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Ackary SJ, Cabrera PJD, Santiago AJA, Amul GGH. An analysis of flavor descriptors on tobacco products in the Philippines: Regulatory implications and lessons for low- and middle-income countries. Global Health 2024; 20:67. [PMID: 39252089 PMCID: PMC11385504 DOI: 10.1186/s12992-024-01072-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 09/02/2024] [Indexed: 09/11/2024] Open
Abstract
BACKGROUND Historically, tobacco companies have used flavored tobacco products to enhance the appeal of tobacco consumption, encourage initiation and experimentation of tobacco use, and contribute to sustained tobacco use. While flavored tobacco products are regulated in several countries, there is no existing regulation on flavored tobacco products in the Philippines, specifically for cigarettes and cigars. This study aims to update evidence on the flavored tobacco product landscape in the Philippines by assessing both the flavor descriptors and flavor imagery featured on cigarette and cigar packaging. RESULTS We collected 106 cigarette and cigar products from four major cities in the National Capital Region, Balanced Luzon, Visayas, and Mindanao. Of these 106 cigarette and cigar products, 62 (58.49%) had flavor descriptors. Three crushable capsule products did not feature any flavor descriptor but were included for flavor imagery examination. We identified five categories of flavor descriptors: menthol, concept descriptors, tobacco, beverages, and other flavors. Out of 62 packs, ten featured more than one flavor descriptor on the packaging. Menthol flavor descriptors comprised the majority of flavor descriptors. Imagery and other graphic elements closely resonate with and enhance the flavor descriptors found on these packs. CONCLUSIONS This study aimed to update the evidence on the flavored tobacco product landscape in the Philippines and address their absence of regulation. Regulating flavored tobacco products requires a comprehensive policy approach complemented by complete enforcement. Flavor substances, flavor descriptors, and flavor imagery must be regulated altogether; however, it is ideal to enforce a ban on flavored tobacco products in compliance with the WHO FCTC, to which the Philippines is a signatory. Policymakers should consider plain packaging as an intervention to eliminate the appeals associated with flavored tobacco products.
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Affiliation(s)
- Samantha J Ackary
- School of Government, Ateneo de Manila University, Quezon City, Philippines.
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Reboussin BA, Lazard AJ, Ross JC, Sutfin EL, Romero-Sandoval EA, Suerken CK, Lake S, Horton OE, Zizzi AR, Wagoner E, Janicek A, Boucher M, Wagoner KG. A content analysis of cannabis edibles package marketing in the United States. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 130:104526. [PMID: 39032269 PMCID: PMC11348886 DOI: 10.1016/j.drugpo.2024.104526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 06/28/2024] [Accepted: 07/05/2024] [Indexed: 07/23/2024]
Abstract
BACKGROUND With states legalizing cannabis at a rapid pace, and the increasing popularity of edibles, it is important to document marketing practices to better understand how they might be appealing and misleading to consumers to guide state policymakers. METHODS A descriptive content analysis of 1229 cannabis edible packages advertised on a publicly available website between June and November 2022 and available for sale in licensed dispensaries was performed. RESULTS Healthy ingredient descriptors were the most common type of descriptor with 31 % of packages including words like "vegan", "gluten free" and "natural". Quality descriptors like "handcrafted" were on 28 % of packages. Other descriptors were focused on the consumer experience including expected effects (e.g., "relax") (27 %), taste or flavor (e.g., "sour") (21 %) and pharmacokinetics (e.g., "fast-acting") (19 %). Images of non-cannabis plants and outdoor nature settings were on half of packages. Images of the cannabis plant were on 33 % of packages. Flavor imagery including images of food were common (43 %). Other marketing appeals included images of people (15 %), animals (12 %) and space (10 %). CONCLUSIONS Package marketing used by other commercial industries was common on cannabis edible packages. Edibles marketing is distinct from other cannabis products in its ability to focus on the food ingredients which could mislead consumers into thinking the cannabis, rather than the food, is healthy or less harmful. Research examining the impact of cannabis edibles marketing strategies on appeal and harm perceptions is critically needed to guide policymakers as they establish packaging regulations to optimize public health and safety.
