When considering the strength of the association with strongly favoring the menthol cigarette or flavored cigar policies, the “potential to gain” ranged from 6% to 47%. The top five beliefs based on “potential to gain” were related to adult choice (44% menthol cigarettes, 47% flavored cigars), facts about the focus of the policies on stores (39% menthol cigarettes, 38% flavored cigars), and tobacco companies (35% menthol cigarettes, 37% flavored cigars), negative impacts of the policies on Black communities (“do more harm than good in Black communities”: 33% menthol cigarettes, 28% flavored cigars), and positive impacts of the policies for Black people (“lower smoking rates in Black people”: 32% menthol cigarettes; 29% flavored cigars). In total, there were seven beliefs with “potential to gain” greater than 30% for either the menthol cigarette or flavored cigar ban.

Discussion

In this large, national study of non-Hispanic Black adults, we identified seven beliefs with the largest potential percentage to gain (>30%) for favoring the menthol cigarette or flavored cigar bans: two addressed the focus of the proposed policies on tobacco companies and retailers (as opposed to individuals), three addressed the positive impacts of the proposed bans, one addressed the potential negative impact of doing more harm than good in Black communities, and one addressed adult choice of cigarettes and cigar products. We also found that fewer than half of the participants knew about the negative public health impact of menthol cigarettes or flavored cigars (eg, impact on smoking progression) or about the focus of the proposed policies on manufacturers and sales, not individuals. Fewer than a quarter of participants strongly agreed with potential positive impacts of menthol cigarette bans; agreement with the potential positive impact of flavored cigar bans was even lower. It is important to note, however, that strong agreement with positive impacts of the policies and strong disagreement with some negative impacts of the policies were associated with favoring the bans, suggesting that efforts to educate individuals about the positive benefits of the proposed bans could lead to policy support. However, the impact of changing these beliefs on policy support should be examined using experimental message testing approaches.

Prevalent beliefs about the negative impacts of the policies align with messages perpetuated by tobacco companies via news articles,42 public comments to the FDA docket,22 and direct-to-consumer e-mails,19 which focus on the use of these products and the potential impact of the proposed bans at the individual level. Tobacco company messaging asserts that the availability of these products is a matter of “individual choice” and that bans will increase negative interactions with law enforcement. Just like tobacco companies’ marketing efforts have been successful in maintaining high prevalence of use among Black Americans, marketing strategies have also been leveraged to disseminate disinformation about the proposed menthol and flavored cigar bans, as described earlier (eg, financial contributions to prominent Black leaders.)21

These findings highlight the need to address disinformation regarding the impact of these policies on Black individuals rather than on the manufacture, distribution and sales of menthol cigarettes and flavored cigars. These messages should be culturally relevant and developed in partnership with the Black community who are part of the target audience in order to enhance message credibility and effectiveness.43,44 Our findings also support the importance of countering false statements about the potential impact of menthol cigarettes and flavored cigars bans, as well as educating people about expected positive health impacts of these policies, which have largely been absent from public commentary.42 While the FDA is no longer considering implementing federal bans on menthol cigarettes and characterizing flavors in cigars at this time, messaging efforts to correct misperceptions about the bans remain important. A number of states and localities are considering similar bans or will consider them in the future, and FDA could introduce product standards again to ban menthol cigarettes and characterizing flavors in cigars. Public support for such policies at the local, state, and federal levels will be essential for successful implementation of such policies.

While there has been prior research examining public support for menthol cigarette and flavored cigar bans,45,46 our study advances health communication science. First, much of the research on support of these policies is conducted using majority white adult samples, whereas our study only included non-Hispanic Black adults. This is meaningful, since few studies have examined policy support specifically among Black populations, who have historically and disproportionately been targeted by tobacco companies45,46 and who would be most greatly impacted by the proposed policies. Additionally, this is the first study to investigate policy support, attitudes, and beliefs about the proposed bans since 2022 and was therefore able to capture the potential effects of tobacco company efforts to disseminate disinformation and generate opposition to the proposed bans.

This study has limitations. First, data are cross-sectional therefore causality cannot be inferred from the observed associations between a given belief and our outcome of interest. Further, most of the sample consisted of non-smoking adults and although recruitment oversampled for adults who currently smoke cigarettes, our sample size of adults who smoke was limited, and did not allow for further analysis of results among adults who smoke menthol cigarettes specifically. Our limited sample of adults who smoke cigars also prevented us from stratifying analyses by cigar use. Third, although the study is national, it may not represent all subgroups within the Black community, especially those who identify as Hispanic or are not engaged with online panels. Lastly, while the Hornik method has been used to guide a number of successful public health campaigns, there are other factors that can influence campaign success, including whether the belief is feasible to message on, how the messages are delivered to the target audience, and the political environment.

Despite tremendous efforts from community groups, activists, and health organizations to advocate for a ban on menthol cigarettes locally and federally,44,47,48 population-level public education efforts to support these efforts are mostly absent. Findings from this study support the opportunity to message to Black adults on potential positive impacts of menthol cigarette and flavored cigar bans and to correct misperceptions about the bans, and suggest that changing these beliefs may impact support for these policies. A critical component of the methodology developed by Hornik et al. in selecting beliefs to target as part of public health messaging efforts is determining if a belief is one a campaign can feasibly message.32 Our study has identified promising beliefs that are (1) associated with policy support and (2) have “room to move,” but what remains to be seen is whether these beliefs can be affected via a public education campaign. Future studies should examine how beliefs associated with the favoring of menthol cigarette and flavored cigar policies with the highest “percentage to gain” can inform strategic message concepts and be tested in messaging studies.

Funding

This work was supported in part by the National Institute on Minority Health and Health Disparities (NIMHD) of the National Institutes of Health under award R01MD018728. This content is solely the responsibility of the authors and does not necessarily represent the official views of NIMHD.

Footnotes

Declaration of interests

None declared.

Data availability

Data are available upon reasonable request. The corresponding author will make deidentified participant data and the data dictionary available following publication. Institutions and individuals wishing to access any resources or data must contact the corresponding author (og96@sph.rutgers.edu). Data will only be made available to those whose proposed use of the data has been approved by the corresponding author. The recipient must agree to not transfer the data to other users and that the data are only to be used for research purposes. The investigators will require requestors of data to sign a data sharing agreement that will ensure (1) use of the data is only for research purposes, (2) data security using appropriate technology/firewalls, (3) destruction of data after data analysis and (4) proper citation in publications or other written materials. A record of transfer of data and a copy of the dataset that was distributed will be kept by Rutgers University.

References

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Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Data Availability Statement

Data are available upon reasonable request. The corresponding author will make deidentified participant data and the data dictionary available following publication. Institutions and individuals wishing to access any resources or data must contact the corresponding author (og96@sph.rutgers.edu). Data will only be made available to those whose proposed use of the data has been approved by the corresponding author. The recipient must agree to not transfer the data to other users and that the data are only to be used for research purposes. The investigators will require requestors of data to sign a data sharing agreement that will ensure (1) use of the data is only for research purposes, (2) data security using appropriate technology/firewalls, (3) destruction of data after data analysis and (4) proper citation in publications or other written materials. A record of transfer of data and a copy of the dataset that was distributed will be kept by Rutgers University.

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