ashley grant, mph caitlin weiger, mhs mark spires, mph ... · flavored cigarettes at the pos in...

FlavoredCigarettesatthePOSinLatinAmerica1

Writtenby:AshleyGrant,MPHCaitlinWeiger,MHSMarkSpires,MPHJoannaCohen,PhDProducedJune2017by:InstituteforGlobalTobaccoControlJohnsHopkinsBloombergSchoolofPublicHealth2213McElderrySt.,FourthFloorBaltimore,MD21205USAwww.jhsph.edu/igtcwww.globaltobaccocontrol.orgAcknowledgementsTheInstituteforGlobalTobaccoControl(IGTC)attheJohnsHopkinsBloombergSchoolofPublicHealth(JHSPH)wishestoacknowledgeAliançadePromoçaodaSáude,ComisiónNacionalPermanentedeLuchaAntitabáquica,EducaciónPopularenSalud,FundaciónInterAmericanadelCorazónArgentina,andtheFundaciónInterAmericanadelCorazónBoliviafortheirassistancewithdatacollection,andtheCampaignforTobacco-FreeKidsforfacilitatingworkbetweenIGTCandtheorganizationslistedaboveandforprovidingbackgroundinformation.IGTCalsothanksTeresaDeAtleyforleadingthetraininginChileandJoannaLopezforleadingthetrainingsinBoliviaandPeru.ThisworkwassupportedwithfundingfromBloombergPhilanthropies’BloombergInitiativetoReduceTobaccoUse(www.bloomberg.org).Copyright2017InstituteforGlobalTobaccoControlSuggestedCitation:InstituteforGlobalTobaccoControl.TechnicalReportonFlavoredCigarettesatthePoint-of-SaleinLatinAmerica:AvailabilityandMarketingaroundPrimaryandSecondarySchoolsinFiveCountries.Baltimore,MD:JohnsHopkinsBloombergSchoolofPublicHealth;June2017.Formoreinformation,pleasecontact:[email protected]


TableofContentsTableofContents............................................................................................................................................................................................2

ExecutiveSummary.......................................................................................................................................................................................3

Introduction......................................................................................................................................................................................................4

FlavoredTobaccoProducts..................................................................................................................................................................4

MarketingFlavoredTobaccoProducts............................................................................................................................................6

TheFrameworkConventiononTobaccoControl.......................................................................................................................7

CountryMarketsandRegulations......................................................................................................................................................7

Argentina.................................................................................................................................................................................................8

Bolivia.......................................................................................................................................................................................................8

Brazil.........................................................................................................................................................................................................9

Chile...........................................................................................................................................................................................................9

Peru.........................................................................................................................................................................................................10

Methods...........................................................................................................................................................................................................10

SamplingApproach...............................................................................................................................................................................10

SurveyInstrument.................................................................................................................................................................................11

DataCollectionProtocol......................................................................................................................................................................12

Training......................................................................................................................................................................................................13

Results..............................................................................................................................................................................................................15

MarketingforCigaretteswithMentholorOtherFlavorDescriptorsAcross5Countries......................................16

Argentina...................................................................................................................................................................................................21

Bolivia..........................................................................................................................................................................................................29

Brazil............................................................................................................................................................................................................35

Chile..............................................................................................................................................................................................................44

Peru..............................................................................................................................................................................................................53

Discussion.......................................................................................................................................................................................................61

Limitations......................................................................................................................................................................................................61

Conclusions....................................................................................................................................................................................................61

KeyTermsandDefinitions......................................................................................................................................................................62

AppendixA:CigarettePacksPurchasedinArgentina.................................................................................................................64

AppendixB:CigarettePacksPurchasedinBolivia........................................................................................................................66

AppendixC:CigarettePacksPurchasedinBrazil..........................................................................................................................66

AppendixD:CigarettePacksPurchasedinChile...........................................................................................................................70

AppendixE:CigarettePacksPurchasedinPeru............................................................................................................................72

References......................................................................................................................................................................................................72


ExecutiveSummaryThetobaccoepidemickillsmorethansixmillionpeopleworldwideeachyearandisprojectedtokillonebillionpeoplethiscentury.InLatinAmerica,totalcigarettesalesaredeclining,butthesalesofflavoredcigarettesareclimbing.Thisreportdescribesastudythatexaminedcigaretteretailerswithinaradiusof100-250metersaroundschoolsinArgentina,Bolivia,Brazil,Chile,andPeru.

Theresultsofthisstudyshowthatcigarettepackscarryingflavordescriptorswerefrequentlydisplayedandadvertisedatthepoint-of-salenearschools.Mostoftheflavoredcigarettesobservedaresoldbylarge,multinationalcompaniessuchasBritishAmericanTobacco,JapanTobaccoInternational,andPhilipMorrisInternational.

Flavoredproductsappealtoyoungandinexperiencedsmokers,potentiallyleadingtoalifetimeofaddictionanddisease.Inordertomaintainprofits,tobaccocompaniesmustattractyoungsmokerstoreplacethemillionsofcustomersthatdiefromtobacco-causeddiseasesorquiteachyear.Mostflavoredcigarettesobservedcontainedmintflavoringormenthol–asubstancethatalsomakesiteasiertoinhalecigarettesmokeandabsorbnicotinethusacceleratingtheaddictionprocess.Otherflavorsincludedfruits,alcohol,andspices.Manyoftheflavorsusednon-conventionaldescriptionssuchas“DoubleClickCrisp”or“IceBlast”tocommunicatetheirflavorcomponents.

Inordertoprotectandsavelives,countriesshouldadoptandeffectivelyimplementpoliciesthatprohibittheuseoftobaccoproductflavorings,prohibittheuseofmisleadingpackagingandlabeling,andprohibitallformsofdirectandindirectadvertising,promotion,andsponsorship,includingthedisplayoftobaccoproductsatretailpointsofsale.


IntroductionTobaccouseistheleadingcauseofpreventabledeathanddiseaseacrosstheglobe.1InLatinAmerica,morethan370,000peopledieeveryyearfromdiseasescausedbytobaccouse.2AlthoughthesaleoftobaccoflavoredcigaretteshasseenasteadydeclineintheLatinAmericanregionoverthepastseveralyears,thedeclinehasbeentemperedbyamarkedincreaseinsalesofflavoredcigarettes,particularlythosecontainingflavorcapsules.3ThisreportexaminestheavailabilityandmarketingofflavoredcigarettesinfivecitiesinLatinAmerica:BuenosAires,Argentina,LaPaz,Bolivia,RiodeJaneiro,Brazil,Santiago,ChileandLima,Peru.

Flavoringagentsaredefinedas“anaturalorsyntheticsubstanceormixtureofsubstancesthatimparts,modifies,enhancesorintensifiestheflavoroftobaccoproducts,”whichcanbeaddedtocigarettestocreateflavoredcigarettes.4 Someflavoredcigarettescontainflavorcapsulesthatareembeddedinthefilter.Consumerspressonthefiltertocrushthecapsuleandreleasealiquidthatflavorsthesmoke.5 Branddescriptorsarewords,numbersorimagerythatareincorporatedintothemarketingofthetobaccoproduct(suchaspackdesignorposters)andcanbeusedtodenoteflavorandtaste.6 Flavordescriptorscanalsobefoundonotherpartsofthepackotherthaninthebrandvariantname.