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Affiliation(s)
- Beth A Reboussin
- Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, United States.
| | - Allison J Lazard
- University of North Carolina at Chapel Hill Hussman School of Journalism and Media, 384 Carroll Hall, Chapel Hill, NC 27599, United States
| | | | - Erin L Sutfin
- Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, United States
| | - E Alfonso Romero-Sandoval
- Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, United States
| | - Cynthia K Suerken
- Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, United States
| | - Shelby Lake
- University of North Carolina at Chapel Hill Hussman School of Journalism and Media, 384 Carroll Hall, Chapel Hill, NC 27599, United States
| | - Olivia E Horton
- Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, United States
| | - Alexandra R Zizzi
- Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, United States
| | - Emily Wagoner
- North Carolina State University Poole College of Management, 2801 Founders Dr., Raleigh, NC 27695, United States
| | - Alondra Janicek
- Wake Forest University College of Arts and Sciences, 104 Reynolda Hall, PO Box 7225, Winston-Salem, NC 27109, United States
| | - Madeleine Boucher
- Wake Forest University College of Arts and Sciences, 104 Reynolda Hall, PO Box 7225, Winston-Salem, NC 27109, United States
| | - Kimberly G Wagoner
- Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, United States
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Hobin E, Thielman J, Forbes SM, Poon T, Bélanger-Gravel A, Demers-Potvin É, Haynes A, Li Y, Niquette M, Paradis C, Provencher V, Smith BT, Wells S, Atkinson A, Vanderlee L. Can a health warning label diminish the persuasive effects of health-oriented nutrition advertising on ready-to-drink alcohol product packaging? A randomized experiment. Addiction 2024; 119:1238-1252. [PMID: 38528612 DOI: 10.1111/add.16475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 02/11/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND AND AIMS A health warning label (HWL) cautioning about the link between alcohol and cancer may be able to communicate alcohol risks to consumers and potentially counter health-oriented nutrition advertising on ready-to-drink alcoholic beverages. This study aimed to examine the independent and combined effects of nutrient content claims (e.g. 0 g sugar) and a HWL on perceived product characteristics and intentions to consume, and whether these effects differed by gender and age. DESIGN A between-subjects randomized experiment. Participants were randomized to view one of six experimental label conditions: nutrient content claims plus nutrition declaration (NCC + ND), ND only, NCC + ND + HWL, ND + HWL, HWL only and no NCC, ND or HWL, all on a ready-to-drink (RTD) vodka-based soda container. SETTING AND PARTICIPANTS Alcohol consumers (n = 5063; 52% women) in Canada aged 18-64 recruited through a national online panel. MEASUREMENTS Participants completed ratings of perceived product characteristics, perceived product health risks, and intentions to try, buy, binge and drink the product. FINDINGS Compared with the reference condition NCC + ND (current policy scenario in Canada), the other five experimental label conditions were associated with lower ratings for perceiving the product as healthy. All experimental conditions with a HWL were associated with lower product appeal, higher risk perceptions and reduced intentions to try, buy and binge. The experimental condition with a HWL only was associated with intentions to consume fewer cans in the next 7 days (β = -0.72, 95% confidence interval [CI] = -1.37,-0.08) versus the reference. Few interactions were observed, suggesting that label effects on outcomes were similar by gender and age. CONCLUSIONS Health warning labels on alcohol packaging appear to be associated with lower product appeal, higher perceived health risks and reduced consumption intentions, even in the presence of nutrient content claims.
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Affiliation(s)
- Erin Hobin
- Public Health Ontario, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | | | | | | | - Ariane Bélanger-Gravel
- Department of Information and Communication, Université Laval, Québec, Canada
- Centre NUTRISS-Nutrition, santé et société, Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, Canada
- Research Center of the Quebec Heart and Lung Institute, Québec, Canada
| | - Élisabeth Demers-Potvin
- Centre NUTRISS-Nutrition, santé et société, Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, Canada
- École de nutrition, Université Laval, Québec, Canada
| | - Ashleigh Haynes
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Ye Li
- Public Health Ontario, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Manon Niquette
- Centre NUTRISS-Nutrition, santé et société, Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, Canada
- Département d'information et de communication, Université Laval, Québec, Canada
| | | | - Véronique Provencher
- Centre NUTRISS-Nutrition, santé et société, Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, Canada
- École de nutrition, Université Laval, Québec, Canada
| | - Brendan T Smith
- Public Health Ontario, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Samantha Wells
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Department of Epidemiology and Biostatistics, University of Western Ontario, London, Canada
- School of Psychology, Deakin University, Geelong, Australia
| | - Amanda Atkinson
- Public Health Institute, Faculty of Health, Liverpool John Moores University, Liverpool, UK
| | - Lana Vanderlee
- Centre NUTRISS-Nutrition, santé et société, Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, Canada
- École de nutrition, Université Laval, Québec, Canada
