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Minacapilli Manetti ML, Gonzalez Peluffo V, Taglioretti V, Barros M, Nunez V, Melian T, Grilo G, Llambi L. Flavours and design features on tobacco product packaging near schools before and after plain packaging implementation in Montevideo, Uruguay. Tob Control 2024:tc-2023-058287. [PMID: 38519081 DOI: 10.1136/tc-2023-058287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 02/01/2024] [Indexed: 03/24/2024]
Abstract
INTRODUCTION Monitoring tobacco industry marketing strategies in countries that have introduced plain packaging helps with documenting variations in the market during the transition period. Uruguay implemented plain packaging in February 2020. We describe changes in the characteristics of tobacco packaging, content and sticks before and after plain packaging implementation. METHODS Data were collected across 15 neighbourhoods in different socioeconomic areas in Montevideo, Uruguay, before and after implementation (2019 and 2021). A high school or college was selected in each neighbourhood as the walking protocol starting point. Two stores were visited per neighbourhood. Cigarettes and roll-your-own tobacco (RYO) were purchased and coded for the presence of taste or sensation lexical and imagery features. RESULTS The number of unique products increased between 2019 (n=23) and 2021 (n=40). Prior to implementation, all packs presented design features. After its implementation, 95.7% of cigarette packs complied with regulations. Overall, 34.7% of cigarettes and RYO were flavoured in 2019 versus 50.0% in 2021 (p=0.01). In 2019, all flavoured cigarette packs conveyed taste through language and/or imagery, while cigarettes had designs on the filter suggesting the potential for altering the flavour. In 2021, 44.0% of cigarette packs indicated flavour through lexicon; and 81.0% of cigarette sticks still included a flavour capsule. CONCLUSIONS After implementation, we noticed an increase in the availability of unique flavoured cigarettes and RYO among surveyed retailers. However, this increase was less pronounced compared with what is reported in the Latin American region. Non-compliance was identified. Greater efforts should be made enforcing current policy.
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Affiliation(s)
- Mauricio Luis Minacapilli Manetti
- Unidad de Tabaquismo, Departamento Clinico de Medicina, Hospital de Clinicas, Universidad de la Republica Facultad de Medicina, Montevideo, Uruguay
| | - Valentina Gonzalez Peluffo
- Unidad de Tabaquismo, Departamento Clinico de Medicina, Hospital de Clinicas, Universidad de la Republica Facultad de Medicina, Montevideo, Uruguay
| | - Victoria Taglioretti
- Unidad de Tabaquismo, Departamento Clinico de Medicina, Hospital de Clinicas, Universidad de la Republica Facultad de Medicina, Montevideo, Uruguay
| | - Mary Barros
- Unidad de Tabaquismo, Departamento Clinico de Medicina, Hospital de Clinicas, Universidad de la Republica Facultad de Medicina, Montevideo, Uruguay
| | - Virginia Nunez
- Unidad de Tabaquismo, Departamento Clinico de Medicina, Hospital de Clinicas, Universidad de la Republica Facultad de Medicina, Montevideo, Uruguay
| | - Tamara Melian
- Unidad de Tabaquismo, Departamento Clinico de Medicina, Hospital de Clinicas, Universidad de la Republica Facultad de Medicina, Montevideo, Uruguay
| | - Graziele Grilo
- Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Laura Llambi
- Unidad de Tabaquismo, Departamento Clinico de Medicina, Hospital de Clinicas, Universidad de la Republica Facultad de Medicina, Montevideo, Uruguay
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Giovenco DP, Ganz O, Spillane TE, Easter AG, Wackowski OA, Villanti AC, Strasser AA, Delnevo CD. Changes in Pack Features Among Top-Selling Cigarettes in the U.S., 2018 and 2021. Am J Prev Med 2023; 65:1124-1128. [PMID: 37295659 PMCID: PMC10700656 DOI: 10.1016/j.amepre.2023.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/30/2023] [Accepted: 06/01/2023] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Cigarette packaging is designed to increase consumer appeal and remains a primary promotional tool in many countries, including the U.S. This study documented changes in the prevalence of pack characteristics among the top-selling cigarette products in the U.S. in 2018 and 2021. METHODS The 50 cigarette packs with the highest national unit sales in U.S. convenience stores in 2018 and 2021 were identified using Nielsen's Scantrack data and subsequently purchased. Packs were coded for features such as dominant color(s), descriptive text, and promotional language. Descriptive analyses conducted in 2022 weighted by total annual unit sales compared the prevalence of pack characteristics between years. RESULTS Three brands-Marlboro, Newport, and Camel-constituted over 80% of pack sales among the top-selling products. Packs with red as a dominant color grew less popular between years (33.3% vs 29.5%), whereas those with green became more prevalent (25.2% vs 28.9%), consistent with a rise in the proportion of menthol sales. The prevalence of descriptors such as flavor and fresh decreased from 46.0% to 39.4% and 9.7% to 5.2%, respectively. Meanwhile, the prevalence of promotional language (e.g., rewards programs) increased from 60.9% to 69.0%. CONCLUSIONS The use of visual and named colors remains common, which can implicitly communicate sensory or health-related attributes. Moreover, promotions may help recruit and retain consumers in the context of more restrictive tobacco control policies and price increases. Given the strong influence that cigarette packaging exerts on consumers, packaging-focused policies, such as plain packaging laws, may reduce appeal and accelerate declines in cigarette use.