Forthepurposesofthisstudy,tobaccoflavoredcigarettesaredefinedascigarettesthatdonotinclude,somewhereonthecigarettepackortheassociatedmarketingmedia(suchasprintsignage),languageorimageryindicatingacharacterizingflavor,suchasmentholorchocolate,thatwouldchangetheflavorofthetobaccoinamannerthatisnoticeablebythesmoker.Cigarettescategorizedascontainingmentholorotherflavordescriptorsinclude,somewhereonthecigarettepackortheassociatedmarketingmedia,languageorimagerythatimpliesthepresenceofadditives,includingmenthol,thatwouldchangetheflavorofthetobaccowhichisnoticeablebythesmoker,orthattheflavorofthetobaccoisdifferentinsomewayfromtobaccoflavoredcigarettes.Conventionalflavordescriptorsrefertotermsorimagerydescribingarecognizableflavor,suchas:fruit,alcohol,coffee,sweets,spices,andmintormenthol.Non-conventionalflavordescriptors,bycontrast,aretermsorimagerythatdonotcorrespondtoatypicallyrecognizableflavor,andcaninclude:lexicalcolordescriptors(purplecrush,rubyburst),descriptorsindicatingafresh,chill,orcooltaste,technologywordsorsymbols(pressplay),flavorchangedescriptors(clicktoactivate),andalphanumericdescriptors(MX12).

FlavoredTobaccoProductsThetobaccoindustryhaslongsoughttodesigna“youth”cigarettebyincorporatingflavors.7ASeptember1972Brown&WilliamsonTobaccoCorporationProjectReportstates,“It’sawell-knownfactthatteenagerslikesweetproducts.Honeymightbeconsidered.”8Thedocumentsuggestsadditionalflavors,includingcolaandapple.8InaseparateBrown&WilliamsonTobaccoCorporationinternalcorrespondencememodatedJanuary18,1984,theauthorwrites“smokersofflavoredcigaretteswouldlikelybe:youngandinexperiencedsmokers,possiblyfad-consciousteenagersorcollegekidswhowouldliketoexperiment…womenandyoungpeoplewhowanttolooklikesmokerseventhoughtheydonotlikecigarettes.”9Similarly,anOctober1992reportauthoredbyPhilipMorrisconcludesthatflavorshavea“highcuriosity-to-tryfactor”thatcutsacrossgendersandthat“youngadultsthroughearly30’svoicedsimilarlevelsofinterest.”10The


reportsuggestsflavorssuchasmelon,kolaspice,piñacolada,andcreamyorange.10

ResearchersdetectedadiversesetofflavoredcigarettesontheU.S.marketasearlyasOctober2004.11Brown&WilliamsonbroughtflavoredcigarettestothemarketbyintroducingcigarettepackssuchasMochaTabooandMidnightBerry.11RJReynoldsalsobroughtflavoredcigarettestothemarketwithlabelsthatincludedMandarinMint,MargaritaMixer,TwistaLime,andWarmWinterToffee.11Ina2003reportpreparedforRJReynolds,flavoredcigaretteswerefoundtoappealtomultiplesenses(taste,smell,aural,tactile),allowsmokerstocontroltheflavorasdesiredandcontainanelementoffun.12Thereportrecommendsthatmultipleflavorsbemadeavailablebythecompany.12

Cigarettemanufacturerscontroltheirproducts’sensorycharacteristics(e.g.,taste,smell,mouthfeel)inawaythatallowsthemtomaketheirproductsmoreattractivetoconsumergroupsandtotargetthembasedonpreferencesgleanedfromtheirconsumerresearch.Flavoringsareaddedtomasktheharshtasteoftobaccosmoke,makingflavoredproductsmorepalatableandappealingtoyoungpeople.11,13Menthol’scooling,analgesic,andsoothingeffectsonthethroatandmouthreducetheirritatingandharsheffectsofnicotine,increasingtheeaseofsmoking.14

Mentholisaparticularlyimportantadditiveforthetobaccoindustry.Mentholisincludedasanadditiveinmostcigarettesevenwhenitisnotindicatedinthenameofthebrandvariantoronthelabelofthepack.15Internaltobaccoindustrystudiesconfirmthatmentholincreasesproductappealtoinitiatorsbymaskingthetasteoftobacco,reducingthroatirritation,andmakingsmokeeasiertoinhale.16Tobaccoindustrydocumentationhasshownthatmentholisaddedtocigarettesbecauseitisknowntobeattractivetoinexperiencedsmokerswhoperceivementholcigarettesaslessharsh,lessharmful,andeasiertosmoke.17–19Tobaccoindustrydocumentsconfirmitsuseofmenthol,inpart,toattractandretainuninitiated,youngersmokers,someofwhomsmokementholcigarettesbecauseoftheirperceptionthattheyarelessharmfulduetomenthol’scoolingandsmoothingeffects.20Flavoredtobaccoproductsarepopularwithyouth,21,22encouragingearlyinitiation23–25andresultinginhighratesofuseamongyouthandyoungadults.Onestudyfoundthatmorethanhalfoftobacco-usingstudentsingrades9through12inCanadauseflavoredtobaccoproducts,despiteanationalbanoncertainflavoredtobaccoproducts.26AnotherstudyfoundthatsmokersinMexicowhopreferflavoredcigarettes,especiallythosewithcapsules,viewtheseproductsashavingamorepositiveappeal,bettertaste,andlessriskthanotherbrandvarieties.13Asystematicreviewof40studiesfromnumerouscountriesshowedbothsmokersandnon-smokersratedtobaccowithflavordescriptorsasmoreappealingandlessharmful,andthatconsumersofflavoredtobaccoproductsshowdecreasedlikelihoodofintentionstoquit.27In2006theWorldHealthOrganization(WHO)recognizedthedangersofflavoredtobaccoproducts,statingthatthese,“…seeminglyharmless-sounding[flavoring]ingredients,suchaschocolate,licorice,andsugars,…cancontributetoincreasedcarcinogenicandaddictiveeffects.”28Candy-likeflavoringadditivessuchaslicorice,chocolate,cocoa,andvanillaalsoservetoimprovethetasteoftobaccoproductsandreducetheirinitialharshness.Whenburned,someofthese


additivesreleasecancer-causingchemicalcompounds.29“Substancessuchasmentholandsweetenerscanalsomakeiteasiertoinhalethistoxicmixturedeepintothelungs,bysmoothingthesmokeanddeadeningthesenses”.28Inaddition,mentholandotheradditivessuchascocoa,licorice,vanillin,andsugars,havebeenclassifiedbytheEuropeanCommission’sScientificCommitteeonEmergingandNewlyIdentifiedHealthRisksas‘prioritysubstances’becauseoftheirhazardprofile,whichincludestheirpotentialtoxicityandpotentialattractiveness.30AWHOAdvisorynoterecommendsthatmentholshouldbebannedfromuseincigarettes.Itconcludesthatmentholcigarettespromoteyouthexperimentationandprogressiontoregularusemorethannon-mentholcigarettesandthatsmokingratesofmentholcigarettesarehigheramongyouthandyoungadults,females,andethnicminorities.Tailoredadvertisingandinnovativeproductssuchascigaretteswithmentholcapsulescontributetogreateruseofmentholcigarettesbythesegroups.Inaddition,adolescentsmokersoftheseproductsaremoredependentthannon-mentholcigarettesmokersandquitattemptsbymentholsmokersarelesssuccessful.31In2009,theUnitedStatesbannedtheuseofsomeflavorsincigarettes,describingtheproductsas“agatewayformanychildrenandyoungadultstobecomeregularsmokers.”32

MarketingFlavoredTobaccoProductsTobaccocompaniesfurthercapitalizeontheappealofflavoredproductsbyusingdeceptiveandpredatorymarketingpracticestoincreaseconsumptionandmaketobaccouseappearglamorousorsociallyacceptablewhiledismissingtheproducts’adversehealtheffects.33Thisismostevidentthroughadvertisingandpromotioninitiativesatthepoint-of-sale(POS),includingproductdisplays,whereflavoredproductpackagingandimageryarepowerfulsourcesofadvertisingandpromotion.34

