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Nottage MK, Taylor EV, East KA, McNeill A, Thrasher JF, Reid JL, Hammond D, Simonavičius E. Packaging of disposable vaping products and e-liquids in England, Canada and the United States: A content analysis. Addiction 2024. [PMID: 38970447 DOI: 10.1111/add.16611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 06/09/2024] [Indexed: 07/08/2024]
Abstract
BACKGROUND AND AIMS Vaping product packaging is varied and often features bright colours and novel designs, particularly among recently marketed disposable vapes. This study provides an overview of attributes found on the packaging of popular disposable vapes and e-liquid bottles in England, Canada and the United States (US) and assesses compliance with local packaging regulations. DESIGN Content analysis. SETTING Brick-and-mortar and online shops in England (London), Canada (Ontario) and the US (New Hampshire and South Carolina). CASES 108 vaping products (including packaging) from 76 brands in a range of flavours and nicotine levels. Specifically, 48 disposable vapes (15 from England, 16 from Canada, 17 from the US) and 60 e-liquid bottles (20 per country). MEASUREMENTS Textual and graphic branding and marketing elements, independently coded by two researchers and checked by a third. FINDINGS Compliance with local packaging regulations varied across countries. Health warnings were present on the packaging of all but one nicotine-containing product, although 33% of disposables and 17% of e-liquids featuring the warning did not adhere to formatting requirements. Leaflets were seldom included with e-liquid bottles, even in England (45%) where mandatory, and omitted elsewhere. Labelling of nicotine type and batch numbers was inconsistent. Vaping product packaging featured claims relating to sensory perceptions (41%), most often flavours, and some (32%) featured youth-appealing content. Common graphic elements included stylised brand fonts (80%), brand logos (54%), product representations on the external packaging (47%) and abstract graphic elements (64%). Colours on packaging, disposable vapes and e-liquid bottles were associated with product flavour. CONCLUSIONS In England, Canada and the United States, popular disposable vapes and e-liquid bottles appear to have varying compliance with local packaging regulations and inconsistent labelling of nicotine and product characteristics. The use of colourful designs, evocative descriptors and appealing graphics to promote flavours underscores the need for comprehensive packaging regulations and enforcement.
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Affiliation(s)
- Matilda K Nottage
- Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Eve V Taylor
- Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Katherine A East
- Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Ann McNeill
- Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - James F Thrasher
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Jessica L Reid
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Erikas Simonavičius
- Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
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Czaplicki L, Saraf S, Kroart L, Rasheduzzaman ABM, Islam MS, Cohen JE. Standard smokeless tobacco packaging: potential impact on perceived attractiveness, warning label visibility and harm perceptions among adults in Bangladesh. Tob Control 2024; 33:353-359. [PMID: 36316153 DOI: 10.1136/tc-2022-057597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 10/07/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND In Bangladesh, smokeless tobacco (SLT) is available in a variety of pack shapes and sizes. Lack of standard packaging could limit compliance with pictorial health warning label (HWL) requirements. We explored Bangladeshi SLT users' and non-users' perceptions of a proposed standard pack shape for gul (tobacco powder) and zordha (chewing tobacco), including the role that HWL placement plays on harm perceptions. METHODS We conducted 28 focus groups across three regions of Bangladesh: Dhaka, Sylhet and Khulna. Groups were stratified equally by urban/rural residence, gender and SLT use. Trained facilitators used a standardised guide to discuss perceived attractiveness, noticeability of HWLs and perceived harm of current versus standard packs. RESULTS Most groups found bright colours, 'brand owner' portrait imagery, and strong, sturdy pack material of current packs attractive. Many of the same features increased perceived attractiveness of the standard packs. Pictorial HWLs on the standard packs appeared larger and increased the visibility and noticeability of HWLs compared with current packs. Lack of HWLs or limited visibility of HWL due to discolouration contributed to lower levels of perceived harm of the current packs. In contrast, HWL prominence and placement on both sides of the standard pack increased perceived harm of standard packs. CONCLUSION The findings suggest a standard shape and size for SLT sold in Bangladesh, coupled with proper implementation of HWLs per the law, could improve HWL noticeability and increase harm perceptions. Additional plain packaging policies that also standardise pack colour may be required to reduce attractive colours and branding.
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Affiliation(s)
- Lauren Czaplicki
- Institute for Global Tobacco Control, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Sejal Saraf
- Institute for Global Tobacco Control, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Laura Kroart
- Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | | | - Joanna E Cohen
- Institute for Global Tobacco Control, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
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Barker HE, Czaplicki L, Cui Y, Shen R, Nian Q, Xie M, Cohen JE. Exposure to and Appeal of Tobacco Ads and Displays in China: A Qualitative Exploration of Chinese Youth Perceptions. Nicotine Tob Res 2024; 26:427-434. [PMID: 37788378 PMCID: PMC10959156 DOI: 10.1093/ntr/ntad192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 09/15/2023] [Accepted: 09/29/2023] [Indexed: 10/05/2023]
Abstract
INTRODUCTION Adolescents are uniquely vulnerable to nicotine addiction, and smoking is common among male adolescents in China. Although China implemented a ban on cigarette and e-cigarette advertising in public places, Chinese youth remain exposed to this marketing, which may contribute to future use. AIMS AND METHODS From December 2021 to January 2022, we conducted 20 online focus group discussions with 119 adolescents in 10 Chinese cities to explore sources of tobacco marketing exposure, defined as exposure to cigarette and e-cigarette ads and product displays, and what features made marketing attractive. RESULTS All groups discussed exposure to tobacco ads/displays in public places, including locations near their home or school. Nearly all groups discussed that exposure to online tobacco ads was common, particularly exposure to e-cigarette commercial ads and posts made by classmates or friends selling e-cigarettes. Most groups identified how eye-catching colors, imagery, product packaging, and price promotions featured in e-cigarette ads/displays attracted their attention. CONCLUSIONS Results suggest Chinese adolescents are exposed to cigarette and e-cigarette ads and displays, many of which are placed in youth-friendly locations and contain youth-appealing features. IMPLICATIONS Only a handful of studies have examined the influence of cigarette and e-cigarette advertising on youth in the context of China. Prior research has established the relationship between youth exposure to tobacco marketing and increased susceptibility to future use. Our findings emphasize the importance of effectively enforcing and expanding restrictions on cigarette and e-cigarette marketing in order to protect youth from exposure and future smoking/vaping initiation.
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Affiliation(s)
- Hannah E Barker
- Institute for Global Tobacco Control, Department of Health, Behavior and Society, Johns Hopkins Bloomberg Schools of Public Health, Baltimore, MD, USA
| | - Lauren Czaplicki
- Institute for Global Tobacco Control, Department of Health, Behavior and Society, Johns Hopkins Bloomberg Schools of Public Health, Baltimore, MD, USA
| | - Yuxian Cui
- Institute for Global Tobacco Control, Department of Health, Behavior and Society, Johns Hopkins Bloomberg Schools of Public Health, Baltimore, MD, USA
| | - Rachel Shen
- Rising Sun Marketing Research and Consulting, Shanghai, People’s Republic of China
| | - Qinghua Nian
- Institute for Global Tobacco Control, Department of Health, Behavior and Society, Johns Hopkins Bloomberg Schools of Public Health, Baltimore, MD, USA
| | - Marn Xie
- Rising Sun Marketing Research and Consulting, Shanghai, People’s Republic of China
| | - Joanna E Cohen
- Institute for Global Tobacco Control, Department of Health, Behavior and Society, Johns Hopkins Bloomberg Schools of Public Health, Baltimore, MD, USA
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Edwards R, Thomas L, Stanley J, Hoek J. New Zealand adolescents' responses to plain packaging and new pictorial warning labels: Repeat cross-sectional survey analysis. Aust N Z J Public Health 2023; 47:100066. [PMID: 37302905 DOI: 10.1016/j.anzjph.2023.100066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 04/17/2023] [Accepted: 04/28/2023] [Indexed: 06/13/2023] Open
Abstract
OBJECTIVE This article aims to examine the impact on adolescents of New Zealand's 2018 legislation introducing plain (standardised) packaging and enhanced pictorial warning labels (PWLs). METHODS Data came from Year 10 (14-15 years old) students in the 2016 (2,884 participants) and 2018 (2,689 participants) Youth Insights Surveys conducted 2 years before and immediately after legislation implementation. We used binary and ordinal logistic regression to investigate changes in brand awareness and preference, brand and pack appeal, and PWL salience and impact. RESULTS The proportion of all participants, and ever, ex/experimental and current smokers who could name one or five tobacco product brands decreased in 2018. There was a modest and nonstatistically significant decrease in the proportion of current smokers citing brand name and image, and a larger decrease in the proportion stating perceived harm to health, influenced preferred brand choice. Having a preferred brand among current smokers and pack appeal, and PWL salience and impact among ex/experimental and current smokers were largely unchanged. CONCLUSIONS We found preliminary evidence that plain packaging and enhanced PWLs reduced tobacco brand awareness and salience, and misperceptions about tobacco brand harmfulness. Data collection occurred shortly after implementation. Additional studies are required to assess longer term impacts of these interventions. PUBLIC HEALTH IMPLICATIONS The findings complement existing evidence documenting the impact of plain packaging and PWLs on adolescents. Given limitations due to the proximity of the 2018 survey to legislation implementation, further studies with longer follow-up are required.
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Affiliation(s)
- Richard Edwards
- Department of Public Health, University of Otago, Wellington, New Zealand.
| | - Lathan Thomas
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - James Stanley
- Dean's Department, University of Otago, Wellington, New Zealand
| | - Janet Hoek
- Department of Public Health, University of Otago, Wellington, New Zealand
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Kyriakos CN, Zatoński MZ, Filippidis FT. Flavour capsule cigarette use and perceptions: a systematic review. Tob Control 2023; 32:e83-e94. [PMID: 34607888 PMCID: PMC10086486 DOI: 10.1136/tobaccocontrol-2021-056837] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 09/01/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVE This systematic review on flavour capsule cigarettes aims to examine prevalence, correlates of use, behaviours and perceptions of these products globally. DATA SOURCES A search of original, peer-reviewed research without restrictions in publication year, population, study design or language, using a combination of cigarette and capsule terms was conducted across four databases (Medline, Embase, Web of Science and Scopus), indexed until 30 April 2021. STUDY SELECTION Studies were included if they presented original, human subjects research on flavour capsule cigarettes. DATA EXTRACTION Two authors independently extracted data on main outcome results and assessed risk of bias using a validated quality assessment tool (QATSDD). DATA SYNTHESIS Of 842 unduplicated database records and four studies from citation searching screened, 20 studies were included in the review. Studies reported data from 2009 to 2019 across eight countries, the majority of which used cross-sectional or focus group study designs. Current capsule use among smokers was highest in Chile and Mexico (40%) and was associated with younger age, and in some countries, with being female. Capsule cigarettes are perceived as tasting better, being smoother on the throat, more fun to smoke, and more attractive compared with non-capsule cigarettes, particularly among susceptible non-smokers and non-daily smokers. CONCLUSION Findings call for the adoption of comprehensive tobacco control policies that account for flavour capsules and similar iterations, which can increase appeal through flavours and innovative features. Continued monitoring and research of these products is critical, with particular attention to low-income and middle-income countries, which make up a disproportionately larger share of the capsule market.
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Affiliation(s)
- Christina N Kyriakos
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
| | - Mateusz Zygmunt Zatoński
- Tobacco Control Research Group, Department for Health, University of Bath, Bath, UK
- European Observatory of Health Inequalities, Calisia University, Kalisz, Poland
| | - Filippos T Filippidis
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
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Kyriakos CN, Zatoński MZ, Filippidis FT. Marketing of flavour capsule cigarettes: a systematic review. Tob Control 2023; 32:e103-e112. [PMID: 35042725 DOI: 10.1136/tobaccocontrol-2021-057082] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 01/05/2022] [Indexed: 12/11/2022]
Abstract
OBJECTIVE This systematic review aims to identify marketing elements of flavour capsule variants (FCVs), cigarettes that release flavour when a capsule(s) embedded in the filter is crushed. DATA SOURCES A search of original research without restrictions in publication year, population, study design or language using a combination of cigarette and capsule terms was conducted across four databases (Medline, Embase, Web of Science and Scopus), indexed until 13 December 2021, along with a citation search. STUDY SELECTION Studies were included if they presented original research relevant to marketing features of FCVs. DATA EXTRACTION One author performed data extraction and coded outcomes based on '4Ps' of marketing mix theory: product, place, price and promotion. The second author conducted a cross-check. DATA SYNTHESIS Of 2436 unduplicated database records and 30 records from other sources, 40 studies were included in the review. Studies were published between 2009 and 2021. Study methodologies primarily included content analysis of cigarette packs/sticks, review of tobacco industry documents and content analysis of advertising information. Findings suggest FCVs are marketed using a mix of strategies, particularly characterised by product innovation, timing market launches around tobacco policies, point-of-sale advertising and packaging to communicate a high-tech, customisable and flavourful product. CONCLUSION Findings illuminate the marketing strategies of FCVs that are likely driving their global growth, particularly among young people and in low and middle-income countries. Comprehensive tobacco control regulations are needed to close loopholes and curb industry efforts to circumvent existing policies in order to mitigate uptake of FCVs and other product innovations.