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Jeong M, Wackowski OA, Schroth KRJ, Strasser AA, Delnevo CD. Influence of cigarillo packaging characteristics on young adults' perceptions and intentions: findings from three online experiments. Tob Control 2023; 32:344-351. [PMID: 34711667 PMCID: PMC9046465 DOI: 10.1136/tobaccocontrol-2021-056785] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 09/27/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Packaging is an important component of tobacco marketing that influences product perceptions and use intentions. However, little research exists on cigar packaging. We leveraged variability in existing Swisher Sweets cigarillo packaging to extend the evidence base. METHODS Between 2017 and 2019, we conducted three online experiments with 774 young adult past-year cigar smokers recruited via Amazon Mechanical Turk. After viewing Swisher package images that differed by flavour descriptor and/or colour, participants rated them on perceptions and purchase intentions. In study 1, participants viewed one of four cigarillos ('Wild Rush Encore', 'Wild Rush Limited', 'Twisted Berry' and 'Strawberry'). In study 2, participants viewed two different watermelon rum-flavoured cigarillos ('Boozy Watermelon' and 'Island Madness'). In study 3, participants viewed two of three 'Wild Rush' cigarillo versions ('Encore' with or without an explicit flavour descriptor or 'Limited'). RESULTS In study 1, more participants perceived 'Twisted Berry' and 'Wild Rush Limited' as tasting good and less harsh tasting compared with 'Wild Rush Encore'. In study 2, compared with 'Island Madness', more participants perceived 'Boozy Watermelon' as tasting good, less harsh tasting and used by younger users but less by masculine users; female participants were more likely to purchase 'Boozy Watermelon'. In study 3, participants perceived 'Wild Rush Encore' with the explicit flavour descriptor as tasting better than packages without and being used by younger users but less by masculine users. CONCLUSIONS Variations in cigarillo packaging, even among cigarillos with the same flavour, may have differential consumer appeal, suggesting packaging features should be considered in cigar product regulation.
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Affiliation(s)
- Michelle Jeong
- Rutgers Center for Tobacco Studies, Rutgers University, New Brunswick, New Jersey, USA
- Department of Health Behavior, Society, and Policy, Rutgers School of Public Health, Piscataway, New Jersey, USA
| | - Olivia A Wackowski
- Rutgers Center for Tobacco Studies, Rutgers University, New Brunswick, New Jersey, USA
- Department of Health Behavior, Society, and Policy, Rutgers School of Public Health, Piscataway, New Jersey, USA
| | - Kevin R J Schroth
- Rutgers Center for Tobacco Studies, Rutgers University, New Brunswick, New Jersey, USA
- Department of Health Behavior, Society, and Policy, Rutgers School of Public Health, Piscataway, New Jersey, USA
| | - Andrew A Strasser
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Cristine D Delnevo
- Rutgers Center for Tobacco Studies, Rutgers University, New Brunswick, New Jersey, USA
- Department of Health Behavior, Society, and Policy, Rutgers School of Public Health, Piscataway, New Jersey, USA
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Delnevo CD, Ganz O. Association of Flavor Perception With Blue vs Purple Cigar Packaging Among US Adults. JAMA Netw Open 2023; 6:e2254003. [PMID: 36745458 PMCID: PMC9999707 DOI: 10.1001/jamanetworkopen.2022.54003] [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] [Indexed: 02/07/2023] Open
Abstract
This survey study examines the association of cigar flavor perception with blue vs purple packaging among US adults.
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Affiliation(s)
- Cristine D Delnevo
- Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, New Jersey
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, New Jersey
| | - Ollie Ganz
- Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, New Jersey
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, New Jersey
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Ganz O, Wackowski OA, Gratale S, Chen-Sankey J, Safi Z, Delnevo CD. The Landscape of Cigar Marketing in Print Magazines from 2018-2021: Content, Expenditures, Volume, Placement and Reach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16172. [PMID: 36498246 PMCID: PMC9739552 DOI: 10.3390/ijerph192316172] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 11/22/2022] [Accepted: 11/26/2022] [Indexed: 06/17/2023]
Abstract
Cigar consumption has increased in the U.S. over the past decade, yet gaps remain in research on cigar promotion in print magazines. This study examines ad placement, volume, ad characteristics, and associated expenditures for cigars from 2018-2021, and readership data for magazines containing cigar ads. We merged content analysis data with Kantar Media data on magazine placement and expenditures and used magazine readership data from MRI-Simmons. The only brand in print magazines was Black & Mild (B & M), a top cigar brand in the U.S. There were 30 unique B & M magazine ads and 284 occurrences (i.e., appearances in magazines), translating to $46,504,578 in expenditures. All ads featured the word "enjoy/enjoyment" and a warning label. Filtered cigars were the most featured cigar type (75%) and sweets was the most featured flavor (78%). Nearly half of the publications in which B & M were advertised in have substantial Black/African American readership and were featured in publications with disproportionate young adult and Hispanic/Latino readership. This study identified tactics used in print advertising for a top cigar brand. Future research should examine how these tactics impact consumer perceptions. Findings of cigar ads reaching vulnerable populations may inform the FDA's efforts to reduce health disparities through regulations and public education.