Numerouslongitudinalstudiesdemonstratethatexposuretotobaccoproductadvertisingandpromotionincreasesthelikelihoodthatyouthwillstarttosmoke35andthatthedisplayoftobaccoproductsatthePOShasthesameeffectandinfluenceonbehaviorastraditionalmediaadvertising.36Marketinginretailenvironmentsspecificallyhasbeenshowntoincreasethelikelihoodofsmokinginitiationamongyouth.37Onestudyfoundthatstoreswhereadolescentsfrequentlyshopmaycontainnearlythreetimesasmanymarketingmaterialsandshelfspaceforpopulartobaccobrands.38WhiletobaccocompanieslikeBritishAmericanTobacco(BAT),PhilipMorrisInternational(PMI),andJapanTobaccoInternational(JTI)publiclystatethattheirproductsareonlyintendedforandmarketedtoadultconsumers,39–41a2015reportdocumentedmarketingpracticesthatappealtoyouthinArgentina,Brazil,Colombia,andMexico.42Researchershaveobservedtheuseoflongerbrandvariantnamesincludingdescriptorsthatevokesensationsorproductfeaturesthattheindustrywaspreviouslyallowedtomarket,butisnowrestrictedfromusing.43Someofthesenewerbrandvariantnamesmaybetakingtheplaceofexplicitpresentationofflavors.Thereisevidencethatthetobaccoindustryisadaptingtoanincreasinglystrictregulatoryenvironmentthatimposesmorerestrictionsonpacksbychangingoraddingtothenamesoftheirbrandvariants.InAustralia,shortlybeforetherequirementsforplainpackagingcameintoeffect,theindustryincreasinglyincludedcolordescriptorsaspartofthe


brandvariantname.43,44OtherresearchersanalyzingbrandvariantsavailableinAustraliaalsofoundthatcolorwastheleadingthemeofbrandvariantnames,with70%ofthe120variantsidentifiedusingcolorconnotations.OtherdescriptorsrelatingtocolorsuchasSky,Night,Dawn,Sun,Storm,Sea,Ice,Frost,andChillwerealsofrequentlynoted.45Colordescriptorscaninfluenceperceptionsofharmandincreaseproductappeal.Theuseofcertaincolorterms,including‘silver’and‘gold’wereratedaslowertar,lowerhealthrisk,andyouthratedthemasmorelikelytobetheirchoiceofpackiftheychosetosmokeinanonlinesurveyofadultsandyouthsaskedtocomparepairsofpacksonmultipleindicators.46

TheFrameworkConventiononTobaccoControlManygovernmentsatthenationalandsub-nationallevelshaveenactedlawsbanningorrestrictingflavoredand/ormentholtobaccoproducts,infulfillmentofcountryobligationsundertheWHOFrameworkConventiononTobaccoControl.TheWHOFrameworkConventiononTobaccoControl(FCTC)articlesaddressingthepracticesdescribedinthisreportincludeFCTCArticles9,11,and13.47FCTCArticle9requiresPartiestoenactandimplementeffectivemeasurestoregulatetobaccoproductcontentsandemissions.48ThePartialGuidelinesforImplementationofArticle9and10indicatePartiesshouldprohibitorrestrictingredientsthatmaybeusedtoincreasepalatabilityoftobaccoproductsandthatthereisnojustificationforpermittingflavoringagentsintobaccoproductsbecausetheyhelpmaketobaccoproductsmoreattractive,whichinturnencouragestheiruse.49FCTCArticle11.1(a)requiresPartiestoenactandimplementmeasurestoensurethatpackagingandlabelingdonotpromoteatobaccoproductbymeansthatcreateanerroneousimpressionaboutatobaccoproduct’scharacteristics,healtheffects,hazards,oremissions,orthatdirectlyorindirectlycreatethefalseimpressionthataparticulartobaccoproductislessharmfulthanothers.50Article13requiresacomprehensivebanonallformsoftobaccoadvertising,promotionandsponsorship(TAPS).51TheArticle13GuidelinesmakeitclearthatretaildisplayoftobaccoproductsandotherformsofadvertisingandpromotionatretailPOSareformsoftobaccoadvertisingandthatyoungpeopleareparticularlyvulnerabletothepromotionaleffectsofproductdisplays.52CountryMarketsandRegulationsFlavoredcigarettesinLatinAmericahavebecomepopular.Between2010and2015,salesofcapsulecigaretteshaveincreasedinArgentina,Bolivia,Chile,andPeru.53–56CompletedataonthesaleofflavoredcigarettesinBrazilhasnotbeenpublished,asconfirmedbyJakePalley,MPP(emailcommunication,2017).


ArgentinaArgentinabecameasignatorytotheFCTConSeptember25,2003.57AmongArgentina’salmost43millionresidents,5829.4%ofmenand15.6%ofwomen(22.1%overall)currentlysmoketobacco.59Flavoredcigarettes,particularlythosecontainingflavorcapsuleshavebecomepopularinArgentina(especiallyamong“young”smokers),risingfrom1%oftotalcigarettessalesin2010to15%in2015.53PMIwasthemarketshareleaderinArgentinain2015with76.7%ofthemarketin2015.Thatsameyear,BATheld18.9%ofthemarketshare,followedbyJapanTobaccoInc(JTI)with3.6%,ExpertSAwith0.3%,ImperialTobaccowith0.2%,andothercompanieswith0.3%ofthemarket.60

FlavoredtobaccoproductsarenotcurrentlyregulatedinArgentina.Accordingtothenationallaw,theMinistryofHealthisrequiredtoestablishabanontheuseofspecificingredientsthatincreasethetotaltoxicityinherentintheproductsunderanalysisprovideditisshowntobeinaccordancewithobjectivescientificcriteriaandinternationalstandards.61TheMinistryofHealthhasnotusedthisprovisiontobananyadditiveinArgentina.However,tobaccoproductmanufacturersandimporters(butnotretailersorwholesalers)areprohibitedfrompresentinginformationtothepublicconcerningingredientsthataresupposedlybeneficialtohealth,flavoringsoraromaticscents,orstatementsreferringtosuchingredientshavingthepossibleeffectofmakingconsumptionoftheproductmoreattractivetochildrenandadolescents,orgivingtheideathatitislesshazardoustohealth.61Additionally,tobaccoproductpackagingandadvertisingmaynotdirectlyorindirectlycreatethefalse,erroneousordeceptiveimpressionthataparticulartobaccoproductislessharmfulthananotherorthatmayleadtoerrorwithrespecttoitscharacteristics,effectsonhealth,risksoremissions.61POSadvertisingandpromotionisexemptfromthegeneralbanontobaccoadvertisingandpromotion.61Instead,therearerestrictionsplacedonPOSadvertisingandpromotion.Two30cmx30cmtwodimensional,non-illuminatedsignsatthePOSareallowed.Thefirstisforlistingtheproductsavailableforeachmanufacturerorimporter,withthebrand,logo,andpriceoflistedproducts;thesecondisforthepromotionofthelistedproducts.Thesignsmustnotbevisiblefromoutsideandarerequiredtocarryhealthwarningsthatoccupy20%ofthesurfacearea.AllotheradvertisingatPOSisprohibited,including1)directorindirectincentivestostimulatepurchase,2)useofbrandsorlogosfornon-tobaccoproductsontobaccoproducts,and3)thesaleordisplayofnon-tobaccoproductsthatcontaintext,photos,imagesorlogosassociatedwithtobaccoproducts.61ImplementationofthesemeasuresinsubnationaljurisdictionshasbeenchallengedbyNoblezaPiccardo,theBATaffiliateinArgentina.62BoliviaBoliviabecameapartytotheFCTConSeptember15,2015.57AmongBolivia’salmost11millionresidents,6338.6%ofmenand11.2%ofwomensmoketobacco.64Asinotherpartsoftheregion,flavoredcigarettes,includingmenthol,aresoldinBolivia.Innovativetobaccoproductsreleasedrecentlyinthecountryincludedtwocapsulecigarettes.54InBolivia,marketsharesin2015weremainlydividedbetweenthreecompanies:CíaIndustrialdeTobacosSA(56.2%),PMI(32.6%),andJTI(8.1%),withothercompaniesmakingup3.1%ofthemarket.65


