Kevin Welding

Cigarette stick as valuable communicative real estate: a content analysis of cigarettes from 14 low-income and middle-income countries

Background The current cigarette market is heavily focused on low-income and middle-income countries. Branding of tobacco products is key to establishing and maintaining a customer base. Greater restrictions on marketing and advertising of tobacco products create an incentive for companies to focus more on branding via the product itself. We consider how tobacco sticks are used for communicative purposes in 14 low-income and middle-income countries with extensive tobacco markets. Methods In 2013, we collected and coded 3232 cigarette and kretek packs that were purchased from vendors in diverse neighbourhoods in 44 cities across the 14 low-income and middle-income countries with the greatest number of smokers. A single stick from each pack was assessed for branding, decorative and communicative elements using a common coding framework. Stick communication variables included brand name, brand image/logo, brand descriptor, colour and design carried through from pack, ‘capsule cigarette’ symbol, and embellishment of filter end. Results Communication and branding on the stick is essentially ubiquitous (99.75%); 97% of sticks include explicit branding (brand name or logo present). Colour is commonly carried through from the pack (95%), and some sticks (13%) include decorative elements matching the pack. Decorative elements can be found anywhere on the stick, including the filter tip (8%), and ‘convertible’ cigarettes include a symbol to show where to push. Conclusions Cigarette sticks are clearly valuable ‘real estate’ that tobacco companies are using for communicative purposes. Across all countries and brands, the stick communicates branding via text, colour and imagery.

Tobacco industry response to menthol cigarette bans in Alberta and Nova Scotia, Canada

Menthol cigarettes are associated with increased initiation and progression to regular smoking and decreased likelihood of smoking cessation.1–8 Menthol smokers are more likely to be women and adolescents in several countries.9 The Conference of the Parties to the Framework Convention on Tobacco Control recommend that Parties regulate ingredients that make cigarettes more palatable, including flavouring substances like menthol.10 The Canadian province Nova Scotia became the first jurisdiction to implement a ban on menthol tobacco products in May 2015, and the province of Alberta followed in September 2015.11 These regulations extended existing provincial bans on the sale of flavoured tobacco products to include menthol flavoured tobacco products, with the exception of pipe tobacco and some cigars. Additional Canadian provinces, Brazil, Ethiopia, Turkey and the European Union have passed regulations to ban menthol tobacco products.11 As jurisdictions (including cities, states/provinces and countries) consider bans on menthol tobacco products, real-life contextual data on the industry response to such bans can be helpful in formulating effective bans. For example, when misleading descriptors on tobacco packaging such as ‘light’ and ‘low tar’ were prohibited, the tobacco industry continued to communicate those same misleading health messages to the consumer using colour or other descriptors.12 ,13 Industry tactics to undermine the effectiveness of health warnings on tobacco packaging have included the use of promotional packaging and altered pack size.14 ,15 Drawing on a sample of cigarette packs …

The Use of Sports Imagery and Terminology on Cigarette Packs from Fourteen Countries

ABSTRACT Background: Tobacco companies have historically associated their products with sports through event sponsorship and sports-themed advertising campaigns. Such linkages serve to enhance brand image by connecting cigarette brands to ideals associated with sports such as strength, individual accomplishment, and a healthy body. Public health policy progress has created restrictions for tobacco sponsorship and restricted traditional advertising avenues for tobacco products. Nonetheless, the pack itself remains as a mechanism by which to link cigarettes to sports and sporting prowess. Thus, we analyze depictions of sport and references to sports terminology on cigarette packs. Objectives: To describe the sports-related marketing appeals on cigarette packages purchased in 14 low and middle income countries. Methods: In 2013, we collected and coded cigarette packs from 14 low and middle income countries and we returned to four of these countries for further data collection in 2015. Packs from both years were assessed for sports-related appeals (text and imagery) and sports-related brand names to identify sports appeals on cigarette packs. Results: The analysis yielded 36 brands with distinct depictions of sport or sporting terminology on the pack. Text-based appeals were found on 24 of the 36 distinct “sports appeal” packs (e.g., “Polo,” “Olympic,” “Win,” “iScore”). Sporting imagery was present on 22 packs (e.g., soccer ball, race car, wrestling match, trophy). Conclusions: The pack is a powerful medium through which tobacco companies continue to associate their products with idealized concepts associated with sports. These are potentially problematic associations that could be restricted through plain and standardized packaging policy initiatives.

English on cigarette packs from six non-Anglophone low- and middle-income countries

ObjectivesLow- and middle-income countries (LMICs) are vital to the global tobacco market. The pack is key to cigarette branding, and review of cigarette packs revealed English as a common feature. The prevalence of English and its potential branding utility is explored.MethodsEvery available unique cigarette pack was purchased from diverse retailers in six LMICs where English is not the official language (Bangladesh, Brazil, China, Egypt, Ukraine, Vietnam). Packs’ front panels were coded for English on pack fronts. English penetration was quantified by country and a comparison of English use between multinational and national brands was undertaken. A qualitative analysis of symbolic and utilitarian usage of English was conducted.ResultsOf 1303 unique cigarette packs analyzed, 67% (n = 876) included some English. English text conveyed product information and usage instruction. English was more prevalent for multinational brands. Qualitatively, English use frequently connected cigarettes with concepts of quality, style, luxury, and aspirational lifestyle.ConclusionsRestricting English use should be incorporated into plain packaging policy to protect populations from deceptive branding practices, specifically presenting cigarettes as an aspirational product.

Compliance with Uruguay’s single presentation requirement

Introduction Tobacco companies vary pack colours, designs, descriptors, flavours and brand names on cigarette packs to target a multitude of consumers. These different brand variants can falsely imply that some brand variants are less harmful than others. Uruguay is the only country that requires cigarette companies to adhere to a single presentation (one brand variant) per brand family. Methods An existing, systematic pack purchasing protocol was adapted for data collection. Neighbourhoods in Montevideo were categorised into five strata by percentage of poor households. Five neighbourhoods within each stratum were selected based on geographical variation. In each neighbourhood, a ‘starting hub’ was identified and a systematic walking protocol was implemented to purchase unique packs at four key vendor types. Results Unique packs were purchased in 9 out of 25 neighbourhoods. Fifty-six unique packs were purchased, representing 30 brands. Of these, 51 packs were legal, representing 26 brands. The majority of the legal brands (n=16; 62%) were compliant with the requirement. The remaining packs were non-compliant due to differences in colour, design element, brand name, crest and descriptors. Although not prohibited by the single presentation requirement, 16 legal brands had more than one stick count (10, 11, 14 or 20 sticks), and packs from four brands had more than one packaging type (hard, soft or tin). Conclusion Overall, compliance with Uruguay’s single presentation requirement was good. In addition to the current restrictions, future single presentation requirements could expand to include packs in more than one stick count and packaging type.

Weekly enrollment and usage patterns in an Internet smoking cessation intervention

Background Previous analyses of Google search queries identified circaseptan (weekly) rhythms in smoking cessation information seeking, with Google searches for “quit” and “smoking” peaking early in the week. Similar patterns were observed for smoking cessation treatment seeking, such as calls to quitlines. These findings suggest that smoking cessation behaviors may have a weekly rhythm that could be leveraged to improve smoking cessation efforts. Aims To assess whether weekly enrollment and usage patterns exist for an Internet smoking cessation intervention. Methods We used process data from a large, longstanding Internet smoking cessation intervention (www.becomeanex.org). Pearsons chi-squared tests were performed to identify day-of-the week differences in enrollment, first visit to site community pages, and quit date. Differences were considered statistically significant at the 1% level if p < 0.00167 due to multiple comparisons. Regression analysis was used to examine differences in engagement activity based on the day of the week a user enrolled. Results Website users (n = 69,237) were more likely to enroll on the site at the beginning of the week (Mondays and Tuesdays) (p < 0.0001). Current smokers who selected quit dates (n = 5574) preferred quit dates that came early in the week (Sundays and Mondays) compared to other weekdays (p < 0.0001). Generally, there were no significant differences in overall website utilization metrics by day of enrollment, but there were some exceptions. Use of interactive features to select quit dates, track cigarette use, and record coping strategies was generally lower for Friday/Saturday enrollees. Conclusions Consistent with prior research, the beginning of the week appears to be a time when individuals are more likely to enroll in an Internet smoking cessation intervention and engage with its core features. Emphasizing marketing and promotional efforts during the beginning of the week could result in greater reach of Internet smoking cessation interventions.

An analysis of purchase price of legal and illicit cigarettes in urban retail environments in 14 low- and middle-income countries

Abstract Background/Aims To estimate and compare price differences between legal and illicit cigarettes in 14 low‐ and middle‐income countries (LMIC). Design A cross‐sectional census of all packs available on the market was purchased. Setting Cigarette packs were purchased in formal retail settings in three major cities in each of 14 LMIC: Bangladesh, Brazil, China, Egypt, India, Indonesia, Mexico, Pakistan, the Philippines, Russia, Thailand, Turkey, Ukraine and Vietnam. Participants A total of 3240 packs were purchased (range = 58 packs in Egypt to 505 in Russia). Packs were categorized as ‘legal’ or ‘illicit’ based on the presence of a health warning label from the country of purchase and existence of a tax stamp; 2468 legal and 772 illicit packs were in the analysis. Measurements Descriptive statistics stratified by country, city and neighborhood socio‐economic status were used to explore the association between price and legal status of cigarettes. Findings The number of illicit cigarettes in the sample setting was small (n < 5) in five countries (Brazil, Egypt, Indonesia, Mexico, Russia) and excluded from analysis. In the remaining nine countries, the median purchase price of legal cigarettes ranged from US

Do cigarette health warning labels comply with requirements: A 14-country study.

0.32 in Pakistan (n = 72) to US

Is health warning label compliance a country or manufacturer issue: a 9-country multi-year study

3.24 in Turkey (n = 242); median purchase price of illicit cigarettes ranged from US

Illicit cigarette packs found in urban retail locations

0.80 in Ukraine (n = 14) to US