Compliance with Uruguay's single presentation requirement

Where to next for countries with high tobacco taxes? The potential for greater control of tobacco pricing through licensing regulation

Optimising the taxation of tobacco products should be among the highest priorities for health and hence economic policy in every country. The WHO Technical Manual on Tobacco Tax Policy and Administration released in April 2021 provides invaluable advice, including 26 best practice recommendations on policy design, administrative efficiency and addressing industry tactics to circumvent tobacco tax increases. Introducing and increasing tobacco taxes is the most important tobacco control measure for any jurisdiction. The effects of simple tax structures, high tax levels, and frequent above-inflation increases in specific excise duties can be enhanced through strict controls on packaging (including pack size), product design, and discounting. However, even with such measures, tobacco companies can continue to undermine the effectiveness of tax policy by offering some products in their ranges at very low prices, as well as gradually and selectively increasing the prices of some but not all products after tax increases. This paper is aimed at policymakers in countries that have already adopted best practice tax policy. It explores the idea of wholesale price capping combined with retail licensing to address the problems of brand proliferation, dispersion of prices, cushioning and strategic under/overshifting of tax increases, thereby radically and sustainably increasing the effectiveness of tobacco tax policy while also raising additional tax revenue for governments by reducing industry profitability.

Feminine Appeals on Cigarette Packs Sold in 14 Countries

Objective: Limited research has examined feminine marketing appeals on cigarette packs in low-and middle-income countries (LMICs). We reviewed a systematically collected sample of cigarette packs sold across 14 LMICs in 2013 (Wave 1) and 2015–2017 (Wave 2).

Methods: Packs in Wave 1 (n = 3,240) and Wave 2 (n = 2,336) were coded for feminine imagery and descriptors (flowers, fashion, women/girls, color “pink”). We examined trends in feminine appeals over time, including co-occurrence with other pack features (slim or lipstick shape, flavor, reduced harm, and reduced odor claims).

Results: The proportion of unique feminine cigarette packs significantly decreased from 8.6% (n = 278) in Wave 1 to 5.9% (n = 137) in Wave 2 (p < 0.001). Among all feminine packs, flower-and fashion-related features were most common; a substantial proportion also used flavor and reduced odor appeals.

Conclusion: While there was a notable presence of feminine packs, the decline observed may reflect global trends toward marketing gender-neutral cigarettes to women and a general contempt for using traditional femininity to market products directly to women. Plain packaging standards may reduce the influence of branding on smoking among women.

Australian smokers’ experiences and perceptions of recessed and firm filter cigarettes

Background

While cigarette filter modifications have long been used to increase product appeal and assuage health concerns, tighter marketing restrictions, including plain packaging, have further spurred the growth of filter variants. We explored and assessed experiences and perceptions of smokers who had tried and/or currently use recessed filter cigarettes (RFCs) and firm filter cigarettes (FFCs).

Method

In November 2018, we undertook eight exploratory focus groups of Australian adult factory-made cigarette smokers (total n=56). In July 2019, we surveyed 999 smokers aged 18–69 years to quantify ever and current use of these products and associated beliefs and sensory experiences.

Results

Focus group and survey findings were consistent. Among 988 smokers who had at least tried factory-made cigarettes, 28.9% had tried FFCs and 11.1% currently smoked these, while 36.4% had tried RFCs and 7.5% currently smoked these. Smokers in both studies believed these filters may reduce harm and that FFCs increase appeal. In the survey, 58.9% of RFC triers agreed these hide the filter’s brown stain and 48.9% agreed that RFCs keep harmful substances away from the mouth. Similarly, 58.4% of FFC triers agreed these trap more harmful substances than standard filters. Relative to standard filter cigarettes, more smokers experienced FFCs and RFCs as feeling clean (p=0.03) and more current FFC users experienced these as feeling smooth (p=0.01).

Conclusion

RFCs and FFCs undermine plain packaging legislation, which aims to reduce appeal and minimise misperceptions about the relative harms of different tobacco products. Like other filter modifications, these filter variants should be disallowed.

The FCTC dilemma on heated tobacco products

BACKGROUND

In October 2018, the Conference of the Parties of the Framework Convention on Tobacco Control (FCTC or Convention) adopted its first decision on novel and emerging tobacco products, including heated tobacco products (HTPs). The decision remains ambiguous, e.g. by making a distinction between tobacco sticks and HTP devices. Against this background, the article seeks to answer two interrelated questions: whether and to what extent HTPs are covered by the FCTC, and whether regime provided by the Convention is suitable for their regulation.

RESULTS

HTPs need to be classified under the FCTC as tobacco products. The distinction made by the Conference of the Parties between sticks and devices leads however to unsatisfactory results as it creates loopholes in tobacco control standards existing at the international level. A better approach, as argued in this article, is to conceptualize the notion of 'tobacco products' in functional terms as a combination of both a device and stick. While subjecting HTPs to all FCTC disciplines is, in light of our current scientific knowledge, a rational approach, such classification can be modified in the future once a sufficient amount of new evidence on their risk profile is collected. Any decision on the optimal regulatory model for HTPs will need to take into account not only health risks and potential benefits for individual users, but also the specific systemic concerns (e.g. HTPs as a gateway product). The state of scientific research is however not the only factor that will determine the fate of HTPs under the Convention. What is equally important is a conceptualization of the FCTC's objectives. If a complete eradication of the tobacco epidemic is the ultimate goal, reduced levels of risk may not be enough to justify the different (i.e. more lenient) regulatory regime for HTPs.

CONCLUSIONS

The Conference of the Parties should clarify the definition of tobacco products in light of recent changes in the market. When designing the regulatory regime for HTPs under the FCTC in the future, one has to consider not only scientific evidence but also pay attention to the objective of the Convention (or more generally to the values that underlie the current tobacco control paradigm).