Bolivianlawdoesnotregulateflavoredtobaccoproducts.Misleadingdescriptorsandclaimsareprohibitedonpacks.66POSadvertisingisspecificallyallowed,provideditcarriesahealthwarning,isnotvisiblefromoutside,anddoesnotincludesuggestionsthatpromotetheproductbymeansthatarefalse,misleading,ordeceptiveorlikelytocreateanerroneousimpressionaboutitshazards,healtheffects,oremissions;orthatclaimtheyarelessharmfulthanothertobaccoproducts.66BrazilBrazilbecameapartytotheFCTCon3November,2005.57AmongBrazil’salmost206millionresidents,6718.9%ofmenand11%ofwomen(14.7%overall)currentlysmoketobacco.68InBrazilin2015,BATcontrolled80%ofthemarketofcigarettes,PMIhad15.8%andothercompaniesmadeup4.2%.69Marketanalystsestimatethataround2%oftotalcigarettesalesinBrazilareflavored,withthemostpopularflavorsbeingchocolate,menthol,vanillaandgillyflower.70Thisestimate,however,isnotbasedoncompletesalesdataincludingflavorcapsules,which,unlikeforotherlargemarketsintheregion,hasnotbeenmadepubliclyavailableforBrazil,asconfirmedbyJakePalley,MPP(emailcommunication,2017).InformationfromtheAgênciaNacionaldeVigilânciaSanitária(ANVISA),Brazil’spublichealthsurveillanceauthority,asretrievedbyJakePalley,MPP,showsthatofthe510newtobaccoproductapplicationsthathavebeenapprovedsince2012,45.3%(n=231)wereforflavoredproducts(emailcommunication,2017).Thegovernmentissuedaregulationbanningmosttobaccoproductadditives,includingflavorings,in2012.4However,implementationhasbeenstayedpendingtheresolutionofalegalchallengefiledbySinditabaco,atobaccolobbyinggroup.71Misleadingtermsonpackagingandlabelingandmisleadingordeceptiveadvertisingareprohibited.72,73POSadvertisingandpromotionareprohibited,withtheexceptionofproductdisplays.74ChileChilebecameapartytotheFCTCon13June,2005.57AmongChile’sover17andahalfmillionresidents,7532.1%ofmenand26.3%ofwomensmoketobacco.76MoresmokersinChileareusingflavoredcigarettes,with2015seeinga6%increaseinsalesofflavorcapsulecigarettes,whichnowaccountfor32%ofcigarettesales.55BATdominatedthemarketwitha95.8%shareinChilein2015;PMIhadonly3.3%,andothercompaniesmadeup0.9%ofthemarket.77TheMinistryofHealthhastheauthoritytoprohibittheuseofadditivesandsubstancesduringmanufacturingthatincreaselevelsofaddiction,harm,orriskintheconsumersoftobaccoproducts.78,79TheMinistryofHealthattemptedtobanmentholbuttheregulationswereneveradoptedandimplemented.80AdraftbillcurrentlyunderdiscussionintheNationalCongressproposestoclarifytheauthoritygiventotheMinistryofHealth,explicitlyallowingittobanadditivesthatincreaseaddictivenessorharmeitherdirectlyorindirectly.81Moreover,itproposestodirectlybanthesaleofcigaretteswithdistinctiveflavorsthatareknowntobehabituallyconsumedbychildren,suchasmenthol,vanilla,andlemon.81


Chile’slawsalsoprohibitincludingmisleadingterms,butnotothersigns,suchascolorsandnumbersinthenameorpropertiesassociatedwiththeproductbrand.78,82Advertisingoftobaccoandelementsofthebrandsareprohibited,includingatPOS,subjecttoafewexceptionsincludingPOSproductdisplays.78PeruPerubecameapartytotheFCTCon30November,2004.57AmongPeru’s30.74millionresidents,8317.9%ofmenand4.5%ofwomensmoketobacco.84In2015,flavoredcigarettesaccountedfor43%ofoverallcigarettesalesinPeru,withnewtwocapsulecigarettesintroducedduringtheyear.56In2015inPeru,BATcontrolledthemajorityofthemarket(86.1%),PMIhad10.3%,JTI2.2%andothercompanies1.4%.85LawsinPerudonotregulateflavoredtobaccoproducts.Thereisabroadprohibitiononmisleadingpackagingandlabelingthatincludestermsandanyothersigns.86,87Tobaccoadvertisingandpromotion,includingproductdisplays,areallowedatthePOS,providedtheproductsaredisplayedinamannerthatshowsthepackwarnings.87Peru’stobaccocontrollawallowsotherformsandmeansoftobaccoadvertisingandpromotion,butadvertisingcannotbeaimedatminors.86

MethodsThisstudyaboutthemarketingandavailabilityofflavoredcigarettesatthePOSinfivecitiesinLatinAmericawasledbytheInstituteforGlobalTobaccoControl(IGTC)attheJohnsHopkinsBloombergSchoolofPublicHealth(JHSPH).IGTCpartneredwiththeCampaignforTobacco-FreeKids(CTFK)andwithalocaltobaccocontrolorganizationineverycity.Localpartnersprovidedguidanceandcontextaboutthesamplingframework,andIGTCdesignedthesurveyinstrumentanddatacollectionprotocol.Ineachcity,investigatorsfromIGTCandCTFKtrained6-8peopletoconductthefieldwork.Thegroupsofdatacollectorsincludedstudentsandprofessionalsfromvariousfields.TheIGTCandCTFKstudyteamwason-siteineachcityfortraininganddatacollectiontotroubleshootanylogisticalortechnicalissues.Datacleaning,validation,andanalysiswerecarriedoutbyIGTC.

SamplingApproachThisstudysurveyedtobaccoretailersinBuenosAires,Argentina;LaPaz,Bolivia;RiodeJaneiro,Brazil;Santiago,Chile;andLima,Peru.InBrazilandChile,weselectedprimaryandsecondaryschoolswithineachofthecityboundaries,withconsiderationfortheneighborhood’s(1)retaildensity,(2)schooldensity,and(3)safetyandeaseofaccessibilityfordatacollectorstraversingthecitiesviapublictransportation.Eachschoolwasassignedauniqueidentificationcode.Anonlinemappinganddistancetoolwasusedtodefineasamplingarearadiusof100-250meterssurroundingeachschool,ensuringthatnoneofthesamplingareasoverlapped.Thesizeoftheradiiineachcitywasadjustedinordertomaximizethenumberofschoolsincludedinthesamplewhenschoollocationsweremoredenselyclusteredandlargerradiioverlapped.Datacollectorssurveyedaconveniencesampleoftobaccoretailerswithineachsamplingardea.InBrazil,datacollectorsobservednewsstands,smallbarsordrinkshops,bakeries,luncheonettesorjuiceshops,andbeachkiosks.InChile,datacollectorsobservedalmacenesdelbarrio,botillerias,mini-markets,kioskos,andsupermercados.