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Affiliation(s)
- Christina N Kyriakos
- Department of Primary Care and Public Health, Imperial College London School of Public Health, London, UK
| | - Mateusz Zygmunt Zatoński
- Department for Health, University of Bath, Bath, UK
- European Observatory of Health Inequalities, Calisia University, Kalisz, Poland
| | - Filippos T Filippidis
- Department of Primary Care and Public Health, Imperial College London School of Public Health, London, UK
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Davidson M, Al-Hamdani M. An examination of the social perceptions and vaping preferences of young electronic nicotine delivery system users. Front Public Health 2023; 11:1150368. [PMID: 37151590 PMCID: PMC10162018 DOI: 10.3389/fpubh.2023.1150368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 03/08/2023] [Indexed: 05/09/2023] Open
Abstract
Background Little research has been conducted on social aspects and preferences of electronic nicotine delivery system (ENDS) use among young ENDS users, and none have examined differences in these aspects and preferences by gender and tobacco use status. Methods A total of 558 young regular vapers (ages 16-24; vaped at least once a week for the last 3 months) from Nova Scotia were recruited to complete a demographic and vaping questionnaire. A 2 x 3 study design was used to compare participants on social aspects and vaping preferences based on gender (male or female) and tobacco use status (never, former, or current smoker). Chi-square tests were used to determine significant differences, and Bonferroni tests were used to assess over- and under-representation within significant variables. Results Current tobacco-using male vapers had a higher frequency of experiencing pressure to vape from friends and current employment as compared to females. Former and never tobacco-using male vapers had a higher frequency of parental awareness of their vaping behavior than females. Former tobacco-using female vapers had a higher frequency of being influenced to vape by others they know on social media than males. Both never and former tobacco-using females reported a higher frequency of exposure to vaping content on social media than males. Never tobacco-using female vapers preferred vape pen devices relative to males. Conclusions Important gender differences by tobacco use status exist and demonstrate differential patterns of social influence for ENDS use and their experiences within this demographic.
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Affiliation(s)
- Myles Davidson
- Department of Psychology, Saint Mary's University, Halifax, NS, Canada
| | - Mohammed Al-Hamdani
- Department of Public Health, College of Health Science, QU Health, Qatar University, Doha, Qatar
- *Correspondence: Mohammed Al-Hamdani
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Kowitt SD, Yockey RA, Lee JGL, Jarman KL, Gourdet CK, Ranney LM. The Impact of Cannabis Packaging Characteristics on Perceptions and Intentions. Am J Prev Med 2022; 63:751-759. [PMID: 35835626 PMCID: PMC9588761 DOI: 10.1016/j.amepre.2022.04.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 04/26/2022] [Accepted: 04/28/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION As cannabis increasingly becomes a consumer product in the U.S., its product packaging has become critically important to regulators. This study examined the influence of recreational cannabis packaging characteristics. METHODS Five online between-subjects experiments were conducted in April 2021, and data were analyzed in May 2021-July 2021. Experiments randomized participants to view different (1) types of cannabis, (2) visual displays of tetrahydrocannabinol content, (3) cannabis packages designed around brand personality research, (4) health warnings, and (5) health claims. Outcomes included cognitive, affective, and behavioral responses. RESULTS A total of 841 adults from the U.S. (49% male, 50% young adults, 44% White, 17% Hispanic) were included in the study. Edible gummies were perceived as healthier (β=0.32, 95% CI=0.03, 0.62), less grown up (β= -0.58, 95% CI= -0.86, -0.28), and more socially acceptable to consume (β=0.30, 95% CI=0.01, 0.59) than cannabis concentrate in a medical dropper. Participants also had more interest in trying edible gummies (β=1.33, 95% CI=1.04, 1.62) and trying a free sample (β=1.30, 95% CI=1.01, 1.60) than trying cannabis concentrate. Cannabis packages with a helps-you-relax health claim elicited more happy (β=0.34, 95% CI=0.04, 0.64) and good (β=0.37, 95% CI=0.07, 0.67) feelings than cannabis packages without this claim. Minimal effects were found for visual displays of tetrahydrocannabinol content and health warnings. CONCLUSIONS Edibles are a unique type of cannabis that should be given special consideration under state laws, and lawmakers should consider limiting and governing the use of both implicit and explicit health claims on recreational cannabis packages when implementing laws.
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Affiliation(s)
- Sarah D Kowitt
- Department of Family Medicine, UNC School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
| | - R Andrew Yockey
- Department of Biostatistics and Epidemiology, The University of North Texas Health Science Center at Fort Worth, Fort Worth, Texas
| | - Joseph G L Lee
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, North Carolina
| | - Kristen L Jarman
- Department of Family Medicine, UNC School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | | | - Leah M Ranney
- Department of Family Medicine, UNC School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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van der Eijk Y, Yang AY. Tobacco industry marketing adaptations to Singapore plain packaging. Tob Control 2022; 31:744-749. [PMID: 33980723 DOI: 10.1136/tobaccocontrol-2020-056324] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 01/28/2021] [Accepted: 02/23/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Singapore has implemented plain packaging, a measure that strips all colours, logos and branding elements from tobacco packs. In other countries, tobacco companies responded to plain packaging with a variety of marketing tactics. Our goal was to describe the tobacco industry's marketing adaptations to Singapore plain packaging. METHODS Qualitative analysis of 378 cigarette packs sampled from Singapore retailers in March 2019, March 2020 and January 2021, 12 months prior to, 2 weeks prior to and 6 months after plain packaging phase-in, respectively. For each pack, we collected descriptive information on the brand and variant name, pack and stick dimensions, pack shape, differentiating features and distinctive scents, as well as photographic data of the pack, cigarette sticks and any distinct features. We used the March 2019 collection as our baseline dataset, and March 2020 and January 2021 collections as comparison datasets to examine changes in tobacco marketing strategies just before and after plain packaging phase-in. RESULTS Around Singapore's plain packaging phase-in, tobacco companies launched variants with flavour capsules, novelty filter features and new flavours and used more descriptive variant names reflecting the variant's colour coding or market positioning. Tobacco companies revamped some existing variants, often with Japanese marketing themes to convey a more premium product image. After plain packaging, tobacco companies used longer packs and variations in stick length, filter length and foil texture to further differentiate products. CONCLUSIONS Following plain packaging in Singapore, tobacco companies rely increasingly on nomenclature and the cigarette stick itself to market and differentiate products.
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Affiliation(s)
- Yvette van der Eijk
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Adonsia Yating Yang
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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Grilo G, Lagasse LP, Cohen JE, Moran MB, Reynales-Shigematsu LM, Smith KC. "It's all About the Colors:" How do Mexico City Youth Perceive Cigarette Pack Design. Int J Public Health 2021; 66:585434. [PMID: 34744557 PMCID: PMC8565279 DOI: 10.3389/ijph.2021.585434] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 01/12/2021] [Indexed: 11/21/2022] Open
Abstract
Objectives: Cigarette packs are relevant to branding strategies, designed to appeal to specific groups. There is little research on how pack features increase product appeal among key constituents such as youth in low- and middle-income countries. Methods: We conducted 10 focus group discussions (FGDs) with adolescents and 5 FGDs with young adult smokers in Mexico City, separated by age, gender, smoking, and socioeconomic status. Participants separated 23 cigarette packs into “appealing” and “unappealing” groups, and were asked to explain their decisions, describing the features that supported their views. FGDs were video-recorded, transcribed in Spanish, translated into English, and subjected to thematic analysis. Results: Pack groupings did not differ greatly across FGDs; bold, contrasting colors and elements communicating flavor and promotion increased cigarette pack appeal and desire to try. Participants perceived packs with these features to be used by and designed for youth, like themselves. Conclusion: Our findings reinforce the importance of packaging design in attracting new consumers and maintaining current ones. Mexico should consider stronger tobacco advertising policies that include packaging color and depiction of flavor to reduce product appeal.
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Affiliation(s)
- Graziele Grilo
- Department of Health, Behavior and Society, Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Lisa P Lagasse
- Department of Health, Behavior and Society, Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Joanna E Cohen
- Department of Health, Behavior and Society, Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Meghan B Moran
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Luz Myriam Reynales-Shigematsu
- Departamento de Prevención y Control de Tabaquismo, Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - Katherine C Smith
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
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The Effect of Cigarillo Packaging Characteristics on Young Adult Perceptions and Intentions: An Experimental Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084330. [PMID: 33921793 PMCID: PMC8073489 DOI: 10.3390/ijerph18084330] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/13/2021] [Accepted: 04/15/2021] [Indexed: 02/07/2023]
Abstract
Research demonstrates that characteristics of cigarette packaging influence consumer product perceptions, yet the current literature on the impact of cigar packaging is limited. This study aims to examine how different cigarillo packaging features influence young adult cigar smokers’ perceptions. In 2016, we recruited past-year cigar users aged 18–34 from Amazon Mechanical Turk (N = 1260). We utilized a 2 × 2 × 3 × 2 between-subjects factorial design, randomly assigning participants to view one of 24 images of a cigarillo package that varied by brand (Black & Mild vs. Swisher Sweets), brand name (full vs. abbreviated), color (brown vs. green vs. purple), and price promotion (present vs. absent). Participants rated the product on several perceptions and purchase intentions, and they reported on cigar use and demographics. Overall, color and brand name influenced perceptions, but effects varied by brand. For Swisher Sweets, only price promotions influenced perceptions (e.g., taste, use for marijuana); for Black & Mild, all packaging features influenced perceptions (e.g., harshness, tobacco quality), and price promotions increased purchase intentions. Our findings also raise questions that product features may interact with one another, with certain features, such as color, overpowering other attributes. More research is needed to understand the impact of other packaging features, such as warning labels, on product perceptions across a variety of brands.
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Leos-Toro C, Fong GT, Hammond D. The efficacy of health warnings and package branding on perceptions of cannabis products among youth and young adults. Drug Alcohol Rev 2021; 40:637-646. [PMID: 33539597 DOI: 10.1111/dar.13240] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 11/30/2020] [Accepted: 12/02/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Little empirical evidence exists about the efficacy of labelling and marketing restrictions in a regulated cannabis market. This study examined perceptions of cannabis product packaging designs, health warning labels (HWL) and perceptions of packs displaying brand imagery and leading descriptors on measures of appeal, and perceived consumer attributes. METHODS An online experimental survey of Canadian cannabis users and non-users (n = 870) aged 16-30 years containing eight between-group experiments was conducted in October 2017. Primary outcomes were appeal and perceived consumer attributes of cannabis product packaging, including the likelihood of being younger, female, fashionable, health conscious and likely to go out and party. RESULTS When cannabis product branding was present, respondents were more likely (P = 0.027) to report greater appeal than when branding was absent. When an HWL was present, respondents were less likely (P = 0.010) to report greater appeal than when absent. The presence of a celebrity sponsor (P < 0.001), music references (P < 0.001) or party references (P < 0.001) increased the likelihood that respondents perceived the product as targeted at someone younger, and a party lifestyle. Differences by cannabis use status were observed across experiments; those who had used were more likely to find branding elements appealing. DISCUSSION AND CONCLUSIONS The findings demonstrate that brand imagery on cannabis packaging can promote lifestyle associations and increase the appeal of cannabis products among young people. Plain/standardised packs displaying HWLs were perceived as less appealing than packs with branding or without HWLs. Lifestyle associations can be communicated through brand imagery on cannabis packaging.
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Affiliation(s)
- Cesar Leos-Toro
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada
| | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Waterloo, Canada.,Ontario Institute for Cancer Research, MaRS Centre, Toronto, Canada
| | - David Hammond
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada
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Xue W, Zhang C, Wang K, Guang M, Chen Z, Lu H, Feng X, Xu Z, Wang L. Tobacco industry strategies to prevent a ban on the display of tobacco products and changes to health warning labels on the packaging in Brazil. Tob Prev Cessat 2020. [PMID: 33069530 PMCID: PMC7737563 DOI: 10.18332/tpc/128321] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Through packaging and marketing, the tobacco industry (TI) is able to increase the appeal of its products and reduce the effectiveness of health warning labels (HWLs). Based on scientific evidence and the principles of the WHO Framework Convention on Tobacco Control (FCTC), ANVISA, the Brazilian surveillance and regulatory agency, conducted a process to implement new regulations at the point-of-sale (POS), including a display ban, and new parameters to HWLs. In order to prevent the regulation from entering into force, the TI strategically used several approaches. The objective of this study was to analyze the approaches used by the TI to prevent the implementation of a tobacco display ban and new requirements to HWLs. METHODS In order to identify and describe TI’s approaches, we reviewed several sources of documentation, including published articles, reports, legislation, TI documents, and media stories. RESULTS Well-known, reported approaches were used by the TI in order to prevent the implementation of new regulations. These approaches included political interference, litigation, and funding studies to question tobacco control measures as previously reported in Brazil and other countries. CONCLUSIONS Using established approaches, the TI successfully stopped the implementation of a tobacco display ban and new parameters to HWLs in Brazil.
