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Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.. http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/." /> <meta name="DC.AccessRights" content="open-access" /> <meta name="DC.Description" content="Since May 2020, cigarettes and roll-your-own (RYO) tobacco with a characterising flavour of menthol have been banned in the European Union (EU) owing to the European Tobacco Products Directive (EU TPD). Other characterising flavours were banned in 2016. Cigars, cigarillos, pipe tobacco, heated tobacco and tobacco accessories are exempt from the ban.1 Despite the ban, a substantial proportion of adolescents and young adults in Denmark still smoke menthol cigarettes (29% pre-ban vs 20% post-ban).2 3 This may be due to tobacco industry tactics to circumvent the ban. This paper provides insights into the response of the tobacco industry to the implementation of the menthol ban in Denmark. In this case study, we identify loopholes in the characterising flavour ban and discuss how to make bans on menthol-flavoured tobacco most effective. The analysis is based on screening tobacco products using online tobacco stores, and samples of cigarette packages, tobacco flavour accessories, and menthol-flavoured cigarette-like products purchased between December 2019 and January 2022. ### Flavoured tobacco accessories Various types of tobacco flavour accessories to insert into cigarette packs, cigarette filters and RYO tobacco have been introduced to the Danish market. These products enable users to customise their cigarettes with menthol and sweet flavours. In some cases, the products are produced by tobacco companies (figure 1). After the ban, 3.4% of smokers aged 25–29 years used flavour accessories.4 Moreover, there was an increase in the use of RYO tobacco among adult smokers (13% pre-ban vs 17% post-ban).2 3 Figure 1 Examples of tobacco flavour accessories marketed in Denmark. (A) Menthol filter sprays (Egogreen and Ottaman). (B) Menthol drops (Instahit). (C) Capsules with menthol, candy and soft drinks flavours (Aroma King and Hoffmann). (D) Menthol flavour stone (Flavor By Stone). (E) Loose mint filter tips for cigarettes with recessed filters (FlavorMe, King’s Tobacco International). (F) Menthol …" /> <meta name="DC.Contributor" content="Anne-Line Brink" /> <meta name="DC.Contributor" content="Andrea Stadil Glahn" /> <meta name="DC.Contributor" content="Niels Them Kjaer" /> <meta name="article:published_time" content="2023-11-01" /> <meta name="article:section" content="Industry watch" /> <meta name="citation_title" content="Tobacco companies’ exploitation of loopholes in the EU ban on menthol cigarettes: a case study from Denmark" /> <meta name="citation_journal_title" content="Tobacco Control" /> <meta name="citation_publisher" content="BMJ Publishing Group Ltd" /> <meta name="citation_publication_date" content="2023/11/01" /> <meta name="citation_mjid" content="tobaccocontrol;32/6/809" /> <meta name="citation_id" content="32/6/809" /> <meta name="citation_public_url" content="https://tobaccocontrol.bmj.com/content/32/6/809" /> <meta name="citation_abstract_html_url" content="https://tobaccocontrol.bmj.com/content/32/6/809.abstract" /> <meta name="citation_full_html_url" content="https://tobaccocontrol.bmj.com/content/32/6/809.full" /> <meta name="citation_pdf_url" content="https://tobaccocontrol.bmj.com/content/tobaccocontrol/32/6/809.full.pdf" /> <meta name="citation_issn" content="0964-4563" /> <meta name="citation_issn" content="1468-3318" /> <meta name="citation_doi" content="10.1136/tobaccocontrol-2021-057213" /> <meta name="citation_pmid" content="35314507" /> <meta name="citation_volume" content="32" /> <meta name="citation_issue" content="6" /> <meta name="citation_article_type" content="Other" /> <meta name="citation_section" content="Industry watch" /> <meta name="citation_firstpage" content="809" /> <meta name="citation_lastpage" content="812" /> <meta name="citation_access" content="all" /> <meta name="citation_author" content="Anne-Line Brink" /> <meta name="citation_author_institution" content="Department of Cancer Prevention and Information" /> <meta name="citation_author_institution" content="Danish Cancer Society" /> <meta name="citation_author_orcid" content="http://orcid.org/0000-0003-1878-9209" /> <meta name="citation_author" content="Andrea Stadil Glahn" /> <meta name="citation_author_institution" content="Department of Cancer Prevention and Information" /> <meta name="citation_author_institution" content="Danish Cancer Society" /> <meta name="citation_author" content="Niels Them Kjaer" /> <meta name="citation_author_institution" content="Department of Cancer Prevention and Information" /> <meta name="citation_author_institution" content="Danish Cancer Society" /> <meta name="citation_reference" content="citation_journal_title=Off J Eur Union;citation_title=Directive 2014/40/EU of the European Parliament and of the Council of 3 April 2014 on the approximation of the laws, regulations and administrative provisions of the member states concerning the manufacture, presentation and sale of tobacco and related products and repealing Directive 2001/37/EC;citation_pages=1-38;citation_volume=127;citation_year=2014" /> <meta name="citation_reference" content="citation_title=Danskernes rygevaner 2019. Delrapport 1: Nikotinafhængighed;citation_year=2020" /> <meta name="citation_reference" content="citation_title=Danskernes Rygevaner 2020. Delrapport 1: Nikotinafhængighed;citation_year=2021" /> <meta name="citation_reference" content="citation_title=§RØG – En undersøgelse af tobak, adfærd og regler. Udvalgte tendenser 2021;citation_year=2021" /> <meta name="citation_reference" content="citation_title=Ultramarine;citation_year=2021" /> <meta name="citation_reference" content="citation_title=Efter mentolforbud: Tobaksproducent sælger stadig cigaretter med mentol. DR Nyheder;citation_year=2020" /> <meta name="citation_reference" content="Sikkerhedsstyrelsen [Danish Safety Technology Authority]. Tobaksregister. Available: https://www.sik.dk/registre/tobaksregister?search=break&produkt_type=Cigarillo [Accessed 8 Aug 2021]." /> <meta name="citation_reference" content="citation_title=233;citation_title=Salget af cigaretter faldt - salget af tobak steg. Nyt fra Danmarks Statistik;citation_year=2021" /> <meta name="citation_reference" content="Piber.dk. Cigaretter. Available: www.piber.dk/shop/430-cigaretter/ [Accessed 28 May 2020]." /> <meta name="citation_reference" content="Kiosken Rødbyhavn. Opal menthol pibetobak. Available: https://www.kioskenrodbyhavn.dk/rulletobak-dase/1169-opal-menthol-pibetobak-180-gr-5707294291125.html [Accessed 13 Sep 2021]." /> <meta name="citation_reference" content="citation_journal_title=Tob Control;citation_author=R. Hiscock;citation_author=K. Silver;citation_author=M. Zatoński;citation_title=Tobacco industry tactics to circumvent and undermine the menthol cigarette ban in the UK;citation_volume=29;citation_year=2020;citation_pmid=32418921;citation_doi=10.1136/tobaccocontrol-2020-055769" /> <meta name="citation_reference" content="citation_journal_title=Tob Control;citation_author=T. Borland;citation_author=SA. D'Souza;citation_author=S. O'Connor;citation_title=Is blue the new green? Repackaging menthol cigarettes in response to a flavour ban in Ontario, Canada;citation_volume=28;citation_year=2019;citation_pmid=30377244;citation_doi=10.1136/tobaccocontrol-2018-054454" /> <meta name="citation_reference" content="citation_journal_title=Tob Control;citation_author=J. Brown;citation_author=T. DeAtley;citation_author=K. Welding;citation_title=Tobacco industry response to menthol cigarette bans in Alberta and Nova Scotia, Canada;citation_volume=26;citation_year=2017;citation_pmid=27435736;citation_doi=10.1136/tobaccocontrol-2016-053099" /> <meta name="citation_reference" content="citation_title=Minister calls on EU to act against tobacco firms ‘undermining’ menthol ban in Ireland. The Irish Times;citation_year=2020" /> <meta name="citation_reference" content="citation_journal_title=Tob Control;citation_author=AL. Oliveira da Silva;citation_author=SA. Bialous;citation_author=PGD. Albertassi;citation_title=The taste of smoke: tobacco industry strategies to prevent the prohibition of additives in tobacco products in Brazil;citation_volume=28;citation_year=2019;citation_pmid=31152115;citation_doi=10.1136/tobaccocontrol-2018-054892" /> <meta name="citation_reference" content="citation_title=Order amending the schedule to the Tobacco Act (Menthol). Canada Gazette Part 2;citation_pages=665-85;citation_volume=151;citation_year=2017" /> <meta name="citation_reference" content="Bundesinstitut für Risikobewertung (BfR) [The German Federal Institute for Risk Assessment]. No more menthol in cigarettes and smoking