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Affiliation(s)
- Ollie Ganz
- Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, NJ 08901, USA
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, NJ 08854, USA
| | - Olivia A. Wackowski
- Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, NJ 08901, USA
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, NJ 08854, USA
| | - Stefanie Gratale
- Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, NJ 08901, USA
| | - Julia Chen-Sankey
- Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, NJ 08901, USA
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, NJ 08854, USA
| | - Zeinab Safi
- Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, NJ 08901, USA
| | - Cristine D. Delnevo
- Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, NJ 08901, USA
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, NJ 08854, USA
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Pike Moore S, Osborn C, Koopman Gonzalez S, Quisenberry A, Klein EG, Kaur M, Suratkal J, Trapl E. Flavour loyalty may predict cessation or substitution following a cigarillo flavour ban among young adults in the USA. Tob Control 2022; 31:s206-s213. [PMID: 36328462 PMCID: PMC9641532 DOI: 10.1136/tc-2022-057487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 06/24/2022] [Indexed: 11/22/2022]
Abstract
Significance The purpose of this research was to measure flavour loyalty and identify how current cigarillo users may respond to a hypothetical flavour ban in the USA. Methods Cigarillo users aged 21–28 (n=531) were recruited between October 2020 and April 2021 to participate in an online survey. Respondents categorised their preferred, usual and current cigarillo flavours. Individuals who preferred tobacco flavours were compared with individuals who preferred any other flavours. Strength of preferences, or flavour loyalty, was defined when an individual’s preferred flavour matched what they use both usually and currently creating a spectrum of individuals with a strong tobacco preference (n=34), weak tobacco preference (n=20), weak flavour preference (n=162) and strong flavour preference (n=315). Those preferring tobacco were aggregated into any tobacco preference (n=54). Results Individuals who preferred any flavour scored higher on a scale of nicotine dependence. There was a dose–response relationship in those who said they would discontinue cigarillos if flavoured options were not available: 11.4% of individuals with any tobacco flavour preference, 27.8% of those with a weak flavour preference and 38.1% of those with a strong flavour preference. A similar trend was noted among those who would switch to another product: 19.2% of those with tobacco flavour preference, 34.3% of those with a weak flavour preference and 43.2% of those with a strong flavour preference. Conclusion Individuals who display strong flavour preferences were more likely to say they would discontinue use or seek out alternative flavoured products following a ban on flavoured cigarillos.
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Affiliation(s)
- Stephanie Pike Moore
- Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - Catherine Osborn
- Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - Sarah Koopman Gonzalez
- Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | | | - Elizabeth G Klein
- College of Public Health, Ohio State University, Columbus, Ohio, USA
| | - Manpreet Kaur
- Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - Jessica Suratkal
- Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - Erika Trapl
- Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, USA
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Giovenco DP, Spillane TE, Talbot E, Wackowski OA, Audrain-McGovern J, Ganz O, Delnevo CD. Packaging Characteristics of Top-Selling Cigars in the United States, 2018. Nicotine Tob Res 2022; 24:1678-1683. [PMID: 35287167 PMCID: PMC9575977 DOI: 10.1093/ntr/ntac070] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 02/03/2022] [Accepted: 03/11/2022] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Tobacco product packaging is an influential industry marketing tool, but research on cigar packaging characteristics is limited. This study leveraged a pack archive of the top-selling, mass-market cigar products in the US and their corresponding sales data to assess the prevalence of common pack features in the marketplace. METHODS The 50 cigar products with the highest national unit sales in 2018 were identified using Nielsen's Scantrack data. A content analysis captured common packaging features within four domains: physical, textual, graphical, and promotional elements. Descriptive statistics, weighted by each pack's 2018 unit sales, documented the market share of pack characteristics overall and by brand. RESULTS Products in the sample constituted 62% of all convenience store cigar sales in 2018. Black & Mild, the most popular brand, did not display warning labels on its single stick, cellophane-wrapped products, which constituted nearly all of its sales (96.3%). Resealable foil pouches were the most common packaging style across other brands, and were most often sold in predominantly red, green, or silver packaging. Common flavor categories included concept (eg, "Jazz", 32.4%), fruit (15.7%), and sweet (14.5%). Prepricing (eg, "2 for 99 cents") was a popular promotional strategy, appearing on 74% of all packs sold. CONCLUSIONS Cigar packaging features such as small pack sizes, innovative materials, flavor names, bright colors, and cost-saving promotions are prevalent among the top-selling products. Stronger packaging-focused policies at the federal and local levels may help reduce appeal and potentially curb cigar use. IMPLICATIONS Sales of mass-market cigars in the US have remained strong over the past decade, propelled by lax product regulations. This study demonstrated that cigar packaging features that may enhance consumer appeal, such as small pack sizes, flavor names, sensory descriptors, bright colors, and cost-saving promotions, are prevalent among the top-selling products. Stronger packaging-focused policies at the federal and local levels may help curb cigar use, reduce youth appeal, and potentially minimize existing disparities in cigar use.