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Affiliation(s)
- Wei Xue
- The Key Laboratory of Industrial Biotechnology, Ministry of Education, Jiangnan University, Lihu Road 1800, Wuxi 214122, China; National Engineering Laboratory for Cereal Fermentation Technology, Jiangnan University, Lihu Road 1800, Wuxi 214122, China; Jiangsu Provincial Research Center for Bioactive Product Processing Technology, Jiangnan University, Lihu Road 1800, Wuxi 214122, China
| | - Congnan Zhang
- The Key Laboratory of Industrial Biotechnology, Ministry of Education, Jiangnan University, Lihu Road 1800, Wuxi 214122, China; National Engineering Laboratory for Cereal Fermentation Technology, Jiangnan University, Lihu Road 1800, Wuxi 214122, China; Jiangsu Provincial Research Center for Bioactive Product Processing Technology, Jiangnan University, Lihu Road 1800, Wuxi 214122, China; Jiangsu Nongken Agricultural Development Co., Ltd., Hengshan Road 136, Nanjing 210019, China
| | - Kang Wang
- The Key Laboratory of Industrial Biotechnology, Ministry of Education, Jiangnan University, Lihu Road 1800, Wuxi 214122, China; National Engineering Laboratory for Cereal Fermentation Technology, Jiangnan University, Lihu Road 1800, Wuxi 214122, China; Jiangsu Provincial Research Center for Bioactive Product Processing Technology, Jiangnan University, Lihu Road 1800, Wuxi 214122, China; Jiangsu Nongken Agricultural Development Co., Ltd., Hengshan Road 136, Nanjing 210019, China
| | - Min Guang
- Grain and Oil Food Inspection Center of Wuhan, Jianghan Road 7, Wuhani 430000, China
| | - Zhengxing Chen
- The Key Laboratory of Industrial Biotechnology, Ministry of Education, Jiangnan University, Lihu Road 1800, Wuxi 214122, China; National Engineering Laboratory for Cereal Fermentation Technology, Jiangnan University, Lihu Road 1800, Wuxi 214122, China; Jiangsu Provincial Research Center for Bioactive Product Processing Technology, Jiangnan University, Lihu Road 1800, Wuxi 214122, China
| | - Hui Lu
- Jiangsu Nongken Agricultural Development Co., Ltd., Hengshan Road 136, Nanjing 210019, China
| | - Xiaoyu Feng
- Jiangsu Nongken Agricultural Development Co., Ltd., Hengshan Road 136, Nanjing 210019, China
| | - Zhicun Xu
- Jiangsu Nongken Agricultural Development Co., Ltd., Hengshan Road 136, Nanjing 210019, China
| | - Li Wang
- The Key Laboratory of Industrial Biotechnology, Ministry of Education, Jiangnan University, Lihu Road 1800, Wuxi 214122, China; National Engineering Laboratory for Cereal Fermentation Technology, Jiangnan University, Lihu Road 1800, Wuxi 214122, China; Jiangsu Provincial Research Center for Bioactive Product Processing Technology, Jiangnan University, Lihu Road 1800, Wuxi 214122, China.
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Mitchell D, Critchlow N, Moodie C, Bauld L. Reactions to Standardized Cigarette Packs With Varying Structural Designs, and the Association With Smoking Susceptibility: A Postimplementation Cross-Sectional Survey With Never-Smoking Adolescents in Scotland. Nicotine Tob Res 2020; 22:2041-2050. [PMID: 32577739 DOI: 10.1093/ntr/ntaa109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 06/15/2020] [Indexed: 11/14/2022]
Abstract
INTRODUCTION From May 20, 2017, cigarettes in the United Kingdom must be sold in standardized (plain) packaging. We explore postimplementation reactions to standardized cigarette packaging among never-smokers in Scotland, whether reactions vary in relation to permitted variations in pack structure, and whether reactions are associated with susceptibility. AIMS AND METHODS A cross-sectional survey with 12-17-year-old never-smokers (n = 507) in Scotland, conducted November 2017-November 2018. Participants were shown one "regular" standardized cigarette pack (flip-top lid and straight-edged pack, similar to designs in Australia) and three standardized packs with varied pack structures (beveled-edges, slim pack, and shoulder box), which are permitted postimplementation in the United Kingdom. Participants rated each pack on eight five-point reaction measures (eg, attractiveness). Participants also indicated which pack, if any, they would choose. Smoking susceptibility was the outcome. RESULTS The mean reaction scores for all four packs were mostly negative, however the shoulder box was consistently rated less negatively than the regular, slim, or beveled-edge packs. Most participants (87%) said they would not select any of the four packs, although susceptible participants were more likely to select one than nonsusceptible participants (25% vs. 7%; χ 2 = 29.70; p < .001). For all four packs, not finding them off-putting was associated with susceptibility (Adjusted Odds Ratio range: 2.73-3.69), albeit only a minority of adolescents did not find each pack off-putting. CONCLUSIONS Adolescents have negative reactions to the standardized cigarette packs implemented in the United Kingdom, albeit permitted variations in structure can reduce the extent of negativity. Most reactions to standardized packaging had no association with susceptibility. IMPLICATIONS We provide the first empirical evidence that adolescents find the standardized cigarette packs implemented in the United Kingdom unappealing and that most pack reactions have no association with susceptibility among never-smokers, with the exception of the minority who did not think that they would put them off smoking. This suggests that the legislation is achieving one of its primary aims, to reduce the appeal of packaging. That permitted variations in pack structure (eg, shoulder boxes) somewhat reduce negative reactions suggests that the United Kingdom, and other countries introducing similar legislation, should ensure that all aspects of pack design are fully standardized.
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Affiliation(s)
- Danielle Mitchell
- Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirlingshire, UK
| | - Nathan Critchlow
- Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirlingshire, UK
| | - Crawford Moodie
- Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirlingshire, UK
| | - Linda Bauld
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Stirlingshire, UK
- SPECTRUM Consortium, University of Edinburgh, Edinburgh, UK
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van Schalkwyk MCI, McKee M, Been JV, Millett C, Filippidis FT. Size matters: An analysis of cigarette pack sizes across 23 European Union countries using Euromonitor data, 2006 to 2017. PLoS One 2020; 15:e0237513. [PMID: 32790798 PMCID: PMC7425903 DOI: 10.1371/journal.pone.0237513] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 07/28/2020] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION The tobacco industry (TI) has used small cigarette pack sizes to encourage brand-switching and consumption, and to mitigate the impacts of tobacco tax increases. Since 2016, the European Union (EU) Tobacco Products Directive (TPD) specifies a minimum pack size of 20 cigarettes. We examined cigarette pack sizes in the EU and whether pack size composition differed between cheap and expensive price segments, as well as the impact of the revised TPD. METHODS We conducted a longitudinal analysis of pricing data from 23 EU countries between 2006-2017. We examined pack sizes over time to assess the impact of the TPD, differences in pack size composition between cheap and expensive price segments, and compared gaps in median prices between products using actual and 'expected' prices (price if all packs contained 20 sticks). RESULTS Cigarette pack sizes changed over time, across the EU. The distribution of pack sizes varied between price segments, with small pack sizes especially frequent in the cheap segment of the cigarette market, but this varied over time and across countries. Packs of <20 cigarettes almost disappeared from the data samples after implementation of the TPD. CONCLUSION Implementation of the TPD appears to have virtually eliminated packs with <20 cigarettes, restricting their use by the TI. Our analysis suggests pack sizes have been used differentially across the EU. Country-level analyses on the industry's use of pack sizes, consumer responses, and evaluations of restricting certain pack sizes are needed to confirm our findings and strengthen policy.
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Affiliation(s)
- May C. I. van Schalkwyk
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, United Kingdom
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
- * E-mail:
| | - Martin McKee
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jasper V. Been
- Department of Paediatrics, Division of Neonatology, Erasmus MC – Sophia Children’s Hospital, University Medical Centre Rotterdam, Rotterdam, Netherlands
- Department of Public Health, Erasmus MC – Sophia Children’s Hospital, University Medical Centre Rotterdam, Rotterdam, Netherlands
- Usher Institute, The University of Edinburgh, Edinburgh, United Kingdom
| | - Christopher Millett
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, United Kingdom
| | - Filippos T. Filippidis
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, United Kingdom
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Barrientos-Gutierrez I, Islam F, Cho YJ, Salloum RG, Louviere J, Arillo-Santillán E, Reynales-Shigematsu LM, Barnoya J, Saenz de Miera Juarez B, Hardin J, Thrasher JF. Assessing cigarette packaging and labelling policy effects on early adolescents: results from a discrete choice experiment. Tob Control 2020; 30:tobaccocontrol-2019-055463. [PMID: 32665358 PMCID: PMC7855531 DOI: 10.1136/tobaccocontrol-2019-055463] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 05/15/2020] [Accepted: 05/19/2020] [Indexed: 01/20/2023]
Abstract
INTRODUCTION Cigarette packaging is a primary channel for tobacco advertising, particularly in countries where traditional channels are restricted. The current study evaluated the independent and interactive effects of cigarette packaging and health warning label (HWL) characteristics on perceived appeal of cigarette brands for early adolescents in Mexico. METHODS A discrete choice experiment (DCE) was conducted with early adolescents, aged 12-14 years (n=4251). The DCE involved a 3×25 design with six attributes: brand (Marlboro, Pall Mall, Camel), tobacco flavour (regular, menthol), flavour capsule (none, 1 or 2 capsules), presence of descriptive terms, branding (vs plain packaging), HWL size (30%, 75%) and HWL content (emphysema vs mouth cancer). Participants viewed eight sets of three cigarette packs and selected a pack in each set that: (1) is most/least attractive, (2) they are most/least interested in trying or (3) is most/least harmful, with a no difference option. RESULTS Participants perceived packs as less attractive, less interesting to try and more harmful if they had plain packaging or had larger HWLs, with the effect being most pronounced when plain packaging is combined with larger HWLs. For attractiveness, plain packaging had the biggest influence on choice (43%), followed by HWL size (19%). Interest in trying was most influenced by brand name (34%), followed by plain packaging (29%). Perceived harm was most influenced by brand name (30%), followed by HWL size (29%). CONCLUSION Increasing the size of HWLs and implementing plain packaging appear to reduce the appeal of cigarettes to early adolescents. Countries should adopt these policies to minimise the impact of tobacco marketing.
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Affiliation(s)
| | - Farahnaz Islam
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina, USA
| | - Yoo Jin Cho
- Department of Health Promotion, Education and Behavior, University of South Carolina, Columbia, South Carolina, USA
| | | | - Jordan Louviere
- School of Marketing, University of South Australia, Adelaide, South Australia, Australia
| | - Edna Arillo-Santillán
- Tobacco Research Department, National Institute of Public Health, Cuernavaca, Mexico
| | | | - Joaquin Barnoya
- Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis, St. Louis, Mississippi, USA
| | | | - James Hardin
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina, USA
| | - James F Thrasher
- Tobacco Research Department, National Institute of Public Health, Cuernavaca, Mexico
- Department of Health Promotion, Education and Behavior, University of South Carolina, Columbia, South Carolina, USA
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Kyriakos CN, Driezen P, Girvalaki C, Hitchman SC, Filippidis FT, Gravely S, Balmford J, Nikitara K, Mons U, Fernández E, Przewoźniak K, Trofor AC, Demjén T, Zatoński W, Tountas Y, Fong GT, Vardavas CI. Awareness and correlates of noticing changes to cigarette packaging design after implementation of the European Tobacco Products Directive: findings from the EUREST-PLUS ITC Europe Surveys. Eur J Public Health 2020; 30:iii98-iii107. [PMID: 32918819 PMCID: PMC7526785 DOI: 10.1093/eurpub/ckaa057] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The European Tobacco Products Directive (TPD), which went into effect in May 2016, regulates packaging design and labelling of cigarettes and roll-your-own (RYO) tobacco. The aim of the current study was to examine whether smokers and recent quitters in six European Union (EU) countries (Germany, Greece, Hungary, Poland, Romania and Spain) reported noticing TPD-related changes to packaging, and correlates of noticing these changes. METHODS Cross-sectional data from the Wave 2 of the ITC 6 European Country Survey in 2018 after implementation of the TPD. Bivariate analyses included adult smokers (n = 5597) and recent quitters (n = 412). Adjusted logistic regression analyses were restricted to the subset of current smokers (n = 5597) and conducted using SAS-callable SUDAAN. RESULTS Over half of smokers (58.2%) and 30% of quitters noticed at least one of five types of TPD-related pack changes. Over one-quarter of all respondents noticed changes to health warnings (30.0%), standardized openings (27.7%), minimum pack unit size (27.9%), and the removal of tar, nicotine and carbon monoxide information (26.7%) on packaging. Cross-country differences were observed across all measures, with noticing all pack changes markedly lower in Spain than the other countries. Correlates of noticing specific pack changes included sociodemographic characteristics, smoking behaviours and related to packaging. CONCLUSIONS This is one of the first cross-country studies to examine the extent to which TPD changes to cigarette and RYO tobacco packaging are being noticed by smokers and recent quitters. Findings indicate that the majority of smokers noticed at least one type of pack change, but this varied across countries and sub-populations.