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Affiliation(s)
- Daniel P Giovenco
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York.
| | - Ollie Ganz
- Rutgers Biomedical and Health Sciences, Rutgers Center for Tobacco Studies, New Brunswick, New Jersey; Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, New Jersey
| | - Torra E Spillane
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York
| | - Alexa G Easter
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York
| | - Olivia A Wackowski
- Rutgers Biomedical and Health Sciences, Rutgers Center for Tobacco Studies, New Brunswick, New Jersey; Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, New Jersey
| | - Andrea C Villanti
- Rutgers Biomedical and Health Sciences, Rutgers Center for Tobacco Studies, New Brunswick, New Jersey; Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, New Jersey
| | - Andrew A Strasser
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Cristine D Delnevo
- Rutgers Biomedical and Health Sciences, Rutgers Center for Tobacco Studies, New Brunswick, New Jersey; Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, New Jersey
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van der Eijk Y, Teo KW, Tan GPP, Chua WM. Tobacco industry strategies for flavour capsule cigarettes: analysis of patents and internal industry documents. Tob Control 2023; 32:e53-e61. [PMID: 34611048 DOI: 10.1136/tobaccocontrol-2021-056792] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 09/08/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND The global market for flavour capsule variants (FCVs), cigarettes with a crushable flavour capsule, has grown exponentially. To inform further regulatory efforts, it is important to understand tobacco industry strategies for FCVs. METHODS Analysis of data from 65 patents and 179 internal tobacco industry documents, retrieved via snowball searches in Patsnap and the Truth Tobacco Industry Documents Library, describing tobacco industry developments related to FCVs. We used an inductive coding method to identify themes relating to FCV features or developments. RESULTS Tobacco companies were developing FCVs since the 1960s, with little market success until the 2000s following the launch of Camel Crush, a brand which targeted millennials (in their teens or early 20s at the time). Tobacco companies have patented, but not yet marketed, FCVs with microcapsule surface coatings, adjustable or heat-triggered flavour release systems, airflow manipulation features, transparent filters to visualise flavour release, and various flavours and additives for capsules including nicotine/tobacco extracts for an on-demand nicotine hit. Tobacco companies developed FCVs purported to be reduced harm, although their own tests showed that FCVs have higher toxicant concentrations. They have also developed loose flavour capsule units designed to fit into cigarettes, packs, or recessed filters to enable users to customise cigarettes and circumvent tobacco flavour bans. CONCLUSIONS To prevent tobacco companies from targeting young people and exploiting regulatory loopholes, regulations on tobacco products should ban flavours and consider the broad variety of FCV designs, additives and loose products designed to impart flavour into tobacco products.