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Affiliation(s)
- Daniel P Giovenco
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Torra E Spillane
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Eugene Talbot
- Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, USA
| | - Olivia A Wackowski
- Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, USA.,Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Janet Audrain-McGovern
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Ollie Ganz
- Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, USA.,Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Cristine D Delnevo
- Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, USA.,Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, NJ, USA
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Vassey J, Donaldson S, Dormanesh A, Allem JP. THEMES IN TIKTOK VIDEOS FEATURING LITTLE CIGARS AND CIGARILLOS: A CONTENT ANALYSIS (Preprint). J Med Internet Res 2022; 24:e42441. [DOI: 10.2196/42441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 10/26/2022] [Accepted: 11/01/2022] [Indexed: 11/05/2022] Open
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Young WJ, Ganz O, Jeong M, Wackowski OA, Delnevo CD. Perceptions of Game cigarillo packaging among young adult tobacco users: The effect of package color and the "natural leaf" descriptor. Addict Behav 2022; 132:107334. [PMID: 35617767 PMCID: PMC9190173 DOI: 10.1016/j.addbeh.2022.107334] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 04/08/2022] [Accepted: 04/09/2022] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Tobacco packaging elements have been shown to influence product perceptions and use intentions. Garcia y Vega's Game cigarillos are distinct from other brands in their use of "natural leaf" on packaging. The term "natural" has been linked to misperceptions about lower risk in the context of cigarettes. This study examines the impact of the "natural leaf" descriptor and pack color on young adults' cigarillo perceptions and intentions. METHODS In April-June 2020, we conducted an online experiment with 1,063 young adults (ages 18-34) that were past year users of cigars, vaping products, or marijuana. Subjects were randomly assigned to view one of eight images of Game cigarillo packs that varied in color and presence of the "natural leaf" descriptor. RESULTS Purple packaging increased perceptions that the product tasted good, smelled nice, was flavored, and that a typical user was young. "Natural leaf" increased beliefs that the product contained high quality tobacco and that a typical user was trendy. When on grey packs, it increased favorable perceptions compared to when on brightly colored packs, including perceptions that the product tasted good, was fresh, that a typical user was trendy, and that the product was flavored. CONCLUSIONS This study is the first to present quantitative evidence on the impact of the "natural leaf" descriptor on cigarillo perceptions and intentions, extending work that has been done in the context of cigarettes. Utilizing highly realistic stimuli, findings demonstrate that both the term "natural leaf" and packaging color can increase favorable perceptions of cigarillos.
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Affiliation(s)
- William J Young
- Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, USA.
| | - Ollie Ganz
- Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, USA; Department of Health Behavior, Society and Policy, Rutgers School of Public Health, USA; Rutgers Cancer Institute of New Jersey, USA.
| | - Michelle Jeong
- Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, USA; Department of Health Behavior, Society and Policy, Rutgers School of Public Health, USA; Rutgers Cancer Institute of New Jersey, USA.
| | - Olivia A Wackowski
- Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, USA; Department of Health Behavior, Society and Policy, Rutgers School of Public Health, USA; Rutgers Cancer Institute of New Jersey, USA.
| | - Cristine D Delnevo
- Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, USA; Department of Health Behavior, Society and Policy, Rutgers School of Public Health, USA; Rutgers Cancer Institute of New Jersey, USA.
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11
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Ganz O, Jeong M, Schroth KRJ, Hrywna M. The importance of cigarillo product characteristics among young adult cigarillo users: Differences by demographics, cigarillo use and other tobacco/substance use behaviors. PLoS One 2022; 17:e0265470. [PMID: 35395013 PMCID: PMC8993004 DOI: 10.1371/journal.pone.0265470] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 03/02/2022] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Cigar products, including cigarillos, have increased in popularity in the U.S. and are disproportionately used by young adults. Cigarillo product characteristics can influence consumer perceptions and the appeal of these characteristics can vary by subgroup. The goal of this study was to examine a) product characteristics important to young adult cigarillo users and b) differences based on demographics and cigarillo and other tobacco/substance use behaviors. METHODS In 2016, a convenience sample of 628 past-year cigarillo users rated the importance of the following cigarillo product characteristics when choosing a cigarillo to smoke tobacco: brand, tobacco filler quality, tobacco wrap quality, flavors, price, package graphic design, and number of cigars in the pack. Differences in mean importance by demographic, cigarillo use and other tobacco/substance use characteristics were analyzed using t-tests and ANOVA tests. RESULTS The most important cigarillo product characteristics were price, quality of tobacco wrap, and flavors. The least important was graphic design of packaging. There were differences in importance by demographics and/or cigar and other tobacco/substance use behaviors for all product characteristics. In particular, pack size was rated as more important among current cigarillo users, users of foil pouches (2-3 cigarillos) or cardboard/paper boxes or other packaging styles, and current users of cigarettes, blunts and marijuana. Price was rated as more important among Hispanic/Latino and lower income smokers, and current cigarette and blunt smokers. CONCLUSIONS Findings suggest cigarillo users prioritize different product characteristics depending on their demographics or smoking behavior. Further research is needed to examine whether various cigar-related policies, such as those that ban flavors or set minimum pack sizes, could impact sub-populations of cigarillo users differently.