InPeru,ArgentinaandBoliviadatacollectorsreturnedtoaconveniencesampleofretailersthatwereidentifiedandobservedduringapreviousstudywhichtookplaceinFebruary,June,andJulyof2016(respectively),usingthesamesamplingapproachdescribedabove.InPeru,datacollectorsonlyreturnedtobodegas,andwerepermittedtoobservesupermarketsthatwereaddedtothesampleifidentifiedwhilewalkingbetweenbodegasthatwerelocatedwithinthesameschoolsamplingarea.DatacollectorsobservedbodegasandsupermercadosinPeru,andkiosksinArgentina.InBolivia,retailersincludedtiendasdelbarrio,dulceras/anaqueles,kioskos,micromercados,almacenes,andsupermercados.Datacollectorspurchasedcigarettesfromoneretailerineachschoolsamplingarea.InBrazilandChile,datacollectorspurchasedcigarettesfromthefirstretailertheyobservedinschoolsamplingareaswithoddidentificationcodes(101,103,105)andpurchasedcigarettesfromthesecondretailertheyobservedinschoolsamplingareaswithevenidentificationcodes(100,102,104).InPeru,Argentina,andBolivia,arandomnumbergeneratorwasusedtorandomlyselectonetobaccoretailerwithineachschoolsamplingareawheredatacollectorswouldmaketheirpurchase(fromthelistofretailersgeneratedduringapreviousproject).Iftherandomlyselectedretailerwasclosedornolongersoldtobacco,theIGTCstudyteamusedtherandomnumbergeneratortoselectanalternativeretailerwheredatacollectorscouldmakeapurchase.SurveyInstrumentThesurveyinstrumentwasdesignedtoaddressknowntrendsintobaccodisplay,advertisingandpromotionalcharacteristics,andkeycomponentsofPOSmarketingthatmayattractyouth(Figure1).Datacollectorsrecordedthedate,retailergeolocation,schoolsamplingareacode,POScode(whenapplicable),retailertype,retaileraddress,andothernotesorcommentsabouttheretailer.Thesurveyalsoaskedwhichtypesofcigaretteswereforsale,whichbrandshadflavoredcigarettes,whichtypesofflavordescriptorswereobserved,andwhethertheretailersoldlooseorsinglecigarettes.Theinstrumentincludedfieldstocaptureinformationaboutthepurchasedcigarettepacksandphotosofthedisplay,advertisement,orpromotionofcigaretteswithmentholorotherflavorsbothindoorsandoutdoors(Figure2).


Figure1.POSinstrumentcontentDisplay Advertising Promotion PurchasedCigarette

PacksCashierzone Printsignage(posters,

banners,flyers,shelfliners,backgrounds,etc.)

Pricediscounts(sale,coupon,multi-pack)

Cheapesttobaccoflavoredcigarettes(nomentholorotherflavor)

Behindthecashierzone Electronicsignage(digitalorvideo)

Freecigarettes Cheapestmentholonlycigarettes

Onapowerwalloftobaccoproducts

3-dimensionalsignage(e.g.giantcigarettepacks)

Gifts(freeorwithpurchase)

Cheapestcigaretteswithanotherflavor(withorwithoutmenthol)

Usinglights Signagevisiblefromoutdoors(mentholorotherflavoronly)

Contestsorcompetitions

Brandandvariety

Usingmovement Loyalty/rewardsschemeormentionofsocialmediachannel

Price

Onabrandedstandorcabinet

Brandstretching(hats,lighters,umbrella,shoppingbasketwithtobaccobranding)

Withsweets,snacksorsugarydrinks

Promotionsvisiblefromoutdoors(mentholorotherflavoronly)

Withproductsforchildren(toys,stickers,coloringbooks,etc.)

Attheeye-levelofchildren(1meterorlessfromthefloor)Displayvisiblefromoutdoors(mentholorotherflavoronly)Figure2.Purchasedcigarettepackinstrumentcontent

PackCharacteristicsBrand Conventionalflavor

descriptorsNumberofsticksperpack

Manufacturer Non-conventionalflavordescriptors

Mentionofflavorcapsules

Typeofcigarette(tobaccoflavoredorwithmentholorotherflavordescriptors)

Mentionofmenthol Numberofdistinctcapsuleflavorsperpack

Photosofeveryfaceofthepack

Useof"double"mentholdescriptors

Numberofcapsulesperstick

DataCollectionProtocolObservations,purchasedpacksandphotoswerecollectedfromretailersduringnormalbusinesshoursthroughoutthemonthofJanuary2017.InBrazilandChile,eachdatacollectorreceivedapacketofsamplingareamapsincludingtheuniqueschoolidentificationcodeandspacetorecord


theaddressesofretailersinthearea.Streetnamesandradiiboundarieswereclearlyvisibleonallsamplingareamaps.Datacollectorsidentifiedretailerswithinthesamplingareabyusingthemapstofollowasystematic-walkingpattern,observingallstreetswithinthedefinedradius.Themapsandlistofretailersincludedthename,address,anduniqueidentificationcodeoftheschool,aswellastheretaileraddress,type,anduniquePOScode.Duetoatechnicalglitchwiththeonlinemappinganddistancetool,wewereunabletogeneratesamplingareamapsinPeru,andonlyprovidedinformationabouttheschoolsandretailers.

Retailersthatsoldtobaccoproductspromptedarequestfordetailedobservationsoncigarettemarketing,whileonlythedate,retailergeolocation,schoolcode,POScode,retaileraddress,retailertype,andvisibilityfromtheschoolwererecordedforlocationsthatdidnotsellcigarettes.Datacollectorswroteorconfirmedtheaddressofeachcigaretteretailertheyobservedonthecorrespondingsamplingareamaps.Observationaldataandphotosofcigarettedisplays,advertisementsandpromotionswererecordedanduploadedtoacloud-baseddatabaseinreal-timewithinMagpi,amobiledatacollectionapplicationinstalledonsmartphones.Theorderofquestionsandformatofresponseoptionsweredesignedtofacilitaterapidanddiscreteobservationbydatacollectors.

Theinstrumentprompteddatacollectorstochecktheirsamplingareamapsandlistsofretailerstodeterminewhenandwheretheyshouldpurchasecigarettes.ThesamplingareamapsinBrazilandChileincludedaremindertopurchasecigarettesfromthefirstretailerobservedinsamplingareaswithoddidentificationcodes,orfromthesecondretailerobservedinsamplingareaswithevenidentificationcodes.InArgentina,BoliviaandPeru,therandomlyselectedretailerswheredatacollectorspurchasedcigaretteswerestarredandhighlightedonlistsofretailersandaddresses.Whenmakingapurchase,datacollectorswereinstructedtofirstaskthecashierforthecheapesttobaccoflavoredcigarettepackavailable(withoutmentholoranyotherflavor),thenforthecheapestmenthol-onlypackofcigarettes,followedbythecheapestcigarettepackwithanyotherflavor(whichcouldalsoincludementhol).Iftheretailersoldmultiplebrandsofthesametypeatthecheapestprice,datacollectorsaskedfortheproductthatwasmostpopular.Aftercompletingthepurchaseandexitingthestore,datacollectorsrecordedthebrand,price,andaphotoofeachcigarettepack.Packswereplacedinsmallplasticbagsandlabeledwiththeprice,andschoolcodeand/orPOScode.Everyuniquecigarettepackwasindividuallycodedforflavordescriptorsandproductfeatures(Figure2)byamemberofthestudyteam.

Attheendofeachobservationperiod,datacollectorsreportedtheaddress,samplingareacode,and/orPOScodeofeachretailertheyobservedbyenteringinformationintoaspreadsheethostedonGoogleDrive.TheIGTCstudyteamreviewedthesereportsinordertoverifytheuploadeddatasetandensurethatthemobilesoftwareapplicationwasfunctioningproperly.