tobacco, 2020. Available: https://www.bfr.bund.de/en/press_information/2020/19/no_more_menthol_in_cigarettes_and_smoking_tobacco-246948.html [Accessed 13 Sep 2021]." /> <meta name="citation_reference" content="Sundhedsministeriet [The Danish Ministry of Health]. Bekendtgørelse af lov om tobaksvarer m.v. LBK nr 1489 af 18/06/2021. Available: https://www.lovtidende.dk/api/pdf/224175" /> <meta name="citation_reference" content="citation_title=Regeringens proposition till riksdagen med förslag till lag om ändring av tobakslagen, Riksdagen, 52 a §. Förbud mot försäljning av produkter avsedda för smaksättning av tobaksprodukter Sess;citation_year=2021" /> <meta name="citation_reference" content="citation_title=Notification detail. draft act amending and supplementing the tobacco, tobacco and related products act. 2021/650/BG (Bulgaria)" /> <meta name="citation_reference" content="citation_title=Notat: Vurdering om hvorvidt mentol letter inhalering og nikotinoptagelse. Sikkerhedsstyrelsen [Danish Safety Technology Authority];citation_year=2021" /> <meta name="citation_reference" content="citation_journal_title=Nicotine Tob Res;citation_author=G. Ferris Wayne;citation_author=GN. Connolly;citation_title=Application, function, and effects of menthol in cigarettes: a survey of tobacco industry documents;citation_pages=43-54;citation_volume=6(Suppl 1);citation_year=2004;citation_pmid=http://www.n" /> <meta name="citation_reference" content="citation_journal_title=Tob Control;citation_author=GF. Wayne;citation_author=GN. 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Cigars, cigarillos, pipe tobacco, heated tobacco and tobacco accessories are exempt from the ban.1 Despite the ban, a substantial proportion of adolescents and young adults in Denmark still smoke menthol cigarettes (29% pre-ban vs 20% post-ban).2 3 This may be due to tobacco industry tactics to circumvent the ban. This paper provides insights into the response of the tobacco industry to the implementation of the menthol ban in Denmark. In this case study, we identify loopholes in the characterising flavour ban and discuss how to make bans on menthol-flavoured tobacco most effective. The analysis is based on screening tobacco products using online tobacco stores, and samples of cigarette packages, tobacco flavour accessories, and menthol-flavoured cigarette-like products purchased between December 2019 and January 2022. ### Flavoured tobacco accessories Various types of tobacco flavour accessories to insert into cigarette packs, cigarette filters and RYO tobacco have been introduced to the Danish market. These products enable users to customise their cigarettes with menthol and sweet flavours. In some cases, the products are produced by tobacco companies (figure 1). After the ban, 3.4% of smokers aged 25–29 years used flavour accessories.4 Moreover, there was an increase in the use of RYO tobacco among adult smokers (13% pre-ban vs 17% post-ban).2 3 Figure 1 Examples of tobacco flavour accessories marketed in Denmark. (A) Menthol filter sprays (Egogreen and Ottaman). (B) Menthol drops (Instahit). (C) Capsules with menthol, candy and soft drinks flavours (Aroma King and Hoffmann). (D) Menthol flavour stone (Flavor By Stone). (E) Loose mint filter tips for cigarettes with recessed filters (FlavorMe, King’s Tobacco International). (F) Menthol …" /> <meta name="og-title" property="og:title" content="Tobacco companies’ exploitation of loopholes in the EU ban on menthol cigarettes: a case study from Denmark" /> <meta name="og-url" property="og:url" content="https://tobaccocontrol.bmj.com/content/32/6/809" /> <meta name="og-site-name" property="og:site_name" content="Tobacco Control" /> <meta name="og-description" property="og:description" content="Since May 2020, cigarettes and roll-your-own (RYO) tobacco with a characterising flavour of menthol have been banned in the European Union (EU) owing to the European Tobacco Products Directive (EU TPD). Other characterising flavours were banned in 2016. Cigars, cigarillos, pipe tobacco, heated tobacco and tobacco accessories are exempt from the ban.1 Despite the ban, a substantial proportion of adolescents and young adults in Denmark still smoke menthol cigarettes (29% pre-ban vs 20% post-ban).2 3 This may be due to tobacco industry tactics to circumvent the ban. This paper provides insights into the response of the tobacco industry to the implementation of the menthol ban in Denmark. In this case study, we identify loopholes in the characterising flavour ban and discuss how to make bans on menthol-flavoured tobacco most effective. The analysis is based on screening tobacco products using online tobacco stores, and samples of cigarette packages, tobacco flavour accessories, and menthol-flavoured cigarette-like products purchased between December 2019 and January 2022. ### Flavoured tobacco accessories Various types of tobacco flavour accessories to insert into cigarette packs, cigarette filters and RYO tobacco have been introduced to the Danish market. These products enable users to customise their cigarettes with menthol and sweet flavours. In some cases, the products are produced by tobacco companies (figure 1). After the ban, 3.4% of smokers aged 25–29 years used flavour accessories.4 Moreover, there was an increase in the use of RYO tobacco among adult smokers (13% pre-ban vs 17% post-ban).2 3 Figure 1 Examples of tobacco flavour accessories marketed in Denmark. (A) Menthol filter sprays (Egogreen and Ottaman). (B) Menthol drops (Instahit). (C) Capsules with menthol, candy and soft drinks flavours (Aroma King and Hoffmann). (D) Menthol flavour stone (Flavor By Stone). (E) Loose mint filter tips for cigarettes with recessed filters (FlavorMe, King’s Tobacco International). 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data-pisa-master="tobaccocontrol;tobaccocontrol-2021-057213" data-apath="/tobaccocontrol/32/6/809.atom"><cite class="highwire-cite highwire-cite-highwire-article highwire-citation-bmjj-title clearfix"> <div class="highwire-cite-title">Tobacco companies’ exploitation of loopholes in the EU ban on menthol cigarettes: a case study from Denmark</div> <span class="highwire-cite-access"><span class="highwire-citation-access"><svg class="icon icon-open-access bmjj-open-access bmjj-access-tag"><use xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="#icon-openaccess"></use><svg></svg></svg></span></span> </cite> </div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-panel-tabs-container col-narrow-12 clear" > <div class="pane-content"> <div data-panels-ajax-tab-preloaded="jnl_template_bmjj_tab_art" id="panels-ajax-tab-container-highwire_article_tabs" class="panels-ajax-tab-container"><div class="panels-ajax-tab-loading" style ="display:none"><img class="loading" src="https://tobaccocontrol.bmj.com/sites/all/modules/contrib/panels_ajax_tab/images/loading.gif" alt="Loading" title="Loading" /></div><div class="panels-ajax-tab-wrap-jnl_template_bmjj_tab_art"><div class="panel-display panel-1col clearfix" > <div class="panel-panel panel-col"> <div><div class="panel-pane pane-highwire-markup author-affiliates col-narrow-12 author-affiliates-corresp article" > <div class="pane-content"> <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div xmlns:xhtml="http://www.w3.org/1999/xhtml" class="contributors"><ol class="contributor-list" id="contrib-group-1"><li class="contributor" id="contrib-1"><a href="http://orcid.org/0000-0003-1878-9209" class="bmjj-markup-orcid-logo" target="_blank">http://orcid.org/0000-0003-1878-9209</a><span class="name">Anne-Line Brink</span><a id="xref-aff-1-1" class="xref-aff" href="#aff-1"></a>, </li><li class="contributor" id="contrib-2"><span class="name">Andrea Stadil Glahn</span><a id="xref-aff-1-2" class="xref-aff" href="#aff-1"></a>, </li><li class="last" id="contrib-3"><span class="name">Niels Them Kjaer</span><a id="xref-aff-1-3" class="xref-aff" href="#aff-1"></a></li></ol><ol class="affiliation-list"><li class="aff"><a id="aff-1" name="aff-1"></a><address> <span class="institution">Department of Cancer Prevention and Information</span>, <span class="institution">Danish Cancer Society</span>, <span class="addr-line">Copenhagen</span>, Denmark </address></li></ol><ol class="corresp-list"><li class="corresp" id="corresp-1"><span class="corresp-label">Correspondence to</span> Anne-Line Brink, Department of Cancer Prevention and Information, Danish Cancer Society, DK-2100 Copenhagen, Denmark; <span class="em-link"><span class="em-addr">alb{at}cancer.dk</span></span> </li></ol></div></div></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-markup abstract-with-bc" > <div class="pane-content"> <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" id="content-block" xmlns:xhtml="http://www.w3.org/1999/xhtml"><span class="related-urls"></span></div></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-custom pane-2" > <div class="pane-content"> <p><a href="https://doi.org/10.1136/tobaccocontrol-2021-057213" target="_new">https://doi.org/10.1136/tobaccocontrol-2021-057213</a></p> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-altmetrics" > <h2 class="pane-title">Statistics from Altmetric.com</h2> <div class="pane-content"> <div data-badge-details="right" data-badge-type="medium-donut" data-doi="10.1136/tobaccocontrol-2021-057213" data-hide-no-mentions="true" class="altmetric-embed"></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-bmjj-jumplinks" > <div class="pane-content"> <div class="highwire-list-wrapper"><div class="highwire-list"><ul></ul></div></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-custom pane-3 permissions-box" > <h2 class="pane-title">Request Permissions</h2> <div class="pane-content"> <p>If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.