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Affiliation(s)
- Ollie Ganz
- Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, New Jersey, United States of America
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, New Jersey, United States of America
| | - Michelle Jeong
- Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, New Jersey, United States of America
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, New Jersey, United States of America
| | - Kevin R. J. Schroth
- Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, New Jersey, United States of America
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, New Jersey, United States of America
| | - Mary Hrywna
- Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, New Jersey, United States of America
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, New Jersey, United States of America
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12
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Impact of Little Cigars and Cigarillos Packaging Features on Product Preference. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111443. [PMID: 34769959 PMCID: PMC8583443 DOI: 10.3390/ijerph182111443] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/24/2021] [Accepted: 10/26/2021] [Indexed: 11/22/2022]
Abstract
Background: We conducted a discrete choice experiment (DCE) among young adult cigarette smokers in the period July–August 2018 to examine their preference for cigarillos in response to various packaging-related attributes, including flavor, flavor description, quality descriptors, pack size, and prices. Methods: A convenience sample of 566 US young adult cigarette smokers aged 18–34, among whom 296 were current little cigar and cigarillo (LCC) smokers, were recruited using Facebook ads and invited to participate in an online (Qualtrics) tobacco survey containing DCE and tobacco use questions. In the experiment, participants chose among two cigarillo products or “neither” (opt-out). Results: We analyzed preferences for LCCs using multinomial, nested, random parameter logit models. Results showed that young adult cigarette smokers preferred grape over menthol, tobacco/regular, and wine flavors; “color only” and “color and text” flavor depictions over text only; “smooth” and “sweet” quality descriptors over “satisfying”; and larger pack sizes and lower prices. Conclusions: Regulating packaging-related features will impact LCC choices among US young adult smokers. FDA regulation over these packaging-related features may impact LCC use among young adult smokers.
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13
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Sterling K, Vishwakarma M, Ababseh K, Henriksen L. Flavors And Implied Reduced-Risk Descriptors In Cigar Ads At Stores Near Schools. Nicotine Tob Res 2021; 23:1895-1901. [PMID: 34214176 DOI: 10.1093/ntr/ntab136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 07/01/2021] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Although the FDA prohibits using inaccurate, reduced-risk descriptors on tobacco product advertising, descriptors that imply reduced-risk or an enhanced user experience may be present on cigar product advertising in retail outlets near schools. Therefore, to inform the development of federal labeling and advertising requirements that reduce youth appeal of cigars, we conducted a content analysis of cigar ads in retailers near schools to document the presence of implied health claims and other selling propositions that may convey enhanced smoking experience. METHODS Up to four interior and exterior LCC advertisements were photographed in a random sample of licensed tobacco retailers (n=530) near California middle and high schools. Unique ads (n= 234) were coded for brand, flavor, and presence of implicit health claims, premium branding descriptors, and sensory descriptors. Logistic regressions assessed the association among flavored ads and presence of implicit health claims, premium branding, or sensory descriptors. RESULTS Seventeen cigar brands were advertised near schools; Black & Mild (20.1%) and Swisher Sweets (20.1%) were most common. Flavor was featured in 64.5% of ads, with explicit flavor names (e.g., grape) being more prevalent than ambiguous names (e.g., Jazz) (49.6% vs. 34.2%). Compared to ads without flavors, ads with ambiguous flavors were more likely to feature implicit health claims (OR=1.83, 95%CI=1.06, 3.19) and sensory descriptors (OR=2.64, 95%CI=1.39, 5.04); ads with explicit flavors were more likely to feature premium branding (OR=2.84, 95%CI=1.53, 5.41). CONCLUSIONS Cigar ads that featured implicit health claims and premium branding, and sensory selling propositions are present at retailer stores near schools.
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Affiliation(s)
- Kymberle Sterling
- Department of Health Promotion & Behavioral Sciences, School of Public Health, The University of Texas Health Science Center, Dallas Campus, 6011 Harry Hines Blvd., V8.112, Dallas, Texas
| | - Monika Vishwakarma
- Stanford Prevention Research Center, Stanford University School of Medicine, 3300 Hillview Ave, Palo Alto, CA
| | - Kimberly Ababseh
- Stanford Prevention Research Center, Stanford University School of Medicine, 3300 Hillview Ave, Palo Alto, CA
| | - Lisa Henriksen
- Stanford Prevention Research Center, Stanford University School of Medicine, 3300 Hillview Ave, Palo Alto, CA
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14
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Sutfin EL, Lazard AJ, Soule EK, Kimes CM, King J, Jenson D, Ross JC. Health Claims, Marketing Appeals, and Warnings on Popular Brands of Waterpipe Tobacco Packaging Sold in the United States. Nicotine Tob Res 2021; 23:1183-1190. [PMID: 33406241 DOI: 10.1093/ntr/ntab002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 01/05/2021] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Waterpipe tobacco (WT) smoking is associated with misperceptions of harm, especially among users. WT packaging contains imagery, flavor descriptors, and text claims that may contribute to misperceptions. The study goal was to characterize visual and text elements of WT packaging. AIMS AND METHODS Using data from the U.S. Population Assessment on Tobacco and Health Study Wave 2 (October 2014-October 2015), we identified the 10 most popular WT brands. For each brand, we identified available flavors, including flavor collections with unique packaging elements. We randomly selected 10 flavors per brand for purchase (March-April 2018). We conducted descriptive content analysis to code all textual and visual design elements of each package. RESULTS Over half (54%) of WT packages had modified risk tobacco product (MRTP) claims prohibited by federal law, including substance-free MRTP claims (43%) and the descriptor "natural" (11%). No MRTP reduced exposure or reduced risk claims were found. Over a quarter (26%) of packaging including one or more of terms that may imply reduced harm including "fresh," "premium," "quality," and "pure." All packages included a text-only warning, yet none appeared on the primary display panel. Almost all packaging (99%) included imagery, with 72% including flavor imagery. The majority of packages (72%) included a smoking cue. The most popular marketing appeals were "well-made" (57%), "enjoyable" (55%), and "patriotic" (47%). CONCLUSIONS Prohibited MRTP claims, other descriptors, and flavor imagery are common on WT packaging, despite federal law. Future research is needed to evaluate if this marketing contributes to misperceptions of reduced harm. IMPLICATIONS Tobacco packaging is used to convey health-related messages, both explicitly and implicitly; however, information about WT packaging is virtually nonexistent. We conducted a content analysis of WT packaging from the 10 most popular US brands. Over half (54%) of packages had prohibited MRTP claims and over a quarter (26%) included one or more descriptors that may be perceived as implying reduced harm. Use of imagery, including smoking cues, was common. The widespread use of prohibited MRTP claims, other descriptors, and imagery on WT packaging may contribute to misperceptions of reduced harm.
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Affiliation(s)
- Erin L Sutfin
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Allison J Lazard
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Eric K Soule
- Department of Health Education and Promotion, East Carolina University, Greenville, NC, USA
| | - Caroline M Kimes
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Jessica King
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, USA
| | - Desmond Jenson
- Mitchell Hamline School of Law, Public Health Law Center, Saint Paul, MN, USA
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15
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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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16
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Dormanesh A, Kirkpatrick MG, Allem JP. Content Analysis of Instagram Posts From 2019 With Cartoon-Based Marketing of e-Cigarette-Associated Products. JAMA Pediatr 2020; 174:1110-1112. [PMID: 32687566 PMCID: PMC7372496 DOI: 10.1001/jamapediatrics.2020.1987] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
This research study examines the prevalence of cartoon images promoting e-cigarette–associated products on Instagram and their association with likes from users.