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Affiliation(s)
- Christina N Kyriakos
- Laboratory of Toxicology, School of Medicine, University of Crete, Heraklion, Greece
- European Network for Smoking and Tobacco Prevention, Brussels, Belgium
| | - Pete Driezen
- Department of Psychology, University of Waterloo, Waterloo, Canada
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada
| | - Charis Girvalaki
- Laboratory of Toxicology, School of Medicine, University of Crete, Heraklion, Greece
- European Network for Smoking and Tobacco Prevention, Brussels, Belgium
| | | | - Filippos T Filippidis
- Department of Primary Care and Public Health, Imperial College London, London, UK
- Center for Health Services Research, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Shannon Gravely
- Department of Psychology, University of Waterloo, Waterloo, Canada
| | - James Balmford
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg im Breisgau, Germany
| | - Katerina Nikitara
- European Network for Smoking and Tobacco Prevention, Brussels, Belgium
| | - Ute Mons
- Cancer Prevention Unit and WHO Collaborating Centre for Tobacco Control, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Esteve Fernández
- Tobacco Control Unit, Catalan Institute of Oncology (ICO), L'Hospitalet de Llobregat (Barcelona), Catalonia, Spain
- Tobacco Control Research Group, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Catalonia, Spain
- School of Medicine and Health Sciences, Bellvitge Campus, Universitat de Barcelona, L'Hospitalet de Llobregat, Catalonia, Spain
- Consortium for Biomedical Research in Respiratory Diseases (CIBER of Respiratory Diseases, CIBERES), Madrid, Spain
| | - Krzysztof Przewoźniak
- Health Promotion Foundation, Warsaw, Poland
- Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
- Collegium Civitas, Warsaw, Poland
| | - Antigona C Trofor
- University of Medicine and Pharmacy 'Grigore T. Popa' Iasi, Iasi, Romania
- Aer Pur Romania, Bucharest, Romania
| | - Tibor Demjén
- Smoking or Health Hungarian Foundation, Budapest, Hungary
| | - Witold Zatoński
- Health Promotion Foundation, Warsaw, Poland
- European Observatory of Health Inequalities, President Stanislaw, Wojciechowski State University of Applied Sciences, Kalisz, Poland
| | - Yannis Tountas
- Center for Health Services Research, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Geoffrey T Fong
- Laboratory of Toxicology, School of Medicine, University of Crete, Heraklion, Greece
- Department of Psychology, University of Waterloo, Waterloo, Canada
- Ontario Institute for Cancer Research, Toronto, ON, Canada
| | - Constantine I Vardavas
- Laboratory of Toxicology, School of Medicine, University of Crete, Heraklion, Greece
- European Network for Smoking and Tobacco Prevention, Brussels, Belgium
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18
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Kahnert S, Driezen P, Balmford J, Kyriakos CN, Aleyan S, Hitchman SC, Nogueira S, Demjén T, Fernández E, Katsaounou PA, Trofor AC, Przewoźniak K, Zatoński WA, Fong GT, Vardavas CI, Mons U. Effectiveness of tobacco warning labels before and after implementation of the European Tobacco Products Directive-findings from the longitudinal EUREST-PLUS ITC Europe surveys. Eur J Public Health 2020; 30:iii84-iii90. [PMID: 32918822 PMCID: PMC7526774 DOI: 10.1093/eurpub/ckaa039] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Tobacco product packaging is a key part of marketing efforts to make tobacco use appealing. In contrast, large, prominent health warnings are intended to inform individuals about the risks of smoking. In the European Union, since May 2016, the Tobacco Products Directive 2014/40/EU (TPD2) requires tobacco product packages to carry combined health warnings consisting of a picture, a text warning and information on stop smoking services, covering 65% of the front and back of the packages. METHODS Key measures of warning label effectiveness (salience, cognitive reactions and behavioural reaction) before and after implementation of the TPD2, determinants of warning labels' effectiveness and country differences were examined in a longitudinal sample of 6011 adult smokers from Germany, Greece, Hungary, Poland, Romania and Spain (EUREST-PLUS Project) using longitudinal Generalized Estimating Equations (GEE) models. RESULTS In the pooled sample, the warning labels' effectiveness increased significantly over time in terms of salience (adjusted OR = 1.18; 95% CI: 1.03-1.35), while cognitive and behavioural reactions did not show clear increases. Generally, among women, more highly educated smokers and less addicted smokers, the effectiveness of warning labels tended to be higher. CONCLUSION We found an increase in salience, but no clear increases for cognitive and behavioural reactions to the new warning labels as required by the TPD2. While it is likely that our study underestimated the impact of the new pictorial warning labels, it provides evidence that health messages on tobacco packaging are more salient when supported by large pictures.
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Affiliation(s)
- Sarah Kahnert
- Cancer Prevention Unit and WHO Collaborating Centre for Tobacco Control, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Medical Faculty, Heidelberg University, Heidelberg, Germany
| | - Pete Driezen
- Department of Psychology, University of Waterloo, Waterloo, Canada
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - James Balmford
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg im Breisgau, Germany
| | - Christina N Kyriakos
- European Network for Smoking and Tobacco Prevention (ENSP), Brussels, Belgium
- School of Medicine, University of Crete, Heraklion, Greece
| | - Sarah Aleyan
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
- Department of Addictions, Institute of Psychiatry, Psychology & Neuroscience, King’s College London
| | - Sara C Hitchman
- Department of Addictions, Institute of Psychiatry, Psychology & Neuroscience, King’s College London
| | - Sarah Nogueira
- Cancer Epidemiology and Prevention Department, Catalan Institute of Oncology (ICO), L’Hospitalet de Llobregat, Spain
- Tobacco Control Unit, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Spain
- School of Medicine and Health Sciences, University of Barcelona (UB), Barcelona, Spain
- Consortium for Biomedical Research in Respiratory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain
| | - Tibor Demjén
- Smoking or Health Hungarian Foundation, Budapest, Hungary
| | - Esteve Fernández
- Cancer Epidemiology and Prevention Department, Catalan Institute of Oncology (ICO), L’Hospitalet de Llobregat, Spain
- Tobacco Control Unit, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Spain
- School of Medicine and Health Sciences, University of Barcelona (UB), Barcelona, Spain
- Consortium for Biomedical Research in Respiratory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain
| | - Paraskevi A Katsaounou
- First ICU Evaggelismos Hospital Athens, National and Kapodistrian University of Athens, Athens, Greece
- European Respiratory Society, Lausanne, Switzerland
| | - Antigona C Trofor
- University of Medicine and Pharmacy ‘Grigore T. Popa’ Iasi, Iasi, Romania
- Aer Pur Romania, Bucharest, Romania
| | - Krzysztof Przewoźniak
- Health Promotion Foundation, Warsaw, Poland
- Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
- Collegium Civitas, Warsaw, Poland
| | - Witold A Zatoński
- Health Promotion Foundation, Warsaw, Poland
- European Observatory of Health Inequalities, President Stanisław Wojciechowski State University of Applied Sciences, Kalisz, Poland
| | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Waterloo, Canada
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
- Ontario Institute for Cancer Research, Toronto, Canada
| | - Constantine I Vardavas
- European Network for Smoking and Tobacco Prevention (ENSP), Brussels, Belgium
- School of Medicine, University of Crete, Heraklion, Greece
- European Respiratory Society, Lausanne, Switzerland
| | - Ute Mons
- Cancer Prevention Unit and WHO Collaborating Centre for Tobacco Control, German Cancer Research Center (DKFZ), Heidelberg, Germany
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Wade WS, White K. The package as a weapon of influence: Changes to cigarette packaging design as a function of regulatory changes in Canada. Tob Prev Cessat 2020; 6:17. [PMID: 32548354 PMCID: PMC7291918 DOI: 10.18332/tpc/116744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 01/09/2020] [Accepted: 01/20/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Given existing regulations that ban the tobacco industry from engaging in traditional forms of advertising and require warning labels on cigarette packaging, we suggest that one response on the part of tobacco manufacturers has been to make alterations to design elements of cigarette packages themselves. The current research seeks to examine how cigarette manufacturers have altered elements of cigarette packaging in response to regulatory changes by the Government of Canada in 2011, which increased health warning sizes on cigarette packages from 50% of the principal display surface to 75%. METHODS Cigarette packages (n=1689) that had been on the market in Canada in the period 2001-2017 were examined and coded for package design elements including package innovation (size and package style), color (hue and saturation), and branding elements (use of iconography and variant names). Characteristics of pre-regulation packaging were then systematically compared to characteristics of post-regulation packaging. RESULTS Many of these packaging design elements, including package size and package style, primary and secondary hue, color saturation, use of variant label names, and use of iconography have systematically varied in response to regulatory changes in Canada. For example, we observed increases in the use of flip-top (vs slide and shell) packaging, the use of yellow, black and white as the focal color, incidence of color-themed variant names, and the use of female and crest-related logos. CONCLUSIONS The evidence suggests that many packaging design elements have varied systematically along with regulatory changes in Canada.
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Affiliation(s)
- Wade S Wade
- Marketing and Behavioral Sciences Department, Sauder School of Business, University of British Columbia, Vancouver, Canada
| | - Katherine White
- Marketing and Behavioral Sciences Department, Sauder School of Business, University of British Columbia, Vancouver, Canada
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Pope DA, Poe L, Stein JS, Kaplan BA, DeHart WB, Mellis AM, Heckman BW, Epstein LH, Chaloupka FJ, Bickel WK. The Experimental Tobacco Marketplace: Demand and Substitutability as a Function of Cigarette Taxes and e-Liquid Subsidies. Nicotine Tob Res 2020; 22:782-790. [PMID: 31350894 PMCID: PMC7171289 DOI: 10.1093/ntr/ntz116] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 07/23/2019] [Indexed: 11/14/2022]
Abstract
INTRODUCTION The experimental tobacco marketplace (ETM) approximates real-world situations by estimating the effects of several, concurrently available products and policies on budgeted purchasing. Although the effects of increasing cigarette price on potentially less harmful substitutability are well documented, the effects of other, nuanced pricing policies remain speculative. This study used the ETM as a tool to assess the effects of two pricing policies, conventional cigarette taxation and e-liquid subsidization, on demand and substitutability. METHODS During sampling periods, participants were provided 2-day samples of 24 mg/mL e-liquid, after which ETM purchase sessions occurred. Across two ETM sessions, conventional cigarettes were taxed or e-liquid was subsidized in combination with increasing cigarette price. The other four available products were always price constant and not taxed or subsidized. RESULTS E-liquid functioned as a substitute for conventional cigarettes across all conditions. Increasing cigarette taxation and e-liquid subsidization increased the number of participants for which e-liquid functioned as a substitute. Cigarette taxation decreased cigarette demand, by decreasing demand intensity, and marginally increased the initial intensity of e-liquid substitution, but did not affect the functions' slopes (substitutability). E-liquid subsidization resulted in large increases in the initial intensity of e-liquid substitution, but did not affect e-liquid substitutability nor cigarette demand. IMPLICATIONS 24 mg/mL e-cigarette e-liquid was the only product to significantly substitute for cigarettes in at least one condition throughout the experiment; it functioned as a significant substitute throughout all four tax and all four subsidy conditions. Increasing cigarette taxes decreased cigarette demand through decreases in demand intensity but did not affect e-cigarette substitution. Increasing e-liquid subsidies increased e-liquid initial intensity of substitution but did not affect cigarette demand. CONCLUSIONS This study extended research on the behavioral economics of conventional cigarette demand and e-liquid substitutability in a complex marketplace. The results suggest that the most efficacious method to decrease conventional cigarette purchasing and increase e-liquid purchasing may involve greatly increasing cigarette taxes while also increasing the value of e-liquid through potentially less harmful product subsidization or differential taxation.