TrainingSixtoeightpaiddatacollectorsattendedafulldaytrainingonhowtoimplementthestudyprotocolimmediatelybeforeeachdatacollectionperiod.Thestudyteamexplainedindetailthepurposeofthestudy,thecurrenttobaccocontrollaws,thesurveycontent,keytermsanddefinitions,theMapgisoftwareapplication,anddatacollectionprocedures.Datacollectorswereinstructedto


behaveascustomersinordertodiscretelyobservetheretailenvironmentandcapturephotos.Inordertoestimatetheplacementandproximityofproductsattheeyelevelofchildrenornearsweetsandotheryouthproducts,eachdatacollectorusedameasuringtapetoidentifya1-meterreferencepointontheirbody.Thedatacollectionteamwastrainedtorecognizetherelevantcigarettetypes,popularbrands,typesofflavors,andproductdisplay,advertising,andpromotionalcharacteristics.Duringthetraining,datacollectorsparticipatedinafieldtestofthestudyprotocoltopracticeusingthesurvey,mobileapp,anddatacollectionproceduresinnearbyretailers.


ResultsAcrossallfivecountries,weselected399schoolsamplingareas,310ofwhichwerevisited(Figure3).Cigaretteretailerswereidentifiedwithin77.9%(n=285)ofthesamplingareas,withradiithatrangedfrom100-250meterssurroundingtheschools.Datacollectorsidentified1,188storeswithinthesamplingareas,69.4%(n=825)ofwhichsoldcigarettes,andcollectedatotalof601cigarettepacksbypurchasingfromoneretailerwithineveryschoolsamplingarea.Figure3.Sampleofschoolsandretailersacrossfivecountries

Argentina Bolivia Brazil Chile Peru Total

DatesofObservation 18-Jan 20-Jan 10-12Jan 27-31Jan 17-Jan 10-31Jan

SizeofRadius(meters) 250 100 175 250 250 100-250

SchoolsSelected 86 64 92 107 50 399

SchoolSamplingAreasObserved 49 51 86 81 43 310

SchoolSamplingAreaswithCigaretteRetailers

48 44 74 78 41 285

RetailersIdentified 308 114 282 372 112 1188

RetailersSellingCigarettes 244 93 205 183 100 825

CigarettePacksPurchased 108 72 156 195 70 601


MarketingforCigaretteswithMentholorOtherFlavorDescriptorsAcross5CountriesAmongthe825cigaretteretailersobservedacrossthe5countries,85.2%(n=703)soldcigaretteswithmentholorotherflavordescriptors,71.4%(n=589)soldcigaretteswithflavorcapsules,and41.5%(n=342)soldlooseorsinglecigarettes.Theseproductswereondisplayin92.3%(n=649)ofretailersandadvertisedin34.3%(n=241)ofretailers(Figure4).Specialpromotionswereofferedin7.3%(n=51)ofretailers.CigaretteswithflavorcapsulesFigure4.POSmarketingforcigaretteswithmentholandotherflavordescriptorsacross5countries(n=703)

7.3%

34.3%

92.3%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

Promotions Advertising Productdisplay


Acrosstheretailersobservedinallfivecountries,cigaretteswithmentholorotherflavordescriptorsweremostfrequentlyplacedinthecashierzone,(72.2%,n=512),nearsweets,snacks,orsugarydrinks(59.2%,n=416),andbehindthecashierzone(45.9%,n=323)(Figure5).Someretailersusedlighteddisplays(30.2%,n=212)tocallattentiontocigaretteswithmentholorotherflavordescriptors,whichwereoccasionallyplacedattheeye-levelofchildren(11.0%,n=77)ornearyouthproductslikecoloringbooksorstickers(8.8%,n=62).Figure5.POSdisplayofcigaretteswithmentholandotherflavordescriptorsacross5countries(n=703)

0.1% 8.8% 11.0%

19.8% 20.6% 30.2%

45.9%

59.2%

72.7%

92.3%

0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% 80.0% 90.0%

100.0%

Usingmovement

Placednearyouthproducts

Placedattheeye-levelofchildren

Powerwalloftobaccoproducts

Onabrandedstandorcabinet

UsinglightsBehindthecashierzone

Placednear

sweets,snacksorsugarydrinks

Cashierzone

Anydisplay


Retailerstypicallyusedprintsignage(30.4%,n=214)toadvertisecigaretteswithmentholorothertobaccoproducts(Figure6).Three-dimensionalsignage(suchasanoversizedcigarettepack)wasobservedin7.5%ofretailers(n=53),and1.1%(n=8)useddigitaladvertisingsigns.Figure6.POSadvertisingofcigaretteswithmentholandotherflavordescriptorsacross5countries(n=703)

Promotionsforcigaretteswithmentholorotherflavordescriptorstypicallyincludedspecialorlimitededitionpacks(3.6%,n=25),orpricediscounts(2.3%,n=16)(Figure7).

Figure7.POSpromotionsforcigaretteswithmentholandotherflavordescriptorsacross5countries(n=703)

1.1% 7.5%

30.4% 34.3%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

Digitalsignage 3-dimensionalsignage Printsignage Anysignage

0.1% 0.3% 0.6% 0.7% 0.7% 2.3% 3.6% 7.3%

0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% 80.0% 90.0%

100.0%

Contestorcompetition

Freetobaccoproduct

Loyaltyschemeorsocialmedia

Promotionalgift

Brandstretching

Pricediscount Specialorlimited

editionpack

Anypromotion


Amongthe703retailerssellingcigaretteswithmentholorotherflavordescriptors,mintormentholwasthemostfrequentlyobserveddescriptor(74.1%,n=521),followedbynon-conventionalflavordescriptors(69.6%,n=489)(Figure8).Flavordescriptorsforfruitwererecordedoccasionally(10.8%,n=76).

Figure8.FlavordescriptorsobservedatthePOSin5countries(n=703)

Argentina(n=216)

Bolivia(n=72)

Brazil(n=164)

Chile(n=156)

Peru(n=95)

Total(n=703)

Mintormenthol

62.5% 63.9% 97.0% 92.3% 38.9% 74.1%

Non-

conventional

76.9% 68.1% 45.7% 80.1% 77.9% 69.6%

Fruit

2.8% 8.3% 15.9% 19.9% 7.4% 10.8%

SpicesorNuts

0.5% 50.0% 3.0% 0.0% 5.3% 6.7%

Alcohol

5.6% 0.0% 0.0% 6.4% 0.0% 3.1%

Sweets

0.0% 1.4% 0.6% 0.0% 0.0% 0.3%


Non-conventionalflavordescriptorswerethemostfrequentlyobservedtypeofdescriptoracrossflavoredpackspurchasedinall5countries,with92.8%(n=297)ofpackscarryingsuchterminology(Figure9).Descriptorsformintormentholwereobservedon57.8%(n=185)ofallflavoredpacks.

Figure9.Flavordescriptorsonpurchasedcigarettepacksacross5countries(n=320)

Languageorimageryindicatingaflavorchangewasobservedon91.9%(n=295)oftheflavoredpackspurchasedinall5countries,followedbytechnologicaldescriptors(76.8%,n=245),anddescriptorssuchascool,freshorice(33.4%,n=107)(Figure10).