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Affiliation(s)
- Allison Dormanesh
- Keck School of Medicine, University of Southern California, Los Angeles
| | | | - Jon-Patrick Allem
- Keck School of Medicine, University of Southern California, Los Angeles
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17
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Avishai A, Meernik C, Goldstein AO, Lazard AJ, Ranney LM, Sheeran P. Impact and mechanisms of cigarillo flavor descriptors on susceptibility to use among young adult nonusers of tobacco. JOURNAL OF APPLIED SOCIAL PSYCHOLOGY 2020. [DOI: 10.1111/jasp.12706] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Aya Avishai
- Department of Psychology and Neuroscience University of North Carolina at Chapel Hill Chapel Hill NC USA
- Lineberger Comprehensive Cancer Center University of North Carolina at Chapel Hill Chapel Hill NC USA
| | - Clare Meernik
- Department of Epidemiology University of North Carolina at Chapel Hill Chapel Hill NC USA
| | - Adam O. Goldstein
- Lineberger Comprehensive Cancer Center University of North Carolina at Chapel Hill Chapel Hill NC USA
- Department of Family Medicine University of North Carolina at Chapel Hill Chapel Hill NC USA
| | - Allison J. Lazard
- Lineberger Comprehensive Cancer Center University of North Carolina at Chapel Hill Chapel Hill NC USA
- Hussman School of Journalism and Media University of North Carolina at Chapel Hill Chapel Hill NC USA
| | - Leah M. Ranney
- Department of Family Medicine University of North Carolina at Chapel Hill Chapel Hill NC USA
| | - Paschal Sheeran
- Department of Psychology and Neuroscience University of North Carolina at Chapel Hill Chapel Hill NC USA
- Lineberger Comprehensive Cancer Center University of North Carolina at Chapel Hill Chapel Hill NC USA
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18
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Rose SW, Johnson AL, Glasser AM, Villanti AC, Ambrose BK, Conway K, Cummings KM, Stanton CA, Delnevo C, Wackowski OA, Edwards KC, Feirman SP, Bansal-Travers M, Bernat J, Holder-Hayes E, Green V, Silveira ML, Zhou Y, Abudayyeh H, Hyland A. Flavour types used by youth and adult tobacco users in wave 2 of the Population Assessment of Tobacco and Health (PATH) Study 2014-2015. Tob Control 2019; 29:432-446. [PMID: 31542778 DOI: 10.1136/tobaccocontrol-2018-054852] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 05/18/2019] [Accepted: 05/28/2019] [Indexed: 11/04/2022]
Abstract
BACKGROUND Most youth and young adult (YA) tobacco users use flavoured products; however, little is known about specific flavours used. METHODS We report flavour types among US tobacco users from the Population Assessment of Tobacco and Health Study, wave 2, 2014-2015. At wave 2, we examined (1) flavour use and type at past 30-day use; (2) new flavoured tobacco product use and type; (3) product-specific flavour patterns across youth (ages 12-17) (n=920), YA (18-24) (n=3726) and adult (25+) (n=10 346) past 30-day and new tobacco users and (4) concordance between self-coded and expert-coded brand flavour type among all adults (18+). RESULTS Prevalence of flavoured tobacco product use was highest among youth, followed by YA and adult 25+ any tobacco users. Within each age group, flavoured use was greatest among hookah, e-cigarette and snus users. Overall, menthol/mint, fruit and candy/sweet were the most prevalent flavour types at first and past 30-day use across age groups. For past 30-day use, all flavour types except menthol/mint exhibited an inverse age gradient, with more prevalent use among youth and YAs, followed by adults 25+. Prevalence of menthol/mint use was high (over 50% youth, YAs; 76% adults 25+) and exhibited a positive age gradient overall, though the reverse for cigarettes. Brand-categorised and self-reported flavour use measures among adults 18+ were moderately to substantially concordant across most products. CONCLUSIONS Common flavours like menthol/mint, fruit and candy/sweet enhance appeal to young tobacco users. Information on flavour types used by product and age can inform tobacco flavour regulations to addess flavour appeal especially among youth.
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Affiliation(s)
| | - Amanda L Johnson
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland, USA
| | | | - Andrea C Villanti
- Truth Initiative Schroeder Institute, Washington, DC, USA.,Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, Burlington, Vermont, USA
| | - Bridget K Ambrose
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland, USA
| | - Kevin Conway
- Division of Epidemiology, Services, and Prevention Branch, National Institute on Drug Abuse, Bethesda, Maryland, USA
| | - K Michael Cummings
- Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Cassandra A Stanton
- Westat Inc, Rockville, Maryland, USA.,Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, United States
| | - Cristine Delnevo
- Center for Tobacco Studies, School of Public Health, Rutgers University, Piscataway, New Jersey, USA
| | - Olivia A Wackowski
- Center for Tobacco Studies, School of Public Health, Rutgers University, Piscataway, New Jersey, USA
| | | | - Shari P Feirman
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland, USA
| | | | - Jennifer Bernat
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland, USA
| | - Enver Holder-Hayes
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland, USA
| | - Victoria Green
- Division of Epidemiology, Services, and Prevention Branch, National Institute on Drug Abuse, Bethesda, Maryland, USA.,Kelly Government Solutions, Rockville, Maryland, USA
| | - Marushka L Silveira
- Division of Epidemiology, Services, and Prevention Branch, National Institute on Drug Abuse, Bethesda, Maryland, USA.,Kelly Government Solutions, Rockville, Maryland, USA
| | - Yitong Zhou
- Truth Initiative Schroeder Institute, Washington, DC, USA
| | | | - Andrew Hyland
- Health Behavior, Roswell Park Cancer Institute, Buffalo, New York, USA
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