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Affiliation(s)
- Derek A Pope
- Addiction Recovery Research Center, Fralin Biomedical Research Institute at VTC, Roanoke, VA
| | - Lindsey Poe
- Addiction Recovery Research Center, Fralin Biomedical Research Institute at VTC, Roanoke, VA
| | - Jeffrey S Stein
- Addiction Recovery Research Center, Fralin Biomedical Research Institute at VTC, Roanoke, VA
| | - Brent A Kaplan
- Addiction Recovery Research Center, Fralin Biomedical Research Institute at VTC, Roanoke, VA
| | - William B DeHart
- Addiction Recovery Research Center, Fralin Biomedical Research Institute at VTC, Roanoke, VA
| | - Alexandra M Mellis
- Addiction Recovery Research Center, Fralin Biomedical Research Institute at VTC, Roanoke, VA
| | - Bryan W Heckman
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - Leonard H Epstein
- Department of Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY
| | - Frank J Chaloupka
- Department of Economics, University of Illinois at Chicago, Chicago, IL
| | - Warren K Bickel
- Addiction Recovery Research Center, Fralin Biomedical Research Institute at VTC, Roanoke, VA
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Mitchell D, Moodie C, Critchlow N, Bauld L. Adolescents’ reactions to, and perceptions of, dissuasive cigarettes: a focus group study in Scotland. DRUGS-EDUCATION PREVENTION AND POLICY 2020. [DOI: 10.1080/09687637.2020.1732300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Danielle Mitchell
- Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Crawford Moodie
- Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Nathan Critchlow
- Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Linda Bauld
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
- SPECTRUM Consortium, University of Edinburgh, Edinburgh, UK
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Nee-Nee J, Sutherland K, Holland R, Wilson M, Ackland S, Bocock C, Cartmell A, Earp J, Grove C, Hewson C, Jefferies W, Keefe L, Lockyer J, Patel S, Quintans M, Robbie M, Teape L, Yang J, Wilson N, Hoek J, Thomson G. Tobacco pack display at hospitality venues after the introduction of standardised tobacco packaging in New Zealand: a field observation study. BMJ Open 2019; 9:e027868. [PMID: 31494599 PMCID: PMC6731942 DOI: 10.1136/bmjopen-2018-027868] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES In March 2018, New Zealand (NZ) introduced standardised tobacco packaging that also featured new pictorial warnings, with implementation completed by early June 2018. We evaluated how the new packaging affected tobacco pack displays in outdoor areas of hospitality venues. DESIGN Before-and-after descriptive field observation study. SETTING Central city area of the capital city of NZ (Wellington). PARTICIPANTS Observations of people smoking and tobacco packs were made at 56 hospitality venues with outdoor tables (2422 separate venue observations), after the introduction of standardised tobacco packaging. Comparisons were made with a prior study in the same setting, from a time when tobacco packaging still featured brand imagery. RESULTS A total of 8191 patrons, 1113 active smokers and 889 packs and pouches (522 of known orientation) were observed over 2422 venue observations. There were 0.80 visible packs per active smoker in 2018, compared with 1.26 in 2014 (risk ratio (RR)=0.64, 95% CI 0.60 to 0.67, p<0.0001). The new packs in 2018 were also less likely to be displayed face-up, compared with packs in 2014, which had brand imagery on the front face (RR=0.77, 95% CI 0.72 to 0.83, p<0.0001). Pack and pouch display (RR=3.09 in 2014 and 3.10 in 2018) and active smoking (RR=3.16 in 2014 compared with 3.32 in 2018) were higher at venues without children present, compared with venues with children present (this finding was consistent over time). CONCLUSIONS The reduction in the number of visible packs per active smoker, along with the reduction in face-up positioning of packs, suggests that smokers found the new standardised packs less attractive. Countries introducing standardised packaging should consider evaluating social display of tobacco packaging.
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Affiliation(s)
- Johanna Nee-Nee
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Kirsty Sutherland
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Rebecca Holland
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Miriam Wilson
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Samuel Ackland
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Claudia Bocock
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Abbie Cartmell
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Jack Earp
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Christina Grove
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Charlotte Hewson
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Will Jefferies
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Lucy Keefe
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Jamie Lockyer
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Saloni Patel
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Miguel Quintans
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Michael Robbie
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Lauren Teape
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Jess Yang
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Nick Wilson
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Janet Hoek
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - George Thomson
- Department of Public Health, University of Otago, Wellington, New Zealand
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Mitchell D, Moodie C, Critchlow N, Bauld L. Adolescents' perceptions of standardised cigarette packaging design and brand variant name post-implementation: a focus group study in Scotland. BMC Public Health 2019; 19:1227. [PMID: 31488096 PMCID: PMC6727409 DOI: 10.1186/s12889-019-7552-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 08/26/2019] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The United Kingdom (UK) fully-implemented standardised packaging for cigarettes and rolling tobacco on 20th May 2017. We explore adolescent's awareness of, and responses to, standardised cigarette packaging in the UK after it became mandatory. METHODS Eight focus groups were conducted in schools in Scotland with 16-17 year-olds (n = 41), between November 2017 and November 2018, to explore awareness of, and responses to, standardised cigarette packaging. Unlike in Australia, where only straight-edged flip-top cigarette packs are permitted, in the UK standardised cigarette packs can have slim designs, and different edge types (straight, rounded or bevelled) and opening styles (flip-top or shoulder box). We explored how each of these pack formats was perceived. We also explored to what extent brand variant name differentiated cigarettes sold in standardised packaging. RESULTS Most participants were aware of standardised packaging without being shown pack stimuli. Standardised packs were considered embarrassing and off-putting, and the health warnings salient. Among the standardised packs shown, there was a preference for the slimmer pack, viewed as more discrete and the cigarettes potentially less harmful, and the shoulder box, considered cool and different. Participants were interested in some brand variant names on standardised packs (e.g. Legendary Black), particularly those they considered to imply coolness and sophistication. CONCLUSION Adolescents consider standardised cigarette packs in the UK unappealing, and the warnings salient, two core aims of this measure. However, positive reactions to some of the standardised packs (slimmer pack, shoulder box), and variant names used, has implications for countries developing standardised packaging regulations.
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Affiliation(s)
- Danielle Mitchell
- Institute for Social Marketing, Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK9 4LA, Scotland.
| | - Crawford Moodie
- Institute for Social Marketing, Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK9 4LA, Scotland
| | - Nathan Critchlow
- Institute for Social Marketing, Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK9 4LA, Scotland
| | - Linda Bauld
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, EH8 9AG, Scotland
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Moodie C, Hoek J, Scheffels J, Gallopel-Morvan K, Lindorff K. Plain packaging: legislative differences in Australia, France, the UK, New Zealand and Norway, and options for strengthening regulations. Tob Control 2019; 28:485-492. [PMID: 30068563 DOI: 10.1136/tobaccocontrol-2018-054483] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Revised: 07/01/2018] [Accepted: 07/16/2018] [Indexed: 11/04/2022]
Abstract
By July 2018, five countries (Australia, France, the UK, New Zealand and Norway) had fully implemented plain (standardised) packaging. Using government documents, we reviewed the key legislative differences between these five countries to identify best practice measures and potential lacuna. We then discuss how governments planning to introduce plain packaging could strengthen their legislation. Differences between countries include the terminology used (either 'plain', 'standardised' or 'plain and standardised'), products covered and transition times (ranging from 2 to 12 months). Myriad differences exist with respect to the packaging, including the dimensions (explicitly stated for height, width and depth vs minimum dimensions for the health warnings only), structure (straight-edged flip-top packs vs straight, rounded and bevelled-edged flip-top packs and shoulder boxes) and size (minimum number of cigarettes and weight of tobacco vs fixed amounts) and warning content (eg, inclusion of a stop-smoking web address and/or quitline displayed on warnings on one or both principal display areas). Future options that merit further analysis include banning colour descriptors in brand and variant names, allowing pack inserts promoting cessation and permitting cigarettes that are designed to be dissuasive. Plain packaging legislation and regulations are divergent. Countries moving towards plain packaging should consider incorporating the strengths of existing policies and review opportunities for extending these. While plain packaging represents a milestone in tobacco-control policy, future legislation need not simply reflect the past but could set new benchmarks to maximise the potential benefits of this policy.
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Affiliation(s)
- Crawford Moodie
- School of Health Sciences and Sport, Centre for Tobacco Control Research, Institute for Social Marketing, University of Stirling, Stirling, UK
| | - Janet Hoek
- Departments of Public Health and Marketing, University of Otago, Dunedin, New Zealand
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White VM, Guerin N, Williams T, Wakefield MA. Long-term impact of plain packaging of cigarettes with larger graphic health warnings: findings from cross-sectional surveys of Australian adolescents between 2011 and 2017. Tob Control 2019; 28:e77-e84. [DOI: 10.1136/tobaccocontrol-2019-054988] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 05/02/2019] [Accepted: 05/15/2019] [Indexed: 11/04/2022]
Abstract
ObjectiveTo assess the long-term impact of plain packaging (PP) of cigarettes with larger graphic health warnings (HW) introduced in December 2012 on adolescents’ relevant tobacco-related perceptions.MethodsCross-sectional school-based surveys of 12 to 17 year olds in 2011 (n=4413), 2013 (n=4423), 2014 (n=4576) and 2017 (n=4266). Students rated the character of four popular cigarette brands, indicated their agreement regarding brand differences in smoking ease, quitting, addictiveness, harmfulness and pack attractiveness and positive/negative perceptions of pack image. The frequency of students reading, attending to, thinking and talking about HW was assessed. Responses of students seeing cigarette packs in the previous 6 months (2011: 63%; 2013: 67%, 2014: 56%, 2017: 56%) were examined.ResultsSmoking prevalence declined from 2011 to 2017. Among students who had recently seen packs, cigarette packs were rated less positively and more negatively in 2017 than in 2011 (p<0.001) with ratings similar between 2013 and 2017. Positive character ratings for each brand reduced between 2011 and 2013 (ps<0.05) with further reductions between 2013 and 2017 (ps<0.05). Fewer students agreed, and more were uncertain, that brands differed in their smoking ease, addictiveness, harmfulness and pack attractiveness in 2017 than 2011. The frequency of students reading, attending, talking or thinking about HW did not change between 2011 and 2017.ConclusionsPP’s initial impact in reducing adolescent’s positive perceptions of cigarette packs and brand differences continued in the following years with tobacco packaging less appealing to young people in 2017 than 2011 and students more uncertain about brand differences.
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Couch ET, Urata J, Chaffee BW. Limited-edition smokeless tobacco packaging: Behind the
camouflage. Tob Induc Dis 2019; 17:58. [PMID: 31582947 PMCID: PMC6770615 DOI: 10.18332/tid/110676] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 07/11/2019] [Accepted: 07/12/2019] [Indexed: 11/24/2022] Open
Affiliation(s)
- Elizabeth T. Couch
- Division of Oral Epidemiology and Dental Public Health, University of California, San Francisco, United States
| | - Janelle Urata
- Division of Oral Epidemiology and Dental Public Health, University of California, San Francisco, United States
| | - Benjamin W. Chaffee
- Division of Oral Epidemiology and Dental Public Health, University of California, San Francisco, United States
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Epperson AE, Averett PE, Blanchflower T, Gregory KR, Lee JGL. "The Packaging Is Very Inviting and Makes Smokers Feel Like They're More Safe": The Meanings of Natural American Spirit Cigarette Pack Design to Adult Smokers. HEALTH EDUCATION & BEHAVIOR 2019; 46:260-266. [PMID: 30606071 DOI: 10.1177/1090198118820099] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND/AIMS The aim of this investigation was to identify which design elements on Natural American Spirit packs are salient to (i.e., noticed by) U.S. adult smokers and what meanings smokers derive from these elements. METHOD We conducted a secondary analysis of qualitative data from a study of cigarette packaging design. U.S. adult smokers ( n = 33) from all nine census regions participated in six telephone-based focus groups in March 2017. We used constant comparison analysis to identify key themes. RESULTS Four themes were identified, two focused on salient design elements and two focused on design element meanings. The themes of "bright and flashy color" and "the American Indian logo" were identified as key design elements, while the themes of "healthy and safer" and "targeting at-risk smokers" were identified as meanings smokers derived from design elements. CONCLUSIONS Pack design elements influence smokers' perceptions about reduced health risk of Natural American Spirit cigarettes and may be especially dangerous to vulnerable populations, including young adults and American Indians. Findings from this study suggest that the banning of text descriptors may not be enough to address misconceptions about "healthier" cigarettes.
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28
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Mucan B, Moodie C. Young adult smokers' perceptions of plain packs, numbered packs and pack inserts in Turkey: a focus group study. Tob Control 2018; 27:631-636. [PMID: 29123023 DOI: 10.1136/tobaccocontrol-2017-053902] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 09/19/2017] [Accepted: 10/11/2017] [Indexed: 11/04/2022]
Abstract
INTRODUCTION The Turkish Government's 'National Tobacco Control Program 2015-2018' included plans to introduce plain packaging and also a ban on brand names on cigarette packs, allowing only assigned numbers on packs. We explored perceptions of these proposed measures, and also pack inserts with cessation messages, another novel way of using the packaging to communicate with consumers. METHODS Eight focus groups were conducted with 47 young adult smokers in Manisa and Kutahya (Turkey) in December 2016. Participants were shown three straight-edged plain cigarette packs, as required in Australia, and then three bevelled-edged plain packs, as permitted in the UK. They were then shown plain packs with numbers rather than brand names, and finally three pack inserts with messages encouraging quitting or offering tips on how to do so. Participants were asked about their perceptions of each. RESULTS Plain packs were considered unappealing and off-putting, although the bevelled-edged packs were viewed more favourably than the straight-edged packs. Numbered packs were thought by some to diminish the appeal created by the brand name and potentially decrease interest among never smokers and newer smokers. Pack inserts were thought to have less of an impact than the on-pack warnings, but could potentially help discourage initiation and encourage cessation. CONCLUSIONS That bevelled-edged plain packs were perceived more positively than straight-edged plain packs is relevant to countries planning to introduce plain packaging. The study provides a first insight into smokers' perceptions of a ban on brand names, which was perceived to reduce appeal among young people.
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Affiliation(s)
- Burcu Mucan
- Department of Business Administration, Faculty of Business, University of Celal Bayar, Manisa, Turkey
| | - Crawford Moodie
- School of Health Sciences and Sport, Institute for Social Marketing, University of Stirling, Stirlingshire, Scotland, UK
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MacKenzie R, Mathers A, Hawkins B, Eckhardt J, Smith J. The tobacco industry's challenges to standardised packaging: A comparative analysis of issue framing in public relations campaigns in four countries. Health Policy 2018; 122:1001-1011. [PMID: 30139670 DOI: 10.1016/j.healthpol.2018.08.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 08/01/2018] [Accepted: 08/03/2018] [Indexed: 12/30/2022]
Abstract
Tobacco industry public relations campaigns have played a key role in challenges to standardised cigarette packaging. This paper presents a comparative analysis of industry campaigns in Australia and the United Kingdom, which have implemented standardised packaging legislation; Canada, where policy has been adopted but not yet implemented; and the Netherlands, which has considered, but not enacted regulation. Campaigns were identified via Google searches, tobacco industry websites, media coverage, government submissions and previous research; analysis focused on issue framing and supporting evidence. Public relations campaigns in all case study countries drew on similar frames - the illicit trade in tobacco products, the encroaching 'nanny state', lack of evidence for the effectiveness of standardised packaging, a slippery slope of regulation, and inherent threats to intellectual property rights. These claims were supported by industry research, front groups and commissioned reports by accountancy firms, but were not with verifiable research. Independent evidence that contradicted industry positions was overlooked. Similarities in structure and content of public relations campaigns in countries that have enacted or considered regulation points to a strategic co-ordinated approach by cigarette manufacturers. Countries considering standardised packaging policy can expect powerful opposition from the tobacco industry. Tobacco control communities and policy makers can learn from previous experience, and share best practise in countering industry arguments.
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Affiliation(s)
- Ross MacKenzie
- Faculty of Human Sciences, Macquarie University, Sydney, New South Wales 2109, Australia.
| | | | - Benjamin Hawkins
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, United Kingdom
| | - Jappe Eckhardt
- Department of Politics, Faculty of Social Sciences, University of York, United Kingdom
| | - Julia Smith
- Global Tobacco Control Program, Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada
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Moodie C, Angus K, Mitchell D, Critchlow N. How tobacco companies in the United Kingdom prepared for, and responded to, standardised packaging of cigarettes and rolling tobacco. Tob Control 2018; 27:e85-e92. [PMID: 29321273 DOI: 10.1136/tobaccocontrol-2017-054011] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 11/22/2017] [Accepted: 12/08/2017] [Indexed: 11/03/2022]
Abstract
INTRODUCTION As a result of the Standardised Packaging of Tobacco Products Regulations and Tobacco Products Directive, all packs of cigarettes (factory-made and hand-rolled) in the UK must be drab brown, display pictorial warnings on the principal display areas and contain no less than 20 cigarettes or 30 g of tobacco. The legislation was phased in between May 2016 and May 2017. Our objective was to monitor pack, brand and product changes preimplementation and postimplementation. METHODS Our surveillance of the cigarette market involved a review of the trade press, a monthly monitor of online supermarkets and regular visits to stores, from May 2015 to June 2017. RESULTS Before standardised packaging there were changes to the pack graphics (eg, redesigned packs and limited editions) and pack structure (eg, resealable inner foil) and the issue of a number of reusable tins. After standardised packaging, changes included newer cigarette pack sizes for some brand variants (eg, 23 and 24 packs). Changes to the branding prestandardised packaging included brand extensions, and poststandardised packaging included brand and/or variant name change, often with the inclusion of colour descriptors and brand migrations. Product changes prestandardised packaging included the introduction of novel filters (eg, filters with two flavour-changing capsules, tube filters, firmer filters and filters with granular additives). There was non-compliance with the legislation, with slim packs, which are not permitted, on sale after standardised packaging was implemented. CONCLUSIONS Our findings highlight the need to monitor developments in markets introducing standardised packaging and have policy implications for countries considering this measure.
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Affiliation(s)
- Crawford Moodie
- Institute for Social Marketing, Department of Marketing, Stirling, UK
| | - Kathryn Angus
- University of Stirling, Institute for Social Marketing, Stirling, UK
| | - Danielle Mitchell
- Institute for Social Marketing, Department of Marketing, Stirling, UK
| | - Nathan Critchlow
- Centre for Tobacco Control Research, Institute for Social Marketing, Stirling, UK
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Apollonio DE, Glantz SA. Marketing with tobacco pack onserts: a qualitative analysis of tobacco industry documents. Tob Control 2018; 28:274-281. [PMID: 29954860 DOI: 10.1136/tobaccocontrol-2018-054279] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 04/17/2018] [Accepted: 06/06/2018] [Indexed: 11/04/2022]
Abstract
BACKGROUND Cigarette packs are a form of advertising that distributes brand information wherever smokers go. In the 21st century, tobacco companies began using onserts on cigarette packs to communicate new advertising messages to smokers. METHODS We reviewed tobacco industry documents dated 1926 to 2017 to identify how the tobacco industry developed and used onserts in marketing and to serve the industry's political and legal objectives. RESULTS Onserts added to cigarette packs became a more cost-effective way for brands to market in the year 2000. Manufacturers then began studying them, finding that new messages were appealing, while repeated messages were ignored. By 2005, tobacco companies were using onserts to effectively communicate about new tobacco products and packaging changes. They also used repeated 'corporate responsibility' messages that were, according to the industry's own research, likely to be ignored. CONCLUSIONS Tobacco companies have expanded on cigarette pack-based advertising. Twenty-first century onserts simultaneously seek to increase sales using materials that are novel, attractive and provide independent value, while undercutting public health messages about the risks of tobacco use using materials that repeat over time and are comparatively unattractive. Health authorities can use this industry research to mandate onserts to communicate effective health messages.
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Affiliation(s)
- Dorie E Apollonio
- Department of Clinical Pharmacy, University of California, San Francisco, San Francisco, California, USA
| | - Stanton A Glantz
- Department of Medicine, University of California, San Francisco, San Francisco, California, USA
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Dautzenberg B. [Understand the tobacco industry's strategy for recruiting teens: Lessons from a 1973 marketing document]. REVUE DE PNEUMOLOGIE CLINIQUE 2018; 74:196-204. [PMID: 29807733 DOI: 10.1016/j.pneumo.2018.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 04/22/2018] [Indexed: 06/08/2023]
Abstract
UNLABELLED For years, the tobacco industry has organized the inoculation of tobacco addiction to adolescents. METHOD The analysis of a 1973 RJReynols® document identified ten physical and psychological factors in order to increase the number of young users for a brand of cigarettes. These young people are classified into three groups: pre-smokers, learners and smokers. RESULT The taste for pre-smokers and learners and nicotine for smokers are main physical parameters. The industry clearly knows that tobacco is mainly consumed because of nicotine addiction, so it is necessary to make adolescents addict. It is interesting to note that cigarette pack was in 1973 a positive factor to attract young smokers, whereas now with the arrival of the neutral packaging, the tobacco industry declares that packaging has no influence to attract teenagers ! Of the psychological factors, the only negative factor is the self-image of the smoker. The tobacco industry already recognized in 1973 that smokers were unhappy about smoking. For learners, self-image and the experience of adults are most important factor, which is why the industry strives to create a positive image and convey message that smoking initiation is a ritual to become adult. According to the tobacco industry, stress and alleviation of boredom are also important points in turning pre-smokers into learners and learners into smokers. CONCLUSION This article aims to provide practical tools for understanding industry initiatives targeting adolescents. The attached tool can be used by the teens or adults involved to understand the optimization of teenagers tobacco marketing.
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Affiliation(s)
- B Dautzenberg
- Unité tabac, département de pneumologie, AP-HP, Pitié-Salpêtrière-Charles-Foix, Paris, France; Sorbonne université, 75013 Paris, France; Paris sans tabac, 14, avenue du Bosquet, 75007 Paris, France.
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Persoskie A, Donaldson EA, Ryant C. How tobacco companies have used package quantity for consumer targeting. Tob Control 2018; 28:tobaccocontrol-2017-053993. [PMID: 29853560 DOI: 10.1136/tobaccocontrol-2017-053993] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Revised: 04/16/2018] [Accepted: 04/26/2018] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Package quantity refers to the number of cigarettes or amount of other tobacco product in a package. Many countries restrict minimum cigarette package quantities to avoid low-cost packs that may lower barriers to youth smoking. METHODS We reviewed Truth Tobacco Industry Documents to understand tobacco companies' rationales for introducing new package quantities, including companies' expectations and research regarding how package quantity may influence consumer behaviour. A snowball sampling method (phase 1), a static search string (phase 2) and a follow-up snowball search (phase 3) identified 216 documents, mostly from the 1980s and 1990s, concerning cigarettes (200), roll-your-own tobacco (9), smokeless tobacco (6) and 'smokeless cigarettes' (1). RESULTS Companies introduced small and large packages to motivate brand-switching and continued use among current users when faced with low market share or threats such as tax-induced price increases or competitors' use of price promotions. Companies developed and evaluated package quantities for specific brands and consumer segments. Large packages offered value-for-money and matched long-term, heavy users' consumption rates. Small packages were cheaper, matched consumption rates of newer and lighter users, and increased products' novelty, ease of carrying and perceived freshness. Some users also preferred small packages as a way to try to limit consumption or quit. CONCLUSION Industry documents speculated about many potential effects of package quantity on appeal and use, depending on brand and consumer segment. The search was non-exhaustive, and we could not assess the quality of much of the research or other information on which the documents relied.
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Affiliation(s)
| | | | - Chase Ryant
- Office of Science, FDA Center for Tobacco Products, Silver Spring, MD, USA
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Meernik C, Ranney LM, Lazard AJ, Kim K, Queen TL, Avishai A, Boynton MH, Sheeran PJ, Goldstein AO. The effect of cigarillo packaging elements on young adult perceptions of product flavor, taste, smell, and appeal. PLoS One 2018; 13:e0196236. [PMID: 29672604 PMCID: PMC5909610 DOI: 10.1371/journal.pone.0196236] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 04/09/2018] [Indexed: 02/02/2023] Open
Abstract
Introduction Product packaging has long been used by the tobacco industry to target consumers and manipulate product perceptions. This study examines the extent to which cigarillo packaging influences perceptions of product flavor, taste, smell, and appeal. Methods A web-based experiment was conducted among young adults. Participants viewed three randomly selected cigarillo packs, varying on pack flavor descriptor, color, type, branding, and warning—totaling 180 pack images. Mixed-effects models were used to estimate the effect of pack elements on product perceptions. Results A total of 2,664 current, ever, and never little cigar and cigarillo users participated. Cigarillo packs with a flavor descriptor were perceived as having a more favorable taste (β = 0.21, p < .001) and smell (β = 0.14, p < .001) compared to packs with no flavor descriptor. Compared to packs with no color, pink and purple packs were more likely to be perceived as containing a flavor (β = 0.11, p < .001), and were rated more favorably on taste (β = 0.17, p < .001), smell (β = 0.15, p < .001), and appeal (β = 0.16, p < .001). While warnings on packs decreased favorable perceptions of product taste (pictorial: β = -0.07, p = .03) and smell (text-only: β = -0.08, p = .01; pictorial: β = -0.09, p = .007), warnings did not moderate the effects of flavor descriptor or color. Conclusions To our knowledge, this study provides the first quantitative evidence that cigarillo packaging alters consumers’ cognitive responses, and warnings on packs do not suffice to overcome the effects of product packaging. The findings support efforts at federal, state, and local levels to prohibit flavor descriptors and their associated product flavoring in non-cigarette products such as cigarillos, along with new data that supports restrictions on flavor cues and colors.
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Affiliation(s)
- Clare Meernik
- Department of Family Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, United States of America
- * E-mail:
| | - Leah M. Ranney
- Department of Family Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, United States of America
| | - Allison J. Lazard
- School of Media and Journalism, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - KyungSu Kim
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Tara L. Queen
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Aya Avishai
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Marcella H. Boynton
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Paschal J. Sheeran
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Adam O. Goldstein
- Department of Family Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, United States of America
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
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Islam F, Thrasher JF, Szklo A, Figueiredo VC, Perez CDA, White CM, Hammond D. Cigarette flavors, package shape, and cigarette brand perceptions: an experiment among young Brazilian women. Rev Panam Salud Publica 2018; 42:e5. [PMID: 31093036 PMCID: PMC6385815 DOI: 10.26633/rpsp.2018.5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 06/09/2017] [Indexed: 12/25/2022] Open
Abstract
Objective In 2012, a new Brazilian regulation prohibited the use of flavor additives in tobacco products. To better understand the potential impact of this regulation, this study examines how flavor descriptors on cigarette packaging influence brand perceptions among young Brazilian women. Methods An online cross-sectional experiment was conducted with Brazilian women aged 16–26 (N = 640: 182 smokers and 458 nonsmokers) who rated 10 cigarette packages from one of three conditions: 1) branded packs; 2) packs with the same size, shape, and verbal descriptions as in condition 1, but without brand imagery (i.e., “plain pack”); and 3) packs from condition 2 but without brand descriptors (i.e., “plain pack, no descriptors”). Mixed-effects linear regression models were utilized to determine what associations that pack features (i.e., experimental condition; flavor descriptor vs. not; slim pack vs. not) had with participant ratings of nine characteristics, including appeal, taste, smoothness, and attributes of people who smoke the brand. Results Flavored branded packs were rated as more appealing, better tasting, and smoother than flavored plain packs with descriptors. Compared to flavored plain packs with descriptors, the same packs without descriptors were rated less positively on eight of the nine characteristics. Compared to nonsusceptible nonsmokers, susceptible nonsmokers rated flavored packs more positively on eight of the nine characteristics. Slim packs were rated more positively than regular packs on eight of the nine characteristics. Conclusions Slim packs and brands highlighting tobacco flavors appear to increase positive perceptions of tobacco products. Banning tobacco flavorings and slim packs may reduce the appeal of smoking for young Brazilian women, as well as for other vulnerable populations.
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Affiliation(s)
- Farahnaz Islam
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
| | - James F Thrasher
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
| | - André Szklo
- Department of Epidemiology, Instituto Nacional de Câncer, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Valeska Carvalho Figueiredo
- Centro de Estudos sobre Tabaco e Saúde (CETAB), Escola Nacional de Saúde Pública Sergio Arouca, Fiocruz, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Christine M White
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - David Hammond
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
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Lee JGL, Averett PE, Blanchflower T, Gregory KR. Is the cigarette pack just a wrapper or a characteristic of the product itself? A qualitative study of adult smokers to inform U.S. regulations. J Cancer Policy 2018; 15:45-49. [PMID: 29479517 PMCID: PMC5823528 DOI: 10.1016/j.jcpo.2017.12.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Purpose In the U.S., tobacco products are now regulated by the Food and Drug Administration (FDA). Litigation has quickly followed. One area of controversy is when a change to the design of the cigarette pack requires approval through FDA’s rigorous premarket review process. In this paper, we examine how adult U.S. smokers view the connection between the design of cigarette packs and the characteristics of the cigarettes within. Methods Data for this qualitative study came from six focus groups conducted in March 2017 with adult smokers. Two groups consisted of lesbian, gay, and bisexual (LGB) participants; two groups of participants with less than four years of college education; one group of LGB and straight identity; and, one group of the general population. All groups were selected for regional, gender, and racial/ethnic diversity. Participants (n = 33) represented all nine U.S. Census divisions. We conducted constant comparison qualitative analysis utilizing a grounded theory approach. Results Participants’ views reflected a belief that pack design is clearly a reflection of the cigarettes within and that a change in the pack signaled a change in the cigarettes. However, some participants felt price was the salient characteristic of cigarettes and design mattered more for enticing young people to smoke. Conclusions Changes in pack design signal changes to the product for smokers. Pack design and changes to pack design are seen as particularly relevant to new and young smokers. These findings provide support for regulations that require assessment of cigarette pack design changes for impacts on public health.
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Affiliation(s)
- Joseph G L Lee
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Mail Stop 529, 1000 E 5th St, Greenville, NC, United States
| | - Paige E Averett
- School of Social Work, College of Health and Human Performance, East Carolina University, Mail Stop 505, 1000 E 5th St, Greenville, NC, United States
| | - Tiffany Blanchflower
- Department of Interior Design and Merchandising, College of Health and Human Performance, East Carolina University, Mail Stop 505, 1000 E 5th St, Greenville, NC, United States
| | - Kyle R Gregory
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Mail Stop 529, 1000 E 5th St, Greenville, NC, United States
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Lee JGL, Averett PE, Blanchflower T, Gregory KR. Qualitative assessment of a Context of Consumption Framework to inform regulation of cigarette pack design in the U.S. Tob Induc Dis 2018; 16:3. [PMID: 29593883 PMCID: PMC5867908 DOI: 10.18332/tid/82925] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Researchers and regulators need to know how changes to cigarette packages can influence population health. We sought to advance research on the role of cigarette packaging by assessing a theory-informed framework from the fields of design and consumer research. The selected Context of Consumption Framework posits cognitive, affective, and behavioral responses to visual design. To assess the Framework’s potential for guiding research on the visual design of cigarette packaging in the U.S., this study seeks to understand to what extent the Context of Consumption Framework converges with how adult smokers think and talk about cigarette pack designs. METHODS Data for this qualitative study came from six telephone-based focus groups conducted in March 2017. Two groups consisted of lesbian, gay, and bisexual participants; two groups of participants with less than four years college education; one group of LGB and straight identity; and one group the general population. All groups were selected for regional, gender, and racial/ethnic diversity. Participants (n=33) represented all nine U.S. Census divisions. We conducted a deductive qualitative analysis. RESULTS Cigarette package designs captured the participants’ attention, suggested the characteristics of the product, and reflected (or could be leveraged to convey) multiple dimensions of consumer identity. Particular to the affective responses to design, our participants shared that cigarette packaging conveyed how the pack could be used to particular ends, created an emotional response to the designs, complied with normative expectations of a cigarette, elicited interest when designs change, and prompted fascination when unique design characteristics are used. CONCLUSIONS Use of the Context of Consumption Framework for cigarette product packaging design can inform regulatory research on tobacco product packaging. Researchers and regulators should consider multiple cognitive, affective, and behavioral responses to cigarette pack design. ABBREVIATIONS FDA: Food and Drug Administration, FSPTCA: Family Smoking Prevention and Tobacco Control Act of 2009
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Affiliation(s)
- Joseph G L Lee
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, North Carolina, United States
| | - Paige E Averett
- School of Social Work, College of Health and Human Performance, East Carolina University, Greenville, North Carolina, United States
| | - Tiffany Blanchflower
- Department of Interior Design and Merchandising, College of Health and Human Performance, East Carolina University, Greenville, North Carolina, United States
| | - Kyle R Gregory
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, North Carolina, United States
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Minaker LM, Tait H, Ong M, Nguyen N. Slim cigarette smoking prevalence among Canadian youth smokers: Implications for federal standardized packaging legislation. Canadian Journal of Public Health 2018; 108:e565-e570. [PMID: 29356665 DOI: 10.17269/cjph.108.6197] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 10/08/2017] [Accepted: 09/10/2017] [Indexed: 01/09/2023]
Abstract
OBJECTIVES Tobacco companies market to females and young people through slim cigarette design features and packaging. This study assessed the prevalence and perceptions of slim cigarette smoking in grades 9-12 student smokers across Canada using multiple data sources. METHODS Data from three cycles of the Youth Smoking Survey (2008/2009 to 2012/2013) and one cycle of the Cancer Risk Assessment in Youth Survey (2015) were used. The prevalence and perceptions of slim cigarette smoking among current smokers were compared by sex and grade. RESULTS In all surveys, the rate of slim cigarette use was higher among females than males; however, this difference was not statistically significant. In the two most recent surveys, grades 9-10 students had a significantly higher prevalence of use compared with grades 11-12 students. The majority of students (59.8% of females and 53.3% of males) responded, "I don't know" to the survey item seeking to determine perceptions of harm of slim cigarettes compared with regular cigarettes. CONCLUSION Slim cigarette use among Canadian grades 9-12 students represents a small but growing problem. Youths' uncertainty around the harms associated with slim cigarette use and the effect of slim cigarette packaging and design on harm perceptions indicate the need for product design regulations and further education in Canada.
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Affiliation(s)
- Leia M Minaker
- School of Planning, Faculty of Environment, University of Waterloo, Waterloo, ON; Propel Centre for Population Health Impact, University of Waterloo, Waterloo, ON.
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Vardavas C, Filippidis FT, Ward B, Faure M, Jimenez-Ruiz C, Gratziou C, Katsaounou P, Lozano F, Behrakis P, Radu-Loghin C. Plain packaging of tobacco products in the European Union: an EU success story? Eur Respir J 2017; 50:50/5/1701232. [DOI: 10.1183/13993003.01232-2017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 10/02/2017] [Indexed: 11/05/2022]
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"Their Packaging Has Always Been Like a Power": A Qualitative Study of U.S. Smokers' Perceptions of Cigarette Pack Visual Design Features to Inform Product Regulation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14101234. [PMID: 29039769 PMCID: PMC5664735 DOI: 10.3390/ijerph14101234] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 09/30/2017] [Accepted: 10/12/2017] [Indexed: 11/20/2022]
Abstract
Cigarette packaging matters to consumer behavior. However, it is less clear which changes to packaging design would be salient for adult smokers. Such information is critically important to regulators in the United States who are charged with reviewing new tobacco products for their impact on population health. In this qualitative study, U.S. adult smokers (n = 33) participated in six telephone-based focus groups in March 2017. Separate groups were comprised of lesbian, gay, and bisexual (LGB) participants; participants with less than four years of post-secondary education; a mix of LGB and straight participants; and, the general population. All groups were purposely selected for diversity. Open thematic coding identified salient design elements used on cigarette packaging. Smokers articulated design elements’ use, meaning, and links with consumer behaviors. Three themes were identified: (1) the power of color, (2) supporting color with other design elements (e.g., logos/images, typography, the pack itself), and (3) the combined product brand experience of multiple design elements. Participants linked design elements to product characteristics and to consumer behavior (e.g., purchase). As the Food and Drug Administration is charged with regulating tobacco products, these findings suggest the importance of considering the cigarette pack part of the characteristics of a product.
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Dewhirst T. Package size matters: tobacco packaging, retail merchandising and its influence on trial and impulse sales. Tob Control 2017; 27:600-602. [PMID: 29026000 DOI: 10.1136/tobaccocontrol-2017-053962] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 09/12/2017] [Accepted: 09/26/2017] [Indexed: 11/03/2022]
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Mutti S, Hammond D, Reid JL, White CM, Thrasher JF. Perceptions of branded and plain cigarette packaging among Mexican youth. Health Promot Int 2017; 32:650-659. [PMID: 26826368 PMCID: PMC5914357 DOI: 10.1093/heapro/dav117] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Plain cigarette packaging, which seeks to remove all brand imagery and standardize the shape and size of cigarette packs, represents a novel policy measure to reduce the appeal of cigarettes. Plain packaging has been studied primarily in high-income countries like Australia and the UK. It is unknown whether the effects of plain packaging may differ in low-and-middle income countries with a shorter history of tobacco regulation, such as Mexico. An experimental study was conducted in Mexico City to examine perceptions of branded and plain cigarette packaging among smoking and non-smoking Mexican adolescents (n = 359). Respondents were randomly assigned to a branded or plain pack condition and rated 12 cigarette packages for appeal, taste, harm to health and smoker-image traits. As a behavioral measure of appeal, respondents were offered (although not given) four cigarette packs (either branded or plain) and asked to select one to keep. The findings indicated that branded packs were perceived to be more appealing (β = 3.40, p < 0.001) and to contain better tasting cigarettes (β = 3.53, p < 0.001), but were not perceived as less harmful than plain packs. Participants rated people who smoke the branded packs as having relatively more positive smoker-image traits overall (β = 2.10, p < 0.001), with particularly strong differences found among non-smokers for the traits 'glamorous', 'stylish', 'popular' and 'sophisticated' (p < 0.001). No statistically significant difference was found for the proportion of youth that accepted when offered branded compared with plain packs. These results suggest that plain packaging may reduce brand appeal among Mexican youth, consistent with findings in high-income countries.
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Affiliation(s)
- Seema Mutti
- School of Public Health & Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - David Hammond
- School of Public Health & Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - Jessica L. Reid
- Propel Centre for Population Health Impact, University of Waterloo, Waterloo, ON, Canada
| | - Christine M. White
- School of Public Health & Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - James F. Thrasher
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Departamento de Investigaciones sobre Tabaco, Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Publica (INSP), Cuernavaca, Mexico
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Abstract
OBJECTIVE To identify the appealing components of cigar packaging among youth. METHODS We conducted 8 focus groups among cigar users, separated by sex and age group (ie, adolescents, young adults) in Connecticut between February and July, 2016. Participants were shown cigar packages and instructed to circle aspects of the images on the packages that appealed to them independently and a group discussion followed. RESULTS The appealing components identified were flavors (46.8%), price promotions (28.8%), branding (21.2%), marketing claims (17.2%, eg, "natural"), product features (15.2%, eg, the word "cigarillo"), number of cigars (8.0%), color (4.4%), re-sealable features (2.8%), and other (6.0%; eg "limited offer," geographic region). Relative to female participants, male participants were more likely to find flavors and price promotions appealing, and less likely to find colors as appealing (ps < .05). Relative to young adults, adolescents were more likely to find price promotions, branding, marketing claims and number of cigars appealing, and less likely to find colors as appealing (ps < .05). CONCLUSIONS In order to reduce the appeal of cigars to youth, regulatory agencies should consider prohibiting flavors, appealing colors, price promotions, misleading marketing claims, and logos/trademarks on cigar packaging.
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Lempert LK, Glantz S. Packaging colour research by tobacco companies: the pack as a product characteristic. Tob Control 2017; 26:307-315. [PMID: 27255118 PMCID: PMC5135621 DOI: 10.1136/tobaccocontrol-2015-052656] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 05/08/2016] [Indexed: 11/03/2022]
Abstract
BACKGROUND Tobacco companies use colour on cigarette packaging and labelling to communicate brand imagery, diminish health concerns, and as a replacement for prohibited descriptive words ('light' and 'mild') to make misleading claims about reduced risks. METHODS We analysed previously secret tobacco industry documents to identify additional ways in which cigarette companies tested and manipulated pack colours to affect consumers' perceptions of the cigarettes' flavour and strength. RESULTS Cigarette companies' approach to package design is based on 'sensation transference' in which consumers transfer sensations they derive from the packaging to the product itself. Companies manipulate consumers' perceptions of the taste and strength of cigarettes by changing the colour of the packaging. For example, even without changes to the tobacco blends, flavourings or additives, consumers perceive the taste of cigarettes in packages with red and darker colours to be fuller flavoured and stronger, and cigarettes in packs with more white and lighter colours are perceived to taste lighter and be less harmful. CONCLUSIONS Companies use pack colours to manipulate consumers' perceptions of the taste, strength and health impacts of the cigarettes inside the packs, thereby altering their characteristics and effectively creating new products. In countries that do not require standardised packaging, regulators should consider colour equivalently to other changes in cigarette characteristics (eg, physical characteristics, ingredients, additives and flavourings) when making determinations about whether or not to permit new products on the market.
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Affiliation(s)
- Lauren K Lempert
- Center for Tobacco Control Research and Education, Philip R Lee Institute for Health Policy Studies, Helen Diller Family Comprehensive Cancer Center, San Francisco, California, USA
| | - Stanton Glantz
- Center for Tobacco Control Research and Education, Philip R Lee Institute for Health Policy Studies, Helen Diller Family Comprehensive Cancer Center, San Francisco, California, USA
- Department of Medicine, University of California San Francisco, San Francisco, California, USA
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Barraclough S, Gleeson D. Why Packaging Is Commercially Vital for Tobacco Corporations. Asia Pac J Public Health 2017; 29:132-139. [DOI: 10.1177/1010539516688081] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study analyses what British American Tobacco (BAT) and its 4 publicly listed Asian subsidiary companies have told their shareholders about the commercial value of tobacco packaging. The discourse on packaging in BAT annual reports was analyzed, revealing themes of modernization, rejuvenation, internationalism, heritage, innovation, value for money, and competitive edge. Packaging was credited with providing existing brands with a competitive edge and enabling the successful “launch” of new ones. Since advertising, sponsorship, and free samples were prohibited in many countries, packaging has become more important for advertising. New brands and brand variants have proliferated. BAT companies have allocated considerable resources to regularly altering packaging for marketing purposes. Clearly, restrictions on packaging will substantially detract from the promotion of the company’s brands. The findings provide further evidence from industry sources of the vital function of packaging and further justify plain packaging as an essential part of any comprehensive tobacco control policy.
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Greenland SJ. The Australian experience following plain packaging: the impact on tobacco branding. Addiction 2016; 111:2248-2258. [PMID: 27557863 DOI: 10.1111/add.13536] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 05/16/2016] [Accepted: 07/18/2016] [Indexed: 11/30/2022]
Abstract
AIMS Brands are critical to tobacco marketing. Industry stakeholders predicted that plain packaging, by removing key tangible branding dimensions, would restrict new products and brand differentiation. However, manufacturers respond innovatively to limit regulatory impact. This study investigates brand strategy following plain packaging's introduction to Australia. METHODS Brand portfolios were determined using 2006-15 tobacco ingredient reports. These detail the brand and variant names sold and are provided annually as part of a voluntary agreement between the Australian Government and leading manufacturers. Post-plain packaging brand ranges were verified using retail price lists and a supermarket retail audit using a method used previously to verify a period of pre-plain packaging data. RESULTS The verification process identified some data inaccuracies from one manufacturer which resulted in the issuing of corrected data. After plain packaging the leading manufacturers continued with extensive brand ranges differentiated by price. All launched new products. While total brand numbers fell from 29 to 24, the mean number of variants for the leading 12 brands grew from 8.9 to 9.7. Substantial variant name modifications occurred with 50 new or modified names in 2012-13. Among leading brands, the incidence of variant colour names increased from 49.5 to 79.3%. CONCLUSIONS New brands and variants were not inhibited by the introduction of plain packaging in Australia. After plain packaging, leading brand variant numbers expanded by 9 to 116 and colour variant names increased by 73.6% and became the norm-lighter colours (blue, gold and silver) dominated, perpetuating notions of less harmful cigarettes. [Correction added on 09 September 2016, after first online publication: The figures in the last sentence of the Abstract are now corrected from 'expanded by 116' to 'expanded by 9 to 116'.].
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Affiliation(s)
- Steven J Greenland
- Faculty of Business and Law, Swinburne University of Technology, Hawthorn, Victoria, Australia
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Arevalo R, Corral JE, Monzon D, Yoon M, Barnoya J. Characteristics of illegal and legal cigarette packs sold in Guatemala. Global Health 2016; 12:78. [PMID: 27884210 PMCID: PMC5123326 DOI: 10.1186/s12992-016-0219-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 11/15/2016] [Indexed: 11/24/2022] Open
Abstract
Background Guatemala, as a party to the Framework Convention on Tobacco Control (FCTC), is required to regulate cigarette packaging and labeling and eliminate illicit tobacco trade. Current packaging and labeling characteristics (of legal and illegal cigarettes) and their compliance with the FCTC is unknown. Methods We sought to analyze package and label characteristics of illegal and legal cigarettes sold in Guatemala. We visited the 22 largest traditional markets in the country to purchase illegal cigarettes. All brands registered on tobacco industry websites were purchased as legal cigarettes. Analysis compared labeling characteristics of illegal and legal packs. Findings Most (95%) markets and street vendors sold illegal cigarettes; 104 packs were purchased (79 illegal and 25 legal). Ten percent of illegal and none of the legal packs had misleading terms. Half of the illegal packs had a warning label covering 26 to 50% of the pack surface. All legal packs had a label covering 25% of the surface. Illegal packs were more likely to have information on constituents and emissions (85% vs. 45%, p < 0.001) and were less expensive than legal ones (USD 0.70 ± 0.7 and 1.9 ± 1.8, p < 0.001). Conclusions In Guatemala, neither illegal nor legal cigarette packs comply with FCTC labeling mandates. Urgent implementation and enforcement of the FCTC is necessary to halt the tobacco epidemic.
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Affiliation(s)
- Rodrigo Arevalo
- Research Department, Cardiovascular Surgery Unit of Guatemala, 5a Ave 6-22 zona 11, Guatemala City, Guatemala
| | - Juan E Corral
- Research Department, Cardiovascular Surgery Unit of Guatemala, 5a Ave 6-22 zona 11, Guatemala City, Guatemala.,Department of Medicine, University of Miami Miller School of Medicine and Jackson Memorial Hospital, Miami, FL, USA
| | - Diego Monzon
- Research Department, Cardiovascular Surgery Unit of Guatemala, 5a Ave 6-22 zona 11, Guatemala City, Guatemala
| | - Mira Yoon
- Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis, School of Medicine, St. Louis, MO, USA
| | - Joaquin Barnoya
- Research Department, Cardiovascular Surgery Unit of Guatemala, 5a Ave 6-22 zona 11, Guatemala City, Guatemala. .,Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis, School of Medicine, St. Louis, MO, USA.
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Rey-Pino JM, Nerín I, Lacave-García MB. [The plain packaging of tobacco products: a new strategy for tobacco control]. GACETA SANITARIA 2016; 31:62-65. [PMID: 27789049 DOI: 10.1016/j.gaceta.2016.07.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 06/16/2016] [Accepted: 07/11/2016] [Indexed: 11/24/2022]
Abstract
There is evidence that global tobacco smoking control policies contribute to decrease the prevalence of smoking among populations, so there is a need to effectively implement different measures in a coordinated way. The plain packaging and labelling of tobacco products is one of the measures proposed by the World Health Organisation Framework Convention on Tobacco Control. At the moment, leading countries are implementing this tobacco control measure, which involves a plain packaging for all tobacco products, i.e., the absence of any promotional or communication tool in the packaging, except the name of the brand, appearing with a standardised font, size, colour and placing in the pack. Australia was the first country to implement this measure in 2012 and recently other countries are legislating and approving it. In Spain, tobacco legislation (2005 and 2010), was an important advance in tobacco control policies. The introduction of plain packaging in Spain would mean the next step in the development of a global strategy for fighting this significant health problem. The aim of this article is to synthesise in a structured manner the role that the packaging of tobacco products has within marketing and communication strategies, as well as to describe the potential effects that the plain packaging has on some aspects of smoking behaviour, according to current literature.
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Affiliation(s)
- Juan Miguel Rey-Pino
- Departamento de Comercialización e Investigación de Mercados, Facultad de Ciencias Económicas y Empresariales, Universidad de Granada, Granada, España.
| | - Isabel Nerín
- Unidad de Tabaquismo, Departamento de Medicina, Psiquiatría y Dermatología, Facultad de Medicina, Universidad de Zaragoza, Zaragoza, España
| | - Ma Blanca Lacave-García
- Departamento de Marketing y Comunicación, Facultad de Ciencias Económicas y Empresariales, Universidad de Cádiz, Cádiz, España
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Ilakkuvan V, Reubenstein R, Xiao H, Rath J. What Does Having Your Pack in Your Pocket Say About You? Characteristics and Attitude Differences of Youth Carrying Tobacco at a Music Festival. HEALTH EDUCATION & BEHAVIOR 2016; 44:216-221. [PMID: 27179292 DOI: 10.1177/1090198116643964] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this study is to understand differences in demographics, frequency of tobacco use, and tobacco-related attitudes between youth/young adults who carry tobacco products and those who do not. Carrying tobacco is hypothesized to affect individuals' smoker identity and thereby their tobacco-related attitudes. Carriers are an influential peer group, often serving as social sources of tobacco for others, setting tobacco-related social norms, and advertising tobacco via the packs they carry. Thus, understanding their characteristics and attitudes can aid in the targeting and tailoring of cessation messaging. In this study, 3,927 attendees ages 13 to 24 years at the Vans Warped Tour were surveyed using iPads and asked to photograph any tobacco products they were currently carrying. Current tobacco users were classified as proven carriers ( n = 363), unproven carriers ( n = 182), or noncarriers ( n = 1,426). Carriers ( N = 545) were older, were more often White, and used tobacco over twice as often as noncarriers. Results indicated carriers and noncarriers differed significantly on most antitobacco attitudes, with carriers feeling less strongly antitobacco.
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Affiliation(s)
- Vinu Ilakkuvan
- 1 Truth Initiative, Washington, DC, USA.,2 George Washington University Milken Institute School of Public Health, Prevention and Community Health, Washington, DC, USA
| | | | | | - Jessica Rath
- 1 Truth Initiative, Washington, DC, USA.,3 Johns Hopkins Bloomberg School of Public Health, Health, Behavior, and Society, Baltimore, MD, USA
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Abad-Vivero EN, Thrasher JF, Arillo-Santillán E, Pérez-Hernández R, Barrientos-Gutíerrez I, Kollath-Cattano C, Mejía R, Sargent JD. Recall, appeal and willingness to try cigarettes with flavour capsules: assessing the impact of a tobacco product innovation among early adolescents. Tob Control 2016; 25:e113-e119. [PMID: 27060099 PMCID: PMC5055844 DOI: 10.1136/tobaccocontrol-2015-052805] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 03/15/2016] [Indexed: 11/04/2022]
Abstract
Background Use of flavour capsule varieties (FCVs) of cigarettes has rapidly increased in many countries. Adolescents are attracted to flavours; yet, surprisingly, no quantitative study has explored adolescents' perceptions of these products. Objective To characterise the appeal of FCVs for young adolescents in Mexico. Methods In 2015, surveys were conducted with a representative sample of Mexican middle school students (n=10 124; ages 11–16 years; mean 12.4 years). Students viewed and rated packs for FCVs and non-FCVs from major brands (Marlboro, Camel, Pall Mall), with brand names removed. For each pack, students were asked to write the brand name (ie, brand recall), to evaluate pack attractiveness, and to indicate the pack they were most interested in trying (including a ‘none’ option). Logistic generalised estimating equation (GEE) models regressed brand recall, pack attractiveness and interest in trying on brand and FCV (yes vs no), controlling for sociodemographics and smoking risk factors. Results Marlboro regular, Camel regular, Camel light and Pall Mall FCVs were most often recalled (25%, 17%, 9%, 8%). Packs for Pall Mall FCVs and Camel FCVs were most often rated as very attractive (13%, 9%, respectively) and of interest for trial (22%, 13%) along with Marlboro regular (14%). In GEE models, FCVs were independently associated with greater attractiveness (adjusted OR (AOR)=1.83, 95% CI 1.72 to 1.94) and interest in trying (AOR=1.74, 95% CI 1.54 to 1.96). Perceived pack attractiveness was also independently associated with greater interest in trying (AOR=5.63, 95% CI 4.74 to 6.68). Conclusions FCVs appear to be generating even greater appeal among young adolescents than established non-FCVs in dominant brand families.
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Affiliation(s)
- Erika N Abad-Vivero
- Department of Tobacco Research, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, México
| | - James F Thrasher
- Department of Tobacco Research, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, México.,Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Edna Arillo-Santillán
- Department of Tobacco Research, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, México
| | - Rosaura Pérez-Hernández
- Department of Tobacco Research, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, México
| | - Inti Barrientos-Gutíerrez
- Department of Tobacco Research, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, México
| | - Christy Kollath-Cattano
- School of Education, Health and Human Performance, College of Charleston, Charleston, South Carolina, USA
| | - Raúl Mejía
- Salud, Economía y Salud, Centro de Estudios de Estado y Sociedad (CEDES), Buenos Aires, Argentina
| | - James D Sargent
- Norris Cotton Cancer Center, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire, USA
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