</p> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-panels-ajax-pane-content permissions-box pane-highwire-permission-link" id="request-permissions"> <h2 class="pane-title"><span class='panels-ajax-pane-title' data-pid='new-70fd4c70-563e-4b94-ae3b-2a97f3980c13'></span></h2> <div class="pane-content"> <div class='panels-ajax-pane panels-ajax-pane-new-70fd4c70-563e-4b94-ae3b-2a97f3980c13' data-pid='new-70fd4c70-563e-4b94-ae3b-2a97f3980c13'></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-markup" > <div class="pane-content"> <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="article fulltext-view "><span class="highwire-journal-article-marker-start"></span><ul class="kwd-group"><li class="kwd"><a href="/keyword/tobacco-industry" class="hw-term hw-article-keyword hw-article-keyword-tobacco-industry" rel="nofollow">Tobacco industry</a></li><li class="kwd"><a href="/keyword/packaging-and-labelling" class="hw-term hw-article-keyword hw-article-keyword-packaging-and-labelling" rel="nofollow">Packaging and Labelling</a></li><li class="kwd"><a href="/keyword/prevention" class="hw-term hw-article-keyword hw-article-keyword-prevention" rel="nofollow">Prevention</a></li><li class="kwd"><a href="/keyword/advertising-and-promotion" class="hw-term hw-article-keyword hw-article-keyword-advertising-and-promotion" rel="nofollow">Advertising and Promotion</a></li><li class="kwd"><a href="/keyword/public-policy" class="hw-term hw-article-keyword hw-article-keyword-public-policy" rel="nofollow">Public policy</a></li></ul><div class="section" id="sec-1"><h2 class="">Background</h2><p id="p-2">Since May 2020, cigarettes and roll-your-own (RYO) tobacco with a characterising flavour of menthol have been banned in the European Union (EU) owing to the European Tobacco Products Directive (EU TPD). Other characterising flavours were banned in 2016. Cigars, cigarillos, pipe tobacco, heated tobacco and tobacco accessories are exempt from the ban.<a id="xref-ref-1-1" class="xref-bibr" href="#ref-1">1</a> </p><p id="p-3">Despite the ban, a substantial proportion of adolescents and young adults in Denmark still smoke menthol cigarettes (29% pre-ban vs 20% post-ban).<a id="xref-ref-2-1" class="xref-bibr" href="#ref-2">2 3</a> This may be due to tobacco industry tactics to circumvent the ban. This paper provides insights into the response of the tobacco industry to the implementation of the menthol ban in Denmark. In this case study, we identify loopholes in the characterising flavour ban and discuss how to make bans on menthol-flavoured tobacco most effective. The analysis is based on screening tobacco products using online tobacco stores, and samples of cigarette packages, tobacco flavour accessories, and menthol-flavoured cigarette-like products purchased between December 2019 and January 2022.<div class="oas-ads oas-ads-mid pull-right"><div id="dfp-ad-mpu-wrapper" class="dfp-tag-wrapper"> <div id="dfp-ad-mpu" class="dfp-tag-wrapper"> <script type="text/javascript"> googletag.cmd.push(function() { googletag.display("dfp-ad-mpu"); }); </script> </div> </div></div></p></div><div class="section" id="sec-2"><h2 class="">Circumvention of the menthol ban</h2><div id="sec-3" class="subsection"><h3>Flavoured tobacco accessories</h3><p id="p-4">Various types of tobacco flavour accessories to insert into cigarette packs, cigarette filters and RYO tobacco have been introduced to the Danish market. These products enable users to customise their cigarettes with menthol and sweet flavours. In some cases, the products are produced by tobacco companies (<a id="xref-fig-1-1" class="xref-fig" href="#F1">figure 1</a>). After the ban, 3.4% of smokers aged 25–29 years used flavour accessories.<a id="xref-ref-4-1" class="xref-bibr" href="#ref-4">4</a> Moreover, there was an increase in the use of RYO tobacco among adult smokers (13% pre-ban vs 17% post-ban).<a id="xref-ref-2-2" class="xref-bibr" href="#ref-2">2 3</a> </p><div id="F1" class="fig pos-float odd"><div class="highwire-figure"><div class="fig-inline-img-wrapper"><div class="fig-inline-img"><a href="https://tobaccocontrol.bmj.com/content/tobaccocontrol/32/6/809/F1.large.jpg?width=800&height=600&carousel=1" title="Examples of tobacco flavour accessories marketed in Denmark. (A) Menthol filter sprays (Egogreen and Ottaman). (B) Menthol drops (Instahit). (C) Capsules with menthol, candy and soft drinks flavours (Aroma King and Hoffmann). (D) Menthol flavour stone (Flavor By Stone). (E) Loose mint filter tips for cigarettes with recessed filters (FlavorMe, King’s Tobacco International). (F) Menthol and fruit flavour infusion cards (Frizc, Hipzz and Aroma King). (G) RYO cigarette tubes with fruit flavour (Fresh Bomb); RYO cigarette tubes with menthol flavour (Pegasus, Continental Tobacco Corporation). (H) RYO filter tips with menthol and fruit flavours (Fresh Bomb and Frutta). RYO, roll-your-own." class="highwire-fragment fragment-images colorbox-load" rel="gallery-fragment-images-1373899709" data-figure-caption="<div class="highwire-markup">Examples of tobacco flavour accessories marketed in Denmark. (A) Menthol filter sprays (Egogreen and Ottaman). (B) Menthol drops (Instahit). (C) Capsules with menthol, candy and soft drinks flavours (Aroma King and Hoffmann). (D) Menthol flavour stone (Flavor By Stone). (E) Loose mint filter tips for cigarettes with recessed filters (FlavorMe, King’s Tobacco International). (F) Menthol and fruit flavour infusion cards (Frizc, Hipzz and Aroma King). (G) RYO cigarette tubes with fruit flavour (Fresh Bomb); RYO cigarette tubes with menthol flavour (Pegasus, Continental Tobacco Corporation). (H) RYO filter tips with menthol and fruit flavours (Fresh Bomb and Frutta). RYO, roll-your-own.</div>" data-icon-position="" data-hide-link-title="0"><span class="hw-responsive-img"><img class="highwire-fragment fragment-image lazyload" alt="Figure 1" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" data-src="https://tobaccocontrol.bmj.com/content/tobaccocontrol/32/6/809/F1.medium.gif" width="290" height="440"/><noscript><img class="highwire-fragment fragment-image" alt="Figure 1" src="https://tobaccocontrol.bmj.com/content/tobaccocontrol/32/6/809/F1.medium.gif" width="290" height="440"/></noscript></span></a></div></div><ul class="highwire-figure-links inline"><li class="download-fig first"><a href="https://tobaccocontrol.bmj.com/content/tobaccocontrol/32/6/809/F1.large.jpg?download=true" class="highwire-figure-link highwire-figure-link-download" title="Download Figure 1" data-icon-position="" data-hide-link-title="0">Download figure</a></li> <li class="new-tab"><a href="https://tobaccocontrol.bmj.com/content/tobaccocontrol/32/6/809/F1.large.jpg" class="highwire-figure-link highwire-figure-link-newtab" target="_blank" data-icon-position="" data-hide-link-title="0">Open in new tab</a></li> <li class="download-ppt last"><a href="/highwire/powerpoint/167516" class="highwire-figure-link highwire-figure-link-ppt" data-icon-position="" data-hide-link-title="0">Download powerpoint</a></li> </ul></div><div class="fig-caption" xmlns:xhtml="http://www.w3.org/1999/xhtml"><span class="fig-label">Figure 1</span> <p id="p-5" class="first-child">Examples of tobacco flavour accessories marketed in Denmark. (A) Menthol filter sprays (Egogreen and Ottaman). (B) Menthol drops (Instahit). (C) Capsules with menthol, candy and soft drinks flavours (Aroma King and Hoffmann). (D) Menthol flavour stone (Flavor By Stone). (E) Loose mint filter tips for cigarettes with recessed filters (FlavorMe, King’s Tobacco International). (F) Menthol and fruit flavour infusion cards (Frizc, Hipzz and Aroma King). (G) RYO cigarette tubes with fruit flavour (Fresh Bomb); RYO cigarette tubes with menthol flavour (Pegasus, Continental Tobacco Corporation). (H) RYO filter tips with menthol and fruit flavours (Fresh Bomb and Frutta). RYO, roll-your-own.