1
|
Mat Rifin H, Jane Ling MY, Robert Lourdes TG, Saminathan TA, Rodzlan Hasani WS, Ab Majid NL, Hamid HAA, Riyadzi MR, Ahmad A, Mohd Yusoff MF, Muhamad NA. Small/Kiddie Cigarette Packaging Size and Its Impact on Smoking: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12051. [PMID: 36231349 PMCID: PMC9566128 DOI: 10.3390/ijerph191912051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/23/2022] [Accepted: 09/02/2022] [Indexed: 06/16/2023]
Abstract
Background: Small cigarette pack sizes contain less than 20 cigarette sticks in a pack. Smaller packs may suggest lower costs, increasing affordability among lower-income users, especially the younger generation, which could lead to tobacco-related diseases and economic costs, including human capital lost results from tobacco-attributable morbidity and mortality. This concern has caused many countries to ban the sale of single cigarette sticks or kiddie packs. However, small cigarette pack sizes were proposed recently to be reintroduced by the tobacco industry with an excuse to prevent consumers from buying illicit cigarettes. This would demean efforts in combating tobacco consumption based on the existing tobacco control policies to prevent minors from purchasing cigarettes. Given the competing influences of affordability and availability of tobacco on consumption and the dearth of evidence-based review on the impact of pack size on smoking, this systematic review was conducted to identify the link between kiddie packs and smoking specifically on the initiation of smoking, urge/tendency to buy cigarettes among the general population and attempt to reduce cigarette consumption and prevalence of smoking using kiddie packs among current smokers. Methods: We include all studies except for reviews, guidelines, conference papers, commentaries, editorials, or opinion pieces. A database search was conducted in PubMed, EMBASE, CENTRAL, Web of Science and Scopus on 27 November 2021. The results were presented in the form of narrative synthesis under four groups: initiation of smoking; urge/tendency to buy cigarettes; the prevalence of smoking, and attempt to reduce cigarette consumption. The literature search identified 1601 articles, of which 21 articles had met the inclusion criteria. The methodological quality of all included articles was determined using a validated 16-item quality assessment tool (QATSDD). The average quality score for all papers was 34.8%. Discussion: Given the diverse study settings of the articles and despite the challenges of the methodological quality of some articles, this review provides some evidence that kiddie packs may increase the urge/tendency to buy cigarettes and mixed evidence on the attempt to reduce cigarette consumption. This review also found some evidence that kiddie pack purchasing among teenage smokers was higher compared to adults. However, we are uncertain about the link between kiddie packs and smoking initiation. Nevertheless, since most studies were of low quality, further high-quality studies are needed to conclude about the impact of kiddie packs on smoking to assist the policymakers and stakeholders in formulating new policies and strengthening existing strategies related to the kiddie packs.
Collapse
Affiliation(s)
- Halizah Mat Rifin
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia
| | - Miaw Yn Jane Ling
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia
| | - Tania Gayle Robert Lourdes
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia
| | - Thamil Arasu Saminathan
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia
| | - Wan Shakira Rodzlan Hasani
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia
| | - Nur Liana Ab Majid
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia
| | - Hamizatul Akmal Abd Hamid
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia
| | - Mohd Ruhaizie Riyadzi
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia
| | - Ahzairin Ahmad
- Institute for Public Health, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia
| | | | - Nor Asiah Muhamad
- Sector for Evidence-Based Healthcare, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia
| |
Collapse
|
2
|
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.
Collapse
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
| |
Collapse
|
3
|
Mat Rifin H, Rodzlan Hasani WS, Ling MYJ, Robert Lourdes TG, Saminathan TA, Ab Majid NL, Ahmad A, Ismail H, Mohd Yusoff MF. A systematic review protocol on small/kiddie cigarette packaging size and its impact on smoking. Syst Rev 2020; 9:13. [PMID: 31931868 PMCID: PMC6958659 DOI: 10.1186/s13643-019-1263-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 12/20/2019] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Small/kiddie cigarette packs consist of less than 20 cigarette sticks. Kiddie packs were recently proposed to be reintroduced by the tobacco industry with an excuse to prevent consumers from buying illicit cigarettes. By reintroducing kiddie packs, cigarettes will inevitably be more affordable and this would appeal to lower-income consumers especially teens. In this systematic review, we aimed to identify the impact of kiddie packs on smoking, specifically on smoking initiation, the urge/tendency to buy cigarettes and attempts to reduce cigarette consumption. METHODS This systematic review will be based on the review of original articles on the impact of kiddie packs on smoking. There is no restriction on the publication dates. The Cochrane Central Register of Controlled Trials, PubMed, EMBASE, Web of Science and Scopus will be searched to retrieve potential original articles. Additional records identified through other sources: Google Scholar, as well as Journal of Substance Use and Tobacco Control, are also to be searched. These will include original articles in any language which included all study designs (randomised controlled trials, quasi experimental and experimental studies, observational cross-sectional and cohort studies) comparing kiddie packs with regular cigarette packs. The primary outcomes of interest will be initiation of smoking and urge/tendency to buy cigarettes in the general population and attempts to reduce cigarette consumption among current smokers. Secondary outcomes will be the prevalence of smoking using kiddie packs among the current smokers. DISCUSSION This systematic review will provide evidence to support the impact of kiddie packs on smoking in terms of smoking initiation, smoking prevalence, urge/tendency to purchase cigarettes and attempts to reduce cigarette consumption. The findings from this review could be helpful to policymakers in regulating kiddie packs to control the consumption of tobacco. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42018102325.
Collapse
Affiliation(s)
- Halizah Mat Rifin
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Shah Alam, Selangor, Malaysia.
| | - Wan Shakira Rodzlan Hasani
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Shah Alam, Selangor, Malaysia
| | - Miaw Yn Jane Ling
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Shah Alam, Selangor, Malaysia
| | - Tania Gayle Robert Lourdes
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Shah Alam, Selangor, Malaysia
| | - Thamil Arasu Saminathan
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Shah Alam, Selangor, Malaysia
| | - Nur Liana Ab Majid
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Shah Alam, Selangor, Malaysia
| | - Ahzairin Ahmad
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Shah Alam, Selangor, Malaysia
| | - Hasimah Ismail
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Shah Alam, Selangor, Malaysia
| | - Muhammad Fadhli Mohd Yusoff
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Shah Alam, Selangor, Malaysia
| |
Collapse
|
4
|
McDaniel PA. Does size matter? Rethinking the tobacco pack. Tob Control 2019; 28:363-364. [DOI: 10.1136/tobaccocontrol-2018-054458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|