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Affiliation(s)
- Yvette van der Eijk
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Ken Wah Teo
- Preventive Medicine, National University Health System, Singapore
| | - Grace Ping Ping Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Wee Meng Chua
- Department of Biological Sciences, National University of Singapore, Singapore
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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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Guo Y, Xu Y, Chen D. Impact of Visual Elements of Tobacco Packaging on Health Risk Perceptions of Youth Groups. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14097. [PMID: 36360972 PMCID: PMC9659161 DOI: 10.3390/ijerph192114097] [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: 10/14/2022] [Revised: 10/26/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
Tobacco products are hazardous to public health and are one of the greater public health threats facing the world to date. Although international research on tobacco packaging has been thorough and comprehensive, the risk perception of visual elements in tobacco packaging varies by country, race, and smoking status. Therefore, the study aimed to investigate the risk perceptions of visual elements in tobacco packaging among young and middle-aged people in selected cities in China. This study used a questionnaire to construct an index system for visual elements of tobacco packaging and used it to design a related questionnaire. Our group conducted an online questionnaire survey among 296 young people (18-44 years old) in selected cities in China between 16 June and 26 June 2022. The results of the influence of visual elements of tobacco packaging on the perception of tobacco health risks in the youth group were analyzed by SPSS 26.0. A chi-square test analysis yielded differences in the perception of tobacco package color among youths with different smoking status. A linear regression analysis revealed that age group and visual elements were significant, and five groups of visual element comparisons had an effect on the youth group. First, there were differences in the perceptions of tobacco products among participants with different smoking status. Secondly, the more youthful the respondents were, the greater the probability that they were able to identify that the picture fitness warnings had a greater probability of making them conscious of the fitness dangers of smoking (p < 0.05). The older the participants, the greater the probability that the textual content fitness warnings made them conscious of the fitness risks of smoking (p < 0.05). Third, the percentage of health warnings did not make a good-sized impact for the youth groups (p > 0.05). Fourth, the more youthful the participant, the greater the probability that cigarette products with whole brand images would appeal to buyer(p < 0.01).
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Affiliation(s)
- Yanlong Guo
- Social Innovation Design Research Centre, Anhui University, Hefei 203106, China
- Anhui Institute of Contemporary Studies, Anhui Academy of Social Sciences, Hefei 203106, China
| | - Yinrui Xu
- Social Innovation Design Research Centre, Anhui University, Hefei 203106, China
| | - Denghang Chen
- Department of Science and Technology Communication, University of Science and Technology of China, Hefei 203106, China
- Research Center for Science Communication, Chinese Academy of Sciences, Hefei 203106, China
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Kyriakos CN, Qi D, Chang K, Laverty AA, Filippidis FT. Global market trends of flavor capsule cigarettes and
menthol (non-capsule) cigarettes: An ecological analysis
using commercial data across 78 countries, 2010–2020. Tob Induc Dis 2022; 20:85. [PMID: 36304063 PMCID: PMC9549585 DOI: 10.18332/tid/153974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/23/2022] [Accepted: 09/09/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION This study describes market trends of flavor capsule cigarettes (FCCs) and menthol (non-capsule) cigarettes (MNCCs) across 78 countries from 2010 to 2020 and examines country-level factors associated with market shares of these products. METHODS Market share and retail volume data came from the Euromonitor Passport database and country-level data came from the World Health Organization (WHO), World Bank, and International Monetary Fund. Multivariable linear fixed effects panel regression analyses were conducted to evaluate the relationship between predictor variables and the market shares of menthol (non-capsule) cigarettes and flavor capsule cigarettes. RESULTS The overall market share (i.e. the percentage retail volume out of total retail volume of all cigarette types) increased from 0.23% in 2010 to 4.5% in 2020 for FCCs and decreased from 5.0% to 3.8% for MNCCs. Market shares of FCCs grew most rapidly in the Americas region and among upper middle-income countries. Market shares of MNCCs remained stable across most regions and were highest in the Western Pacific and Africa regions. The overall market share of FCCs was positively associated with the unemployment rate (β=0.28; 95% CI: 0.12–0.44, p=0.001), and inversely associated with the percent of the population aged 15–29 years (β= -0.57, 95% CI: -0.98 – -0.15, p=0.008), percent of urban population (β= -0.88; 95% CI: -1.28 – -0.48, p<0.001), GDP PPP per capita (β= -0.13; 95% CI: -0.24 – -0.03, p=0.015), and age-standardized prevalence of cigarette smoking (β= -0.93; 95% CI: -1.38 – -0.49, p<0.001). In contrast, the overall market share of MNCCs was positively associated with urbanicity (β=0.24; 95% CI: 0.08–0.40, p=0.003), and negatively associated with the unemployment rate (β= -0.09; 95% CI: -0.17 – -0.02, p=0.014). CONCLUSIONS Global sales of flavor capsule cigarettes grew substantially in the last decade, surpassing menthol (non-capsule) cigarettes, which also continued to be high in many regions. There is a need for increased efforts to address flavors and novel tobacco products, features that are known to appeal to youth.
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Affiliation(s)
- Christina N. Kyriakos
- Public Health Policy Evaluation Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Dickson Qi
- Public Health Policy Evaluation Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Kiara Chang
- Public Health Policy Evaluation Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Anthony A. Laverty
- Public Health Policy Evaluation Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Filippos T. Filippidis
- Public Health Policy Evaluation Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
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van der Eijk Y. Standardised cigarettes: the next step for tobacco policy? Tob Control 2022:tobaccocontrol-2022-057417. [PMID: 35768214 DOI: 10.1136/tc-2022-057417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 06/20/2022] [Indexed: 11/03/2022]
Abstract
As tobacco marketing restrictions intensify, tobacco companies increasingly turn to the cigarette product itself as a marketing medium with new flavours, capsules, novelty filter features and attractive cigarette stick designs. This paper considers a 'standardised cigarettes' policy as a potential next step in restricting tobacco marketing. This policy would remove from cigarette products all the elements that increase their appeal and addictiveness: added flavours, nicotine, and visual designs and branding. The result would be a cigarette that is flavourless, not especially addicting, and visually off-putting. This paper discusses what a standardised cigarettes policy might look like from a regulatory standpoint, and how it fits into current policy obligations under the WHO Framework Convention on Tobacco Control.
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Affiliation(s)
- Yvette van der Eijk
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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van der Eijk Y. It is time to ban flavor capsule cigarettes. Tob Prev Cessat 2022; 8:22. [PMID: 35795261 PMCID: PMC9179177 DOI: 10.18332/tpc/150334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/18/2022] [Accepted: 05/23/2022] [Indexed: 11/24/2022]
Affiliation(s)
- Yvette van der Eijk
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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Evaluating the public health impact of partial and full tobacco flavour bans: A simulation study. THE LANCET REGIONAL HEALTH - WESTERN PACIFIC 2022; 21:100414. [PMID: 35252911 PMCID: PMC8891712 DOI: 10.1016/j.lanwpc.2022.100414] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background Methods Findings Interpretations Funding
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Moodie C, Hoek J, Hammond D, Gallopel-Morvan K, Sendoya D, Rosen L, Mucan Özcan B, van der Eijk Y. Plain tobacco packaging: progress, challenges, learning and opportunities. Tob Control 2022; 31:263-271. [PMID: 35241599 DOI: 10.1136/tobaccocontrol-2021-056559] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 10/12/2021] [Indexed: 11/03/2022]
Abstract
The aim of this paper is to overview progress made with respect to the adoption of plain (or standardised) packaging, key challenges faced, evaluative evidence and opportunities for extending this policy. It has been a decade since Australia became the first country to require tobacco products to be sold in plain packaging; after slow initial uptake, 16 countries have now fully implemented this policy. Since 2020, plain packaging laws have become more comprehensive in some countries, expanding coverage beyond traditional tobacco products to include heated tobacco, tobacco accessories (rolling papers) and other nicotine-containing products (e-cigarettes). Laws have also become more innovative: some now ban non-biodegradable filters, include provision for a periodic change of the pack colour or require both plain packaging and health-promoting pack inserts. The tobacco industry has and will continue to use multi-jurisdictional strategies to oppose this policy. Evaluations suggest that plain packaging has improved health outcomes and has not burdened retailers, although research is limited to early policy adopters and important gaps in the literature remain. While the power of packaging as a sales tool has diminished in markets with plain packaging, tobacco companies have exploited loopholes to continue to promote their products and have increasingly focused on filter innovations. Opportunities exist for governments to strengthen plain packaging laws.
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Affiliation(s)
- Crawford Moodie
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Janet Hoek
- Departments of Public Health and Marketing, University of Otago, Dunedin, New Zealand
| | - David Hammond
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | | | - Diego Sendoya
- Facultad de Derecho, Universidad de la Republica Uruguay, Montevideo, Uruguay
| | - Laura Rosen
- Department of Health Promotion, School of Public Health, Tel Aviv University Sackler Faculty of Medicine, Tel Aviv, Israel
| | - Burcu Mucan Özcan
- Department of Business Administration, Celal Bayar University, Manisa, Turkey
| | - Yvette van der Eijk
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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