</p><div class="sb-div caption-clear"></div></div></div></div><div id="sec-4" class="subsection"><h3>Recessed cigarette filters</h3><p id="p-6">Recessed filters are a type of specially shaped cigarette filters with a hollow section at the mouth end of the cigarette. This allows for inserting smaller menthol filter tips. Our analysis indicates that in Denmark, cigarettes with recessed filters are found only in menthol replacement packages (packages described by retailers as former menthol packs) or in new cigarette brand variants insinuating menthol-like qualities (packages with no previous counterparts). All the identified variants with recessed filters were produced by British American Tobacco (BAT) (<a id="xref-fig-2-1" class="xref-fig" href="#F2">figure 2</a>).</p><div id="F2" class="fig pos-float odd"><div class="highwire-figure"><div class="fig-inline-img-wrapper"><div class="fig-inline-img"><a href="https://tobaccocontrol.bmj.com/content/tobaccocontrol/32/6/809/F2.large.jpg?width=800&height=600&carousel=1" title="Cigarettes with recessed filters and their menthol characteristics. (A) Pall Mall Ultramarine and King’s Ultramarine (online store description: ‘… gives a cooling effect and a fresh feeling …’), Prince Grey Plus, Pall Mall Balance, Pall Mall Experience, King’s Purple Plus and Prince Black Plus (replacement packages for the former menthol cigarettes: Prince Green Boost, Pall Mall Green, Pall Mall Double Capsule, King’s Double Crush and Prince Double Click). (B) The design of the cigarette sticks with recessed filters." class="highwire-fragment fragment-images colorbox-load" rel="gallery-fragment-images-1373899709" data-figure-caption="<div class="highwire-markup">Cigarettes with recessed filters and their menthol characteristics. (A) Pall Mall Ultramarine and King’s Ultramarine (online store description: ‘… gives a cooling effect and a fresh feeling …’), Prince Grey Plus, Pall Mall Balance, Pall Mall Experience, King’s Purple Plus and Prince Black Plus (replacement packages for the former menthol cigarettes: Prince Green Boost, Pall Mall Green, Pall Mall Double Capsule, King’s Double Crush and Prince Double Click). (B) The design of the cigarette sticks with recessed filters.</div>" data-icon-position="" data-hide-link-title="0"><span class="hw-responsive-img"><img class="highwire-fragment fragment-image lazyload" alt="Figure 2" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" data-src="https://tobaccocontrol.bmj.com/content/tobaccocontrol/32/6/809/F2.medium.gif" width="323" height="440"/><noscript><img class="highwire-fragment fragment-image" alt="Figure 2" src="https://tobaccocontrol.bmj.com/content/tobaccocontrol/32/6/809/F2.medium.gif" width="323" height="440"/></noscript></span></a></div></div><ul class="highwire-figure-links inline"><li class="download-fig first"><a href="https://tobaccocontrol.bmj.com/content/tobaccocontrol/32/6/809/F2.large.jpg?download=true" class="highwire-figure-link highwire-figure-link-download" title="Download Figure 2" data-icon-position="" data-hide-link-title="0">Download figure</a></li> <li class="new-tab"><a href="https://tobaccocontrol.bmj.com/content/tobaccocontrol/32/6/809/F2.large.jpg" class="highwire-figure-link highwire-figure-link-newtab" target="_blank" data-icon-position="" data-hide-link-title="0">Open in new tab</a></li> <li class="download-ppt last"><a href="/highwire/powerpoint/167458" class="highwire-figure-link highwire-figure-link-ppt" data-icon-position="" data-hide-link-title="0">Download powerpoint</a></li> </ul></div><div class="fig-caption"><span class="fig-label">Figure 2</span> <p id="p-7" class="first-child">Cigarettes with recessed filters and their menthol characteristics. (A) Pall Mall Ultramarine and King’s Ultramarine (online store description: ‘… gives a cooling effect and a fresh feeling …’), Prince Grey Plus, Pall Mall Balance, Pall Mall Experience, King’s Purple Plus and Prince Black Plus (replacement packages for the former menthol cigarettes: Prince Green Boost, Pall Mall Green, Pall Mall Double Capsule, King’s Double Crush and Prince Double Click). (B) The design of the cigarette sticks with recessed filters.</p><div class="sb-div caption-clear"></div></div></div></div><div id="sec-5" class="subsection"><h3>Pack designs and brand descriptors insinuating menthol-like qualities</h3><p id="p-8">Cigarette pack designs serve as a marketing tool for tobacco companies to influence consumers’ perceptions of taste. Despite a characterising flavour ban, pack design may manipulate smokers’ experience of menthol/non-menthol flavour. After the ban, one pack from Japan Tobacco International (JTI) retained insinuating menthol-like qualities. It retained the brand descriptor ‘Activate’ and an illustration on the package, indicating that the cigarette still had a click-function (<a id="xref-fig-3-1" class="xref-fig" href="#F3">figure 3A</a>). Moreover, the traditional yellow filter was replaced with a white filter with blue circles, which also insinuate a click-function, although the variant did not have a capsule inside (<a id="xref-fig-3-2" class="xref-fig" href="#F3">figure 3B</a>). The same variant was launched in an edition with menthol aroma added to the lid (<a id="xref-fig-3-3" class="xref-fig" href="#F3">figure 3C</a>). This special edition presented a clear violation of the EU TPD and was on sale for only a brief period. The TPD prohibits flavourings in the package, but it also bans labelling that contains elements or features that refer to taste, smell, flavourings, or create an erroneous impression about the product’s characteristics. Thus, the brand descriptor ‘Activate’ and the illustrations on the Camel package may also contravene the EU TPD.</p><div id="F3" class="fig pos-float odd"><div class="highwire-figure"><div class="fig-inline-img-wrapper"><div class="fig-inline-img"><a href="https://tobaccocontrol.bmj.com/content/tobaccocontrol/32/6/809/F3.large.jpg?width=800&height=600&carousel=1" title="Examples of post-ban design insinuating menthol characteristics. (A) Camel packaging with the brand descriptor ‘Activate’ and an illustration containing a mint-like leaf. (B) Camel Activate cigarette stick with blue circles on the filter insinuating click-function. (C) Camel Activate package with an illustration guiding the consumer to rub on the lid to release a menthol aroma." class="highwire-fragment fragment-images colorbox-load" rel="gallery-fragment-images-1373899709" data-figure-caption="<div class="highwire-markup">Examples of post-ban design insinuating menthol characteristics. (A) Camel packaging with the brand descriptor ‘Activate’ and an illustration containing a mint-like leaf. (B) Camel Activate cigarette stick with blue circles on the filter insinuating click-function. (C) Camel Activate package with an illustration guiding the consumer to rub on the lid to release a menthol aroma.</div>" data-icon-position="" data-hide-link-title="0"><span class="hw-responsive-img"><img class="highwire-fragment fragment-image lazyload" alt="Figure 3" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" data-src="https://tobaccocontrol.bmj.com/content/tobaccocontrol/32/6/809/F3.medium.gif" width="440" height="277"/><noscript><img class="highwire-fragment fragment-image" alt="Figure 3" src="https://tobaccocontrol.bmj.com/content/tobaccocontrol/32/6/809/F3.medium.gif" width="440" height="277"/></noscript></span></a></div></div><ul class="highwire-figure-links inline"><li class="download-fig first"><a href="https://tobaccocontrol.bmj.com/content/tobaccocontrol/32/6/809/F3.large.jpg?download=true" class="highwire-figure-link highwire-figure-link-download" title="Download Figure 3" data-icon-position="" data-hide-link-title="0">Download figure</a></li> <li class="new-tab"><a href="https://tobaccocontrol.bmj.com/content/tobaccocontrol/32/6/809/F3.large.jpg" class="highwire-figure-link highwire-figure-link-newtab" target="_blank" data-icon-position="" data-hide-link-title="0">Open in new tab</a></li> <li class="download-ppt last"><a href="/highwire/powerpoint/167529" class="highwire-figure-link highwire-figure-link-ppt" data-icon-position="" data-hide-link-title="0">Download powerpoint</a></li> </ul></div><div class="fig-caption"><span class="fig-label">Figure 3</span> <p id="p-9" class="first-child">Examples of post-ban design insinuating menthol characteristics. (A) Camel packaging with the brand descriptor ‘Activate’ and an illustration containing a mint-like leaf. (B) Camel Activate cigarette stick with blue circles on the filter insinuating click-function. (C) Camel Activate package with an illustration guiding the consumer to rub on the lid to release a menthol aroma.</p><div class="sb-div caption-clear"></div></div></div><p id="p-10">About 15 months after the ban, BAT launched three different cigarette variants with ‘Ultramarine’ as a brand descriptor. At one online store, the three packages were accompanied by the same description insinuating menthol-like qualities: ‘New product with modern design and a new blend which gives a cooling effect and a fresh feeling to the well-known tobacco taste’.<a id="xref-ref-5-1" class="xref-bibr" href="#ref-5">5</a> These descriptions are violations of the Danish ban on tobacco marketing but provide useful insights into the tactics of the tobacco companies. Moreover, the package design of the variant, King’s Ultramarine, was identical to a former menthol cigarette pack named King’s Double Crush.</p></div><div id="sec-6" class="subsection"><h3>Menthol as an ingredient</h3><p id="p-11">The EU TPD does not ban menthol as an ingredient; it only bans menthol as a characterising flavour. This enables tobacco companies to continue the use of menthol for its anaesthetic and cooling effects. In August 2020, JTI was accused of violating the menthol ban in Denmark by continuing to add menthol flavour to certain cigarette brand variants. In response, JTI stated that the continued use of menthol in their products was in full compliance with the law and that the products did not have a clearly prominent smell or taste of menthol.<a id="xref-ref-6-1" class="xref-bibr" href="#ref-6">6</a> </p></div><div id="sec-7" class="subsection"><h3>Menthol-flavoured cigarette-like products</h3><p id="p-12">Prior to the menthol ban, two variants of cigarillos with menthol flavour were registered in Denmark.<a id="xref-ref-7-1" class="xref-bibr" href="#ref-7">7</a> Both variants resemble cigarettes in size and thickness, and one variant has a click-filter. From 2019 to 2020, the sale of cigarillos and cigars increased by 7%,<a id="xref-ref-8-1" class="xref-bibr" href="#ref-8">8</a> which may be associated with the introduction of these menthol variants. Tobacco companies and retailers also marketed menthol pipe tobacco and electronic cigarettes with menthol flavour as alternatives to menthol cigarettes,<a id="xref-ref-9-1" class="xref-bibr" href="#ref-9">9 10</a> and Phillip Morris International (PMI) promoted mentholated heated tobacco products via displays in supermarkets and cigarette pack inserts (<a id="xref-fig-4-1" class="xref-fig" href="#F4">figure 4</a>).</p><div id="F4" class="fig pos-float odd"><div class="highwire-figure"><div class="fig-inline-img-wrapper"><div class="fig-inline-img"><a href="https://tobaccocontrol.bmj.com/content/tobaccocontrol/32/6/809/F4.large.jpg?width=800&height=600&carousel=1" title="Phillip Morris International promotes IQOS HEETS as exempt from the menthol ban. (A) Marlboro Fuse Beyond package with a pack insert with the text: ‘Important. From 20 May 2020, this product does not contain menthol’ (front) and ‘The best thing you can do is to stop smoking. You can still have a smoke-free alternative with menthol after 20 May 2020, HEETS’ (back). (B) IQOS HEETS promotion display in a supermarket prior to the menthol ban: ‘The menthol ban does not include IQOS heat sticks’." class="highwire-fragment fragment-images colorbox-load" rel="gallery-fragment-images-1373899709" data-figure-caption="<div class="highwire-markup">Phillip Morris International promotes IQOS HEETS as exempt from the menthol ban. (A) Marlboro Fuse Beyond package with a pack insert with the text: ‘Important. From 20 May 2020, this product does not contain menthol’ (front) and ‘The best thing you can do is to stop smoking. You can still have a smoke-free alternative with menthol after 20 May 2020, HEETS’ (back). (B) IQOS HEETS promotion display in a supermarket prior to the menthol ban: ‘The menthol ban does not include IQOS heat sticks’.</div>" data-icon-position="" data-hide-link-title="0"><span class="hw-responsive-img"><img class="highwire-fragment fragment-image lazyload" alt="Figure 4" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" data-src="https://tobaccocontrol.bmj.com/content/tobaccocontrol/32/6/809/F4.medium.gif" width="365" height="440"/><noscript><img class="highwire-fragment fragment-image" alt="Figure 4" src="https://tobaccocontrol.bmj.com/content/tobaccocontrol/32/6/809/F4.medium.gif" width="365" height="440"/></noscript></span></a></div></div><ul class="highwire-figure-links inline"><li class="download-fig first"><a href="https://tobaccocontrol.bmj.com/content/tobaccocontrol/32/6/809/F4.large.jpg?download=true" class="highwire-figure-link highwire-figure-link-download" title="Download Figure 4" data-icon-position="" data-hide-link-title="0">Download figure</a></li> <li class="new-tab"><a href="https://tobaccocontrol.bmj.com/content/tobaccocontrol/32/6/809/F4.large.jpg" class="highwire-figure-link highwire-figure-link-newtab" target="_blank" data-icon-position="" data-hide-link-title="0">Open in new tab</a></li> <li class="download-ppt last"><a href="/highwire/powerpoint/167473" class="highwire-figure-link highwire-figure-link-ppt" data-icon-position="" data-hide-link-title="0">Download powerpoint</a></li> </ul></div><div class="fig-caption"><span class="fig-label">Figure 4</span> <p id="p-13" class="first-child">Phillip Morris International promotes IQOS HEETS as exempt from the menthol ban. (A) Marlboro Fuse Beyond package with a pack insert with the text: ‘Important. From 20 May 2020, this product does not contain menthol’ (front) and ‘The best thing you can do is to stop smoking. You can still have a smoke-free alternative with menthol after 20 May 2020, HEETS’ (back). (B) IQOS HEETS promotion display in a supermarket prior to the menthol ban: ‘The menthol ban does not include IQOS heat sticks’.</p><div class="sb-div caption-clear"></div></div></div></div></div><div class="section discussion" id="sec-8"><h2 class="">Discussion</h2><p id="p-14">The products identified and analysed in this study reveal that tobacco companies use a variety of strategies to undermine the menthol ban. Some of these tactics are also observable in other countries. In the UK, gaps in the EU menthol ban were exploited by tobacco companies to promote tobacco products that are exempt from the ban.<a id="xref-ref-11-1" class="xref-bibr" href="#ref-11">11</a> After province-wide menthol bans in Canada, tobacco companies attempted to retain menthol cigarette smokers by directing them to non-menthol alternatives whose packaging in colour and descriptors communicated menthol-like qualities.<a id="xref-ref-12-1" class="xref-bibr" href="#ref-12">12 13</a> In Ireland, PMI introduced a new cigarette brand variant that it described to retailers as a ‘menthol blend without methylation’.<a id="xref-ref-14-1" class="xref-bibr" href="#ref-14">14</a> </p><p id="p-15">Some countries have adopted regulations that counter the tactics used by tobacco companies to undermine bans on flavoured cigarettes. Brazil is the first country to prohibit all additives that may change the taste of tobacco products, even those additives that do not directly impart a characteristic flavour.<a id="xref-ref-15-1" class="xref-bibr" href="#ref-15">15</a> Canada has prohibited the use of menthol and other flavouring additives in the manufacture of cigarettes and most cigars,<a id="xref-ref-16-1" class="xref-bibr" href="#ref-16">16</a> and Germany has prohibited menthol as an additive in cigarettes and smoking tobacco.<a id="xref-ref-17-1" class="xref-bibr" href="#ref-17">17</a> </p><p id="p-16">In Denmark, a ban on the sale of tobacco equipment, that may change the flavour of tobacco products, has been adopted. Consequently, all flavoured tobacco accessories are banned by April 2022.<a id="xref-ref-18-1" class="xref-bibr" href="#ref-18">18</a> To our knowledge, Denmark is one of the first countries to introduce such a ban, although similar bans have been proposed in Finland and Bulgaria.<a id="xref-ref-19-1" class="xref-bibr" href="#ref-19">19 20</a> Moreover, the Danish Safety Technology Authority has concluded that the use of menthol as an additive in cigarettes is a violation of Danish legislation, which prohibits combustible tobacco products that contain ingredients that facilitate the inhalation of tobacco smoke and nicotine uptake.<a id="xref-ref-21-1" class="xref-bibr" href="#ref-21">21</a> </p><div id="sec-9" class="subsection"><h3>Conclusion and recommendations</h3><p id="p-17">To be efficient, bans on flavoured tobacco products should prohibit menthol and other ingredients with flavour properties, as ingredients. Consequently, authorities are not placed in a position to prove whether a flavour is characterising. Banning menthol as an ingredient will also end tobacco companies’ use of menthol for its pharmacological effects. Internal tobacco industry documents reveal that even subliminal levels of menthol may decrease the harshness of tobacco smoking by making the smoke more ‘smooth’<a id="xref-ref-22-1" class="xref-bibr" href="#ref-22">22</a> and that these properties appeal to novice smokers.<a id="xref-ref-23-1" class="xref-bibr" href="#ref-23">23</a> Other ingredients that have the potential to mask the irritating effect of tobacco smoke, such as ingredients that produce a cooling effect, should also be banned. Moreover, legislation should encompass all tobacco products to avoid the substitution of one product with another. To be comprehensive, the legislation should also prohibit flavoured tobacco accessories and filter modifications which may enable tobacco companies to circumvent the flavour ban. These recommendations should be considered in the revision of the EU TPD. The revised TPD should at least make it clear that member states may go beyond the directive provisions to protect public health.</p><p id="p-18">Efficient legislation should also prohibit distinctive features, colours, and brand descriptors on tobacco packets and the tobacco products itself that connote cooling effects or flavours other than the flavour of tobacco. Accordingly, the implementation of plain packaging of tobacco products can support a menthol ban. A comprehensive ban on tobacco marketing is also essential to avoid the marketing of tobacco products exempt from the ban. Finally, it is recommended that a menthol ban is supported by the prohibition of descriptions of tobacco product sensation in both online and physical stores.</p></div></div><div class="section ethics-statement" id="sec-10"><h2 class="">Ethics statements</h2><div class="section" id="sec-11"><h3>Patient consent for publication</h3><p id="p-24" class="ethics-consent-to-publish">Not required.</p></div><div class="section" id="sec-12"><h3>Ethics approval</h3><p id="p-25" class="ethics-approval">Not applicable.</p></div></div><div class="section ack" id="ack-1"><h2>Acknowledgments</h2><p id="p-19">The authors would like to thank Astrid Knudsen for a critical review of the manuscript.</p></div><div class="section ref-list" id="ref-list-1"><h2 class="">References</h2><ol class="cit-list"><li><a class="rev-xref-ref" href="#xref-ref-1-1" title="View reference 1 in text" id="ref-1">↵</a><div class="cit ref-cit ref-journal" id="cit-32.6.809.1"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth cit-collab">European Union</span></li></ol><cite>. <span class="cit-article-title">Directive 2014/40/EU of the European Parliament and of the Council of 3 April 2014 on the approximation of the laws, regulations and administrative provisions of the member states concerning the manufacture, presentation and sale of tobacco and related products and repealing Directive 2001/37/EC</span>. <abbr class="cit-jnl-abbrev">Off J Eur Union</abbr> <span class="cit-pub-date">2014</span>;<span class="cit-vol">127</span>:<span class="cit-fpage">1</span>–<span class="cit-lpage">38</span>.</cite></div><div class="cit-extra"><a href="{openurl}?query=rft.jtitle%253DOff%2BJ%2BEur%2BUnion%26rft.volume%253D127%26rft.spage%253D1%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx" class="cit-ref-sprinkles cit-ref-sprinkles-openurl cit-ref-sprinkles-open-url"><span>OpenUrl</span></a></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-2-1" title="View reference 2 in text" id="ref-2">↵</a><div class="cit ref-cit ref-book" id="cit-32.6.809.2"><div class="cit-metadata"><ol class="cit-auth-list"><li> </li><li><span class="cit-auth"> <span class="cit-name-surname">Lund</span> <span class="cit-name-given-names">L</span> </span>, </li><li><span class="cit-auth"> <span class="cit-name-surname">Bast</span> <span class="cit-name-given-names">LS</span> </span>, </li><li><span class="cit-auth"> <span class="cit-name-surname">Jørgensen</span> <span class="cit-name-given-names">MB</span> </span> </li></ol><cite>. <span class="cit-source">Danskernes rygevaner 2019. Delrapport 1: Nikotinafhængighed</span>. <span class="cit-publ-name">Statens Institut for Folkesundhed</span>, <span class="cit-pub-date">2020</span>.</cite></div><div class="cit-extra"></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-2-1" title="View reference 3 in text" id="ref-3">↵</a><div class="cit ref-cit ref-book" id="cit-32.6.809.3"><div class="cit-metadata"><ol class="cit-auth-list"><li> </li><li><span class="cit-auth"> <span class="cit-name-surname">Lund</span> <span class="cit-name-given-names">L</span> </span>, </li><li><span class="cit-auth"> <span class="cit-name-surname">Bast</span> <span class="cit-name-given-names">LS</span> </span> </li></ol><cite>. <span class="cit-source">Danskernes Rygevaner 2020. Delrapport 1: Nikotinafhængighed</span>. <span class="cit-publ-name">Statens Institut for Folkesundhed</span>, <span class="cit-pub-date">2021</span>.</cite></div><div class="cit-extra"></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-4-1" title="View reference 4 in text" id="ref-4">↵</a><div class="cit ref-cit ref-book" id="cit-32.6.809.4"><div class="cit-metadata"><ol class="cit-auth-list"><li> </li><li><span class="cit-auth"> <span class="cit-name-surname">Andersen</span> <span class="cit-name-given-names">MB</span> </span>, </li><li><span class="cit-auth"> <span class="cit-name-surname">Bast</span> <span class="cit-name-given-names">LS</span> </span> </li></ol><cite>. <span class="cit-source">§RØG – En undersøgelse af tobak, adfærd og regler. Udvalgte tendenser 2021</span>. <span class="cit-publ-name">Statens Institut for Folkesundhed</span>, <span class="cit-pub-date">2021</span>.</cite></div><div class="cit-extra"></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-5-1" title="View reference 5 in text" id="ref-5">↵</a><div class="cit ref-cit ref-web" id="cit-32.6.809.5"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth cit-collab">Kiosken Rødbyhavn</span></li></ol><cite>. <span class="cit-article-title">Ultramarine</span>, <span class="cit-pub-date">2021</span>. Available: <a href="https://www.kioskenrodbyhavn.dk/soeg?controller=search&orderby=position&orderway=desc&search_query=ultramarine&submit_search">https://www.kioskenrodbyhavn.dk/soeg?controller=search&orderby=position&orderway=desc&search_query=ultramarine&submit_search</a> [Accessed <span class="cit-comment">6 Sep 2021</span>].</cite></div><div class="cit-extra"></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-6-1" title="View reference 6 in text" id="ref-6">↵</a><div class="cit ref-cit ref-web" id="cit-32.6.809.6"><div class="cit-metadata"><ol class="cit-auth-list"><li> </li><li><span class="cit-auth"> <span class="cit-name-surname">Mortensen</span> <span class="cit-name-given-names">EH</span> </span> </li></ol><cite>. <span class="cit-article-title">Efter mentolforbud: Tobaksproducent sælger stadig cigaretter med mentol. DR Nyheder</span>, <span class="cit-pub-date">2020</span>. Available: <a href="https://www.dr.dk/nyheder/indland/efter-mentolforbud-tobaksproducent-saelger-stadig-cigaretter-med-mentol">https://www.dr.dk/nyheder/indland/efter-mentolforbud-tobaksproducent-saelger-stadig-cigaretter-med-mentol</a> [Accessed <span class="cit-comment">13 Aug 2021</span>].</cite></div><div class="cit-extra"></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-7-1" title="View reference 7 in text" id="ref-7">↵</a><div class="cit ref-cit ref-web" id="cit-32.6.809.7"><div class="cit-metadata"><cite><span class="cit-article-title">Sikkerhedsstyrelsen [Danish Safety Technology Authority]. Tobaksregister</span>. Available: <a href="https://www.sik.dk/registre/tobaksregister?search=break&produkt_type=Cigarillo">https://www.sik.dk/registre/tobaksregister?search=break&produkt_type=Cigarillo</a> [Accessed <span class="cit-comment">8 Aug 2021</span>].</cite></div><div class="cit-extra"></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-8-1" title="View reference 8 in text" id="ref-8">↵</a><div class="cit ref-cit ref-web" id="cit-32.6.809.8"><div class="cit-metadata"><ol class="cit-auth-list"><li> </li><li><span class="cit-auth"> <span class="cit-name-surname">Lindeskov</span> <span class="cit-name-given-names">C</span> </span> </li></ol><cite>. <span class="cit-article-title">Salget af cigaretter faldt - salget af tobak steg. Nyt fra Danmarks Statistik</span>, <span class="cit-pub-date">2021</span>. <span class="cit-source">233</span>. Available: <a href="https://www.dst.dk/da/Statistik/nyt/NytHtml?cid=32760">https://www.dst.dk/da/Statistik/nyt/NytHtml?cid=32760</a> [Accessed <span class="cit-comment">2 Nov 2021</span>].</cite></div><div class="cit-extra"></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-9-1" title="View reference 9 in text" id="ref-9">↵</a><div class="cit ref-cit ref-web" id="cit-32.6.809.9"><div class="cit-metadata"><cite><span class="cit-article-title">Piber.dk. Cigaretter</span>. Available: <a href="http://www.piber.dk/shop/430-cigaretter/">www.piber.dk/shop/430-cigaretter/</a> [Accessed <span class="cit-comment">28 May 2020</span>].</cite></div><div class="cit-extra"></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-9-1" title="View reference 10 in text" id="ref-10">↵</a><div class="cit ref-cit ref-web" id="cit-32.6.809.10"><div class="cit-metadata"><cite><span class="cit-article-title">Kiosken Rødbyhavn. Opal menthol pibetobak</span>. Available: <a href="https://www.kioskenrodbyhavn.dk/rulletobak-dase/1169-opal-menthol-pibetobak-180-gr-5707294291125.html">https://www.kioskenrodbyhavn.dk/rulletobak-dase/1169-opal-menthol-pibetobak-180-gr-5707294291125.html</a> [Accessed <span class="cit-comment">13 Sep 2021</span>].</cite></div><div class="cit-extra"></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-11-1" title="View reference 11 in text" id="ref-11">↵</a><div class="cit ref-cit ref-journal" id="cit-32.6.809.11" data-doi="10.1136/tobaccocontrol-2020-055769"><div class="cit-metadata"><ol class="cit-auth-list"><li> </li><li><span class="cit-auth"> <span class="cit-name-surname">Hiscock</span> <span class="cit-name-given-names">R</span> </span>, </li><li><span class="cit-auth"> <span class="cit-name-surname">Silver</span> <span class="cit-name-given-names">K</span> </span>, </li><li><span class="cit-auth"> <span class="cit-name-surname">Zatoński</span> <span class="cit-name-given-names">M</span> </span>, <span class="cit-etal">et al</span> </li></ol><cite>. <span class="cit-article-title">Tobacco industry tactics to circumvent and undermine the menthol cigarette ban in the UK</span>. <abbr class="cit-jnl-abbrev">Tob Control</abbr> <span class="cit-pub-date">2020</span>;<span class="cit-vol">29</span>:<span class="cit-fpage">e138</span>–<span class="cit-lpage">42</span>. <a href="http://dx.doi.org/10.1136/tobaccocontrol-2020-055769">doi:10.1136/tobaccocontrol-2020-055769</a><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>32418921</span> </cite></div><div class="cit-extra"><a href="{openurl}?query=rft.jtitle%253DTob%2BControl%26rft_id%253Dinfo%253Adoi%252F10.1136%252Ftobaccocontrol-2020-055769%26rft_id%253Dinfo%253Apmid%252F32418921%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx" class="cit-ref-sprinkles cit-ref-sprinkles-openurl cit-ref-sprinkles-open-url"><span>OpenUrl</span></a><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiRlVMTCI7czoxMToiam91cm5hbENvZGUiO3M6MTQ6InRvYmFjY29jb250cm9sIjtzOjU6InJlc2lkIjtzOjEwOiIyOS9lMS9lMTM4IjtzOjQ6ImF0b20iO3M6Mjk6Ii90b2JhY2NvY29udHJvbC8zMi82LzgwOS5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-12-1" title="View reference 12 in text" id="ref-12">↵</a><div class="cit ref-cit ref-journal" id="cit-32.6.809.12" data-doi="10.1136/tobaccocontrol-2018-054454"><div class="cit-metadata"><ol class="cit-auth-list"><li> </li><li><span class="cit-auth"> <span class="cit-name-surname">Borland</span> <span class="cit-name-given-names">T</span> </span>, </li><li><span class="cit-auth"> <span class="cit-name-surname">D'Souza</span> <span class="cit-name-given-names">SA</span> </span>, </li><li><span class="cit-auth"> <span class="cit-name-surname">O'Connor</span> <span class="cit-name-given-names">S</span> </span>, <span class="cit-etal">et al</span> </li></ol><cite>. <span class="cit-article-title">Is blue the new green? Repackaging menthol cigarettes in response to a flavour ban in Ontario, Canada</span>. <abbr class="cit-jnl-abbrev">Tob Control</abbr> <span class="cit-pub-date">2019</span>;<span class="cit-vol">28</span>:<span class="cit-fpage">e7</span>–<span class="cit-lpage">12</span>.<a href="http://dx.doi.org/10.1136/tobaccocontrol-2018-054454">doi:10.1136/tobaccocontrol-2018-054454</a><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>http://www.ncbi.nlm.nih.gov/pubmed/30377244</span> </cite></div><div class="cit-extra"><a href="{openurl}?query=rft.jtitle%253DTob%2BControl%26rft_id%253Dinfo%253Adoi%252F10.1136%252Ftobaccocontrol-2018-054454%26rft_id%253Dinfo%253Apmid%252F30377244%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx" class="cit-ref-sprinkles cit-ref-sprinkles-openurl cit-ref-sprinkles-open-url"><span>OpenUrl</span></a><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6MTQ6InRvYmFjY29jb250cm9sIjtzOjU6InJlc2lkIjtzOjg6IjI4L2UxL2U3IjtzOjQ6ImF0b20iO3M6Mjk6Ii90b2JhY2NvY29udHJvbC8zMi82LzgwOS5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-12-1" title="View reference 13 in text" id="ref-13">↵</a><div class="cit ref-cit ref-journal" id="cit-32.6.809.13" data-doi="10.1136/tobaccocontrol-2016-053099"><div class="cit-metadata"><ol class="cit-auth-list"><li> </li><li><span class="cit-auth"> <span class="cit-name-surname">Brown</span> <span class="cit-name-given-names">J</span> </span>, </li><li><span class="cit-auth"> <span class="cit-name-surname">DeAtley</span> <span class="cit-name-given-names">T</span> </span>, </li><li><span class="cit-auth"> <span class="cit-name-surname">Welding</span> <span class="cit-name-given-names">K</span> </span>, <span class="cit-etal">et al</span> </li></ol><cite>. <span class="cit-article-title">Tobacco industry response to menthol cigarette bans in Alberta and Nova Scotia, Canada</span>. <abbr class="cit-jnl-abbrev">Tob Control</abbr> <span class="cit-pub-date">2017</span>;<span class="cit-vol">26</span>:<span class="cit-fpage">e71</span>–<span class="cit-lpage">4</span>.<a href="http://dx.doi.org/10.1136/tobaccocontrol-2016-053099">doi:10.1136/tobaccocontrol-2016-053099</a><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>http://www.ncbi.nlm.nih.gov/pubmed/27435736</span> </cite></div><div class="cit-extra"><a href="{openurl}?query=rft.jtitle%253DTob%2BControl%26rft_id%253Dinfo%253Adoi%252F10.1136%252Ftobaccocontrol-2016-053099%26rft_id%253Dinfo%253Apmid%252F27435736%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx" class="cit-ref-sprinkles cit-ref-sprinkles-openurl cit-ref-sprinkles-open-url"><span>OpenUrl</span></a><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiRlVMTCI7czoxMToiam91cm5hbENvZGUiO3M6MTQ6InRvYmFjY29jb250cm9sIjtzOjU6InJlc2lkIjtzOjk6IjI2L2UxL2U3MSI7czo0OiJhdG9tIjtzOjI5OiIvdG9iYWNjb2NvbnRyb2wvMzIvNi84MDkuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-14-1" title="View reference 14 in text" id="ref-14">↵</a><div class="cit ref-cit ref-web" id="cit-32.6.809.14"><div class="cit-metadata"><ol class="cit-auth-list"><li> </li><li><span class="cit-auth"> <span class="cit-name-surname">Paul</span> <span class="cit-name-given-names">M</span> </span> </li></ol><cite>. <span class="cit-article-title">Minister calls on EU to act against tobacco firms ‘undermining’ menthol ban in Ireland. The Irish Times</span>, <span class="cit-pub-date">2020</span>. Available: <a href="https://www.irishtimes.com/business/retail-and-services/minister-calls-on-eu-to-act-against-tobacco-firms-undermining-menthol-ban-in-ireland-1.4266132">https://www.irishtimes.com/business/retail-and-services/minister-calls-on-eu-to-act-against-tobacco-firms-undermining-menthol-ban-in-ireland-1.4266132</a> [Accessed <span class="cit-comment">29 Sep 2021</span>].</cite></div><div class="cit-extra"></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-15-1" title="View reference 15 in text" id="ref-15">↵</a><div class="cit ref-cit ref-journal" id="cit-32.6.809.15" data-doi="10.1136/tobaccocontrol-2018-054892"><div class="cit-metadata"><ol class="cit-auth-list"><li> </li><li><span class="cit-auth"> <span class="cit-name-surname">Oliveira da Silva</span> <span class="cit-name-given-names">AL</span> </span>, </li><li><span class="cit-auth"> <span class="cit-name-surname">Bialous</span> <span class="cit-name-given-names">SA</span> </span>, </li><li><span class="cit-auth"> <span class="cit-name-surname">Albertassi</span> <span class="cit-name-given-names">PGD</span> </span>, <span class="cit-etal">et al</span> </li></ol><cite>. <span class="cit-article-title">The taste of smoke: tobacco industry strategies to prevent the prohibition of additives in tobacco products in Brazil</span>. <abbr class="cit-jnl-abbrev">Tob Control</abbr> <span class="cit-pub-date">2019</span>;<span class="cit-vol">28</span>:<span class="cit-fpage">e92</span>–<span class="cit-lpage">101</span>.<a href="http://dx.doi.org/10.1136/tobaccocontrol-2018-054892">doi:10.1136/tobaccocontrol-2018-054892</a><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>http://www.ncbi.nlm.nih.gov/pubmed/31152115</span> </cite></div><div class="cit-extra"><a href="{openurl}?query=rft.jtitle%253DTob%2BControl%26rft_id%253Dinfo%253Adoi%252F10.1136%252Ftobaccocontrol-2018-054892%26rft_id%253Dinfo%253Apmid%252F31152115%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx" class="cit-ref-sprinkles cit-ref-sprinkles-openurl cit-ref-sprinkles-open-url"><span>OpenUrl</span></a><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6MTQ6InRvYmFjY29jb250cm9sIjtzOjU6InJlc2lkIjtzOjk6IjI4L2UyL2U5MiI7czo0OiJhdG9tIjtzOjI5OiIvdG9iYWNjb2NvbnRyb2wvMzIvNi84MDkuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-16-1" title="View reference 16 in text" id="ref-16">↵</a><div class="cit ref-cit ref-journal" id="cit-32.6.809.16"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth cit-collab">Government of Canada</span></li></ol><cite>. <span class="cit-article-title">Order amending the schedule to the Tobacco Act (Menthol). Canada Gazette Part 2</span> <span class="cit-pub-date">2017</span>;<span class="cit-vol">151</span>:<span class="cit-fpage">665</span>–<span class="cit-lpage">85</span>.</cite></div><div class="cit-extra"></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-17-1" title="View reference 17 in text" id="ref-17">↵</a><div class="cit ref-cit ref-web" id="cit-32.6.809.17"><div class="cit-metadata"><cite><span class="cit-article-title">Bundesinstitut für Risikobewertung (BfR) [The German Federal Institute for Risk Assessment]. No more menthol in cigarettes and smoking tobacco</span>, <span class="cit-pub-date">2020</span>. Available: <a href="https://www.bfr.bund.de/en/press_information/2020/19/no_more_menthol_in_cigarettes_and_smoking_tobacco-246948.html">https://www.bfr.bund.de/en/press_information/2020/19/no_more_menthol_in_cigarettes_and_smoking_tobacco-246948.html</a> [Accessed <span class="cit-comment">13 Sep 2021</span>].</cite></div><div class="cit-extra"></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-18-1" title="View reference 18 in text" id="ref-18">↵</a><div class="cit ref-cit ref-web" id="cit-32.6.809.18"><div class="cit-metadata"><cite><span class="cit-article-title">Sundhedsministeriet [The Danish Ministry of Health]. Bekendtgørelse af lov om tobaksvarer m.v. LBK nr 1489 af 18/06/2021</span>. Available: <a href="https://www.lovtidende.dk/api/pdf/224175">https://www.lovtidende.dk/api/pdf/224175</a> </cite></div><div class="cit-extra"></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-19-1" title="View reference 19 in text" id="ref-19">↵</a><div class="cit ref-cit ref-web" id="cit-32.6.809.19"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth cit-collab">Statsrådet Finland [The Finnish Government]</span></li></ol><cite>. <span class="cit-article-title">Regeringens proposition till riksdagen med förslag till lag om ändring av tobakslagen, Riksdagen, 52 a §. Förbud mot försäljning av produkter avsedda för smaksättning av tobaksprodukter Sess</span>, <span class="cit-pub-date">2021</span>. Available: <a href="https://www.finlex.fi/sv/esitykset/he/2021/20210141.pdf">https://www.finlex.fi/sv/esitykset/he/2021/20210141.pdf</a> [Accessed <span class="cit-comment">7 Oct 2021</span>].</cite></div><div class="cit-extra"></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-19-1" title="View reference 20 in text" id="ref-20">↵</a><div class="cit ref-cit ref-web" id="cit-32.6.809.20"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth cit-collab">European Commission</span></li></ol><cite>. <span class="cit-article-title">Notification detail. draft act amending and supplementing the tobacco, tobacco and related products act. 2021/650/BG (Bulgaria)</span>. Available: <a href="https://ec.europa.eu/growth/tools-databases/tris/en/search/?trisaction=search.detail&year=2021&num=650">https://ec.europa.eu/growth/tools-databases/tris/en/search/?trisaction=search.detail&year=2021&num=650</a> [Accessed <span class="cit-comment">20 Oct 2021</span>].</cite></div><div class="cit-extra"></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-21-1" title="View reference 21 in text" id="ref-21">↵</a><div class="cit ref-cit ref-web" id="cit-32.6.809.21"><div class="cit-metadata"><ol class="cit-auth-list"><li> </li><li><span class="cit-auth"> <span class="cit-name-surname">Lange</span> <span class="cit-name-given-names">CC</span> </span> </li></ol><cite>. <span class="cit-article-title">Notat: Vurdering om hvorvidt mentol letter inhalering og nikotinoptagelse. Sikkerhedsstyrelsen [Danish Safety Technology Authority]</span>, <span class="cit-pub-date">2021</span>. Available: <a href="https://www.sik.dk/sites/default/files/2021-01/Orientering%20-%20mentol%20-%20DK.pdf">https://www.sik.dk/sites/default/files/2021-01/Orientering%20-%20mentol%20-%20DK.pdf</a> [Accessed <span class="cit-comment">28 Sep 2021</span>].</cite></div><div class="cit-extra"></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-22-1" title="View reference 22 in text" id="ref-22">↵</a><div class="cit ref-cit ref-journal" id="cit-32.6.809.22"><div class="cit-metadata"><ol class="cit-auth-list"><li> </li><li><span class="cit-auth"> <span class="cit-name-surname">Ferris Wayne</span> <span class="cit-name-given-names">G</span> </span>, </li><li><span class="cit-auth"> <span class="cit-name-surname">Connolly</span> <span class="cit-name-given-names">GN</span> </span> </li></ol><cite>. <span class="cit-article-title">Application, function, and effects of menthol in cigarettes: a survey of tobacco industry documents</span>. <abbr class="cit-jnl-abbrev">Nicotine Tob Res</abbr> <span class="cit-pub-date">2004</span>;<span class="cit-vol">6(Suppl 1)</span>:<span class="cit-fpage">43</span>–<span class="cit-lpage">54</span>.<a href="http://dx.doi.org/10.1080/14622203310001649513">doi:10.1080/14622203310001649513</a><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>http://www.ncbi.nlm.nih.gov/pubmed/14982708</span> </cite></div><div class="cit-extra"><a href="{openurl}?query=rft.jtitle%253DNicotine%2BTob%2BRes%26rft.volume%253D61%26rft.spage%253D43%26rft_id%253Dinfo%253Apmid%252Fhttp%253A%252F%252Fwww.n%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx" class="cit-ref-sprinkles cit-ref-sprinkles-openurl cit-ref-sprinkles-open-url"><span>OpenUrl</span></a><a href="/lookup/external-ref?access_num=http://www.n&link_type=MED&atom=%2Ftobaccocontrol%2F32%2F6%2F809.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-23-1" title="View reference 23 in text" id="ref-23">↵</a><div class="cit ref-cit ref-journal" id="cit-32.6.809.23"><div class="cit-metadata"><ol class="cit-auth-list"><li> </li><li><span class="cit-auth"> <span class="cit-name-surname">Wayne</span> <span class="cit-name-given-names">GF</span> </span>, </li><li><span class="cit-auth"> <span class="cit-name-surname">Connolly</span> <span class="cit-name-given-names">GN</span> </span> </li></ol><cite>. <span class="cit-article-title">How cigarette design can affect youth initiation into smoking: camel cigarettes 1983-93</span>. <abbr class="cit-jnl-abbrev">Tob Control</abbr> <span class="cit-pub-date">2002</span>;<span class="cit-vol">11(Suppl 1)</span>:<span class="cit-fpage">i32</span>–<span class="cit-lpage">9</span>.<a href="http://dx.doi.org/10.1136/tc.11.suppl_1.i32">doi:10.1136/tc.11.suppl_1.i32</a><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>http://www.ncbi.nlm.nih.gov/pubmed/11893812</span> </cite></div><div class="cit-extra"><a href="{openurl}?query=rft.jtitle%253DTob%2BControl%26rft.volume%253D111%26rft.spage%253Di32%26rft_id%253Dinfo%253Apmid%252Fhttp%253A%252F%252Fwww.n%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx" class="cit-ref-sprinkles cit-ref-sprinkles-openurl cit-ref-sprinkles-open-url"><span>OpenUrl</span></a><a href="/lookup/external-ref?access_num=http://www.n&link_type=MED&atom=%2Ftobaccocontrol%2F32%2F6%2F809.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li></ol></div><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-markup footnotes" > <div class="pane-content"> <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div xmlns:xhtml="http://www.w3.org/1999/xhtml" class="section fn-group" id="fn-group-1"><h2>Footnotes</h2><ul><li class="fn-other" id="fn-1"><p id="p-20"><span class="fn-label">Contributors</span> A-LB and ASG designed the study and contributed to the data collection, data analysis and first draft of the paper. A-LB and NTK contributed to the revision of the manuscript. All authors approved the final draft before submission.</p></li><li class="fn-other" id="fn-2"><p id="p-21"><span class="fn-label">Funding</span> The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.</p></li><li class="fn-conflict" id="fn-3"><p id="p-22"><span class="fn-label">Competing interests</span> None declared.</p></li><li class="fn-other" id="fn-4"><p id="p-23"><span class="fn-label">Provenance and peer review</span> Not commissioned; externally peer reviewed.</p></li></ul></div></div></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-dfp-pane" > <div class="pane-content"> <div id="dfp-ad-mpu-wrapper" class="dfp-tag-wrapper"> <div id="dfp-ad-mpu" class="dfp-tag-wrapper"> <script type="text/javascript"> googletag.cmd.push(function() { googletag.display("dfp-ad-mpu"); }); </script> </div> </div> </div> </div> </div> </div> </div> </div></div> </div> </div> <div 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