Figure10.Non-conventionalflavordescriptorsonpurchasedcigarettepacksacross5countries(n=320)

0 1 3 10

185

297

0

50

100

150

200

250

300

350

Fruit Alcohol Sweets Spicesornuts Mintormenthol Non-conventional

224

107

245

294

0

50

100

150

200

250

300

350

Alphanumeric Lexicalcolors Cool,fresh,ice Technological Flavorchange


ArgentinaInBuenosAires,datacollectorsvisited49ofthe86schoolsamplingareasweselected,andidentifiedtobaccoretailersnear98.0%(n=48)ofthoseschools.Datacollectorsvisited308retailerslocatedwithin250metersofaschool,79.2%(n=244)ofwhichsoldcigarettes,1.6%(n=5)ofwhichnolongersoldcigarettes,and19.1%(n=59)ofwhichwereclosedorchangedretailertype(allretailerswerekiosks).Cigaretteswithmentholorotherflavordescriptorswereidentifiedin88.5%(n=216)ofretailers,andtobaccoflavoredcigaretteswereidentifiedin93.0%(n=227)ofretailers.Cigaretteswithflavorcapsuleswereobservedin83.6%ofretailers(n=204).Looseorsinglecigaretteswereforsalein21.7%(n=53)ofallretailersobserved.Cigaretteswithmentholorotherflavordescriptorswereondisplayin95.8%(n=207)ofkioskswherementholorotherflavoredcigarettesweresold,andtobaccoflavoredcigarettesweredisplayedin93.4%(n=212)ofkioskswheretobaccoflavoredcigaretteswereavailableforpurchase(Figure11).Cigaretteswithmentholorotherflavordescriptorsweremostfrequentlyplacedinthecashierzone(76.5%,n=163),nearsweets,snacks,orsugarydrinks(74.5%,n=161),orusinglights(55.5%,n=120).Theseproductswereoccasionallyplacednearotherproductsthatappealtoyouth(16.2%,n=35)orattheeye-levelofchildren(5.1%,n=11).Tobaccoflavoredcigarettesweredisplayedsimilarlytocigaretteswithmentholorotherflavordescriptors,inthecashierzone(73.6%,n=167),nearsweets,snacks,orsugarydrinks(71.8%,n=163),andusinglights(52.4%,n=119).Figure11.NumberofkioskswithtobaccoproductdisplaysatthePOS

0 6 1128 35

75

120

161 163

207

0 713

28 37

77

119

163 167

212

0

50

100

150

200

250

Usingmovement

Brandedstandorcabinet

Eye-levelofchildren


Nearyouthproducts

Behindcashierzone

Usinglights Nearsweets,snacks,orsugarydrinks

Cashierzone

Anydisplay

Mentholorotherflavordescriptors(n=216) Tobaccoflavored(n=227)


Figure12.CigarettedisplayatakioskinBuenosAires,Argentina


Only19.4%(n=42)ofkiosksusedadvertisingsignageforcigaretteswithmentholorotherflavordescriptors,usuallyintheformofprintsignage(14.3%,n=31)or3-dimensionalsignage(4.2%,n=9)(Figure13).Halfofkiosks(n=115)advertisedtobaccoflavoredcigarettes,usingprintsignage(30.8%,n=70)and3-dimensionalsignage(21.6%,n=49).Only2digitalsignswereobservedforcigaretteswithmentholorotherflavordescriptors.

Figure13.NumberofkioskswithtobaccoadvertisingsignageatthePOS

2 931

42

0

4970

115

0

50

100

150

200

250




Figure14.PrintsignageforcigarettesatakioskinBuenosAires,Argentina

Only4.2%(n=9)ofkiosksofferedspecialpromotionsforcigaretteswithmentholorotherflavordescriptors(Figure15).Twenty-ninepercent(n=66)ofkioskspromotedtobaccoflavoredcigarettes,typicallyusingspecialorlimitededitionpacks(17.6%,n=40)orpricediscounts(10.1%,n=23).

Figure15.NumberofkioskswithtobaccopromotionsatthePOS

1 1 0 0 0 1 6 90 0 2 5 0

4023

66

0

50

100

150

200

250

Promotionalgift


Brandstretching

Freetobaccoproduct


Specialorlimitededition

pack

Pricediscount Anypromotion



Figure16.Printsignageforanewlimitededition“UrbanExpressions”Camelcigarettes

Cigaretteswithmentholorotherdescriptorswerevisibleondisplayfromoutsidethekioskin31.0%(n=67)ofretailers(Figure17).

Figure17.Numberofcigaretteretailerswithproductdisplay,advertisingsignage,orpromotionsforcigaretteswithmentholorotherflavorsvisiblefromoutdoors(n=216)

19

67 68

0

50

100

150

200

250

Promotions Advertising Productdisplay AnyTAPS


Datacollectorsidentified23uniquecigarettebrandsthatusedmentholorotherflavordescriptors,althoughtheydidnotrecordanexhaustivelistoftheavailablebrands.ThemostfrequentlyobservedbrandofcigarettesusingmentholorotherflavordescriptorswasMarlboroFusionBlast,followedbyPhilipMorrisCaps,LuckyStrikeClickandRoll,PhilipMorrisCapsDuo,ChesterfieldFreshCapsule,MarlboroIceBlast,andViceroySwitch(Figure18).MostbrandsobservedatthePOSareownedbymultinationaltobaccocompanies,suchasBritishAmericanTobacco(BAT),PhilipMorrisInternational(PMI),andR.J.ReynoldsTobaccoCompany(RJR).

Figure18.BrandsusingmentholorotherflavordescriptorsatthePOS(n=216)

n %MarlboroFusionBlast 111 51.4%PhilipMorrisCaps 107 49.5%LuckyStrikeClickandRoll(Blue) 95 44.0%PhilipMorrisCapsDuo 88 40.7%ChesterfieldFreshCapsule 87 40.3%MarlboroIceBlast 80 37.0%ViceroySwitch 15 6.9%LuckyStrikeCapsuleFlow 9 4.2%CamelActivateBlue 7 3.2%CamelFreshness 7 3.2%CamelMenthol 5 2.3%ViceroyMenthol 3 1.4%LuckyStrikeDoubleClickCrisp 2 0.9%PallMallMojitoNights 2 0.9%ViceroyClickBlue 2 0.9%CamelIce 1 0.5%ChesterfieldFresh 1 0.5%L&MFresh 1 0.5%LuckyStrikeFresh 1 0.5%PallMallClickOn 1 0.5%PallMallDaiquiriNights 1 0.5%PallMallFlavorsDuo 1 0.5%RedPointMenthol 1 0.5%


InArgentina,datacollectorspurchased108packsofcigarettes:66withmentholorotherflavordescriptors,and42tobaccoflavoredcigarettepacks.Thenumberofsticksperpackrangedfrom11to20,withmostpackscontaining10or20sticksperpack(Figure19),and71.3%(n=77)ofthepackswereduplicates(seeAppendixA).Theaveragepriceofthecheapestpackswithmentholorotherflavordescriptorswas$34.08pesos,andtheaveragepriceofthecheapesttobaccoflavoredpackswas$30.26pesos.All66ofthepackswithflavordescriptorsmentionedmentholonthepack,andtwoofthepacksmentionedadouble-mentholproductfeature.Sixty-threepacksusedflavorcapsules,27ofwhichhadtwocapsulesineachstick,and36ofwhichhadasingleflavorcapsule.Figure19.Numberofsticksperpackbycigarettetype

1

6

25

34

2

810

22

0

5

10

15

20

25

30

35

40

11sticksperpack 12sticksperpack 10sticksperpack 20sticksperpack



Flavordescriptorsformintormentholwereobservedonallpacks(100.0%,n=66)thatcarriedanyflavordescriptor,followednon-conventionalflavordescriptors(95.5%,n=63).Onepack(1.5%)usedadescriptorforanalcoholicflavor(Figure20).

Figure20.Flavordescriptorsonpurchasedcigarettepacks(n=66)

Languageorimageryindicatingaflavorchangewasobservedon95.5%(n=63)oftheflavoredpackspurchasedinArgentina,followedbytechnologicaldescriptors(45.5%,n=30),anddescriptorssuchascool,freshorice(33.3%,n=22)(Figure21).

