The use of ‘light’ and ‘mild’ descriptors on cigarette packaging has been associated with smoker misperceptions around reduced harm to health.1 As a result of this evidence, many countries have responded to the Framework Convention on Tobacco Control recommendations that these descriptors be banned.2 Such an approach has not yet been taken for the descriptor ‘menthol’ and use of this flavouring ingredient has not yet been restricted by regulations, although the FDA in the United States (US) is reviewing data on this ingredient.3
Research has suggested that mentholated cigarettes (‘menthols’) may pose a greater risk in terms of youth uptake4–6 and that menthol smoking is either “at least” as dangerous as smoking non-mentholated counterparts7 or possibly more hazardous.8,9 Indeed, at a conference about menthols in 2009 there were 10 arguments articulated for the banning of this ingredient.10
The existing literature about smokers’ harm perceptions of menthols is limited to US studies (largely involving African Americans). These have provided evidence that at least some smokers perceive menthols as less hazardous to health.11–14 But one recent US study indicated the opposite pattern was more common in smokers, i.e. menthols were perceived as more risky.15 To explore this issue further, we studied menthol use and harm perceptions among New Zealand (NZ) smokers. This country has an ethnically diverse population and is one where advertising and sponsorship of tobacco products is largely restricted.