Figure21.Non-conventionalflavordescriptorsonpurchasedcigarettepacks(n=66)

0 0 0 1

6366

0

10

20

30

40

50

60

70

Fruit Sweets Spicesornuts Alcohol Non-conventional Mintormenthol

2

10

22

30

63

0

10

20

30

40

50

60

70



BoliviaAmongthe64schoolsamplingareasselected,datacollectorsvisited51oftheseareasandidentifiedcigaretteretailerswithin86.3%(n=44)oftheseareas.Datacollectorsvisited114retailersinLaPaz,81.6%(n=93)ofwhichstillsoldcigarettes.Retailertypesincludedtiendasdelbarrio(n=58),dulceras/anaqueles(n=33),almacenes(n=7),kiosks(n=6),micromercados(n=6),andsupermercados(n=4).Cigaretteswithmentholorotherflavordescriptorswereidentifiedin77.4%(n=72)ofretailers,andtobaccoflavoredcigaretteswereidentifiedin92.5%(n=86)ofretailers.Cigaretteswithflavorcapsuleswereobservedin63.4%ofretailers(n=59).Looseorsinglecigaretteswereforsalein89.2%(n=83)ofallcigaretteretailersobserved.

Cigaretteswithmentholorotherflavordescriptorswereobservedin71.4%(n=35)oftiendasdelbarrio,85.7%(n=18)ofdulceras/anaqueles,66.7%(n=4)ofkioskos,100%(n=6)ofmicromercados,71.4%(n=5)ofalmacenes,and100%ofsupermercados(n=4)(Figure22).tobaccoflavoredcigaretteswereavailablein87.8%(n=43)oftiendasdelbarrio,100%(n=21)ofdulceras/anaqueles,100%(n=6)ofkioskos,100%ofmicromercados(n=6),85.7%(n=6)almacenes,and100%ofsupermercados(n=4).Figure22.NumberoftobaccoretailersobservedbytypeofcigarettessoldandPOStype

4 5 64

18

35

46 6 6

21

43

0

5

10

15

20

25

30

35

40

45

50

Supermercado(n=4)

Almacen(n=7) Micromercado(n=6)

Kiosco(n=6) Dulcera/anaquel(n=21)

Tiendadelbarrio(n=49)



Cigaretteswithmentholorotherflavordescriptorswereondisplayin95.8%(n=69)ofretailers,andtobaccoflavoredcigarettesweredisplayedin98.8%(n=85)ofretailers(Figure23).Cigaretteswithmentholorotherflavordescriptorsweremostfrequentlyplacedinthecashierzone(83.3%,n=60),behindthecashierzone(47.2%,n=34),ornearsweets,snacks,orsugarydrinks(50.0%,n=36).Theseproductswerealsoplacedattheeye-levelofchildrenin34.7%ofretailers(n=25).Tobaccoflavoredcigarettesweredisplayedsimilarlytocigaretteswithflavordescriptors,inthecashierzone(84.9%,n=73),behindthecashierzone(51.2%,n=44),nearsweets,snacks,orsugarydrinks(45.3%,n=39),andattheeye-levelofchildren(34.9%,n=30).Figure23.NumberoftobaccoretailerswithtobaccoproductdisplaysatthePOS

Advertisingsignagewasonlyobservedin12.5%(n=9)ofretailerssellingcigaretteswithmentholorotherflavordescriptors,and9.3%(n=8)ofretailerssellingtobaccoflavoredcigarettes,whichwasalmostalwaysintheformofprintsignage.One(1.9%)retailerused3-dimensionalsignage,andnodigitalsignagewasobserved.

Two(2.8%)retailersofferedanykindofpromotionforcigaretteswithmentholorotherflavordescriptors,and3.5%(n=3)ofretailersofferedpromotionsfortobaccoflavoredcigarettes.Promotionalstrategiesincludedpricediscounts,specialorlimitededitionpacks,andbrandstretching.Nopromotionalgifts,loyaltyschemes,mentionofsocialmedia,freetobaccoproducts,orcontestsandcompetitionswereobserved.

Thedisplayofcigarettesusingmentholorotherflavordescriptorswasvisiblefromoutside8.3%(n=6)ofretailers,andadvertisingsignagewasvisiblein4.2%(n=3)ofretailers.NopromotionaltacticsforcigaretteswithmentholorothercigaretteswerevisiblefromoutsidethePOS.

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Figure24.PrintsignageforcigaretteswithflavorcapsulesatthePOSinLaPaz,Bolivia

Figure25.AspecialpromotionforCamel’s“iWin”toregisteracodeonlinetowin1of60prizes


Datacollectorsidentified20uniquecigarettebrandsatthePOSthatusedmentholorotherflavordescriptors,althoughtheydidnotrecordanexhaustivelistoftheavailablebrands.DerbyCoolwasthemostfrequentlyobservedbrandusingmentholorotherflavordescriptorsatthePOS,followedbyDerbyClickCitrusMint,LuckyStrikeClick,CamelPurpleMint,andMarlboroBlueFresh(Figure26).MostbrandsobservedatthePOSareownedbymultinationaltobaccocompanies,suchasBritishAmericanTobacco(BAT),PhilipMorrisInternational(PMI),andR.J.ReynoldsTobaccoCompany(RJR).


n %DerbyCool 47 65.3%DerbyClickCitrusMint 33 45.8%LuckyStrikeClick 33 45.8%CamelPurpleMint 28 38.9%MarlboroBlueFresh 27 37.5%LuckyStrikeCrisp 17 23.6%MarlboroFusionBlast 16 22.2%L&MKretekMint 13 18.1%CamelActivate 12 16.7%L&MMenthol 8 11.1%L&MForward 5 6.9%Djarum(black,cherry) 3 4.2%CamelActivateDoubleMintPurple 2 2.8%CamelMenthol 1 1.4%DjarumMenthol 1 1.4%MarlboroBlueIce 1 1.4%MarlboroIceExpress 1 1.4%MarlboroKretekMint 1 1.4%JaisalmerMenthol 1 1.4%L&MKretek 1 1.4%


InBolivia,datacollectorspurchased72packsofcigarettes:35withmentholorotherflavordescriptors,and37tobaccoflavoredpacks.Thenumberofsticksperpackrangedfrom10to20,withmostpackscontaining10or20sticksperpack(Figure27),and59.7%(n=43)ofthepackswereduplicates(seeAppendixB).Theaveragepriceofthecheapestpackswithmentholorotherflavordescriptorswas$9.93bolivianos,andtheaveragepriceofthecheapesttobaccoflavoredpackswas$6.59bolivianos.Twenty-threeofthe35packswithflavordescriptorsmentionedmentholonthepack.Seventeenpacksusedflavorcapsules,5ofwhichhadtwocapsulesineachstick,and12ofwhichhadasingleflavorcapsule.Figure27.Numberofsticksperpackbycigarettetype

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Flavordescriptorsformintormentholwereobservedon68.6%(n=24)ofpacksthatcarriedanyflavordescriptor,followednon-conventionalflavordescriptors(57.1%,n=20),anddescriptorsforspicesornuts(20.0%,n=7)(Figure28).


Languageorimageryindicatingaflavorchange(48.6%,n=17),ortechnologicalfeatures(48.6%,n=17)werethemostfrequentlyobserveddescriptorsamongallflavoredpackspurchasedinBolivia,followedbydescriptorssuchascool,fresh,andice(42.9%,n=15)(Figure29).


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BrazilDatacollectorsobserved86ofthe92schoolsamplingareasthatwereselected,andidentifiedtobaccooutletsnear86.0%(n=74)ofthoseschools.Ofthe282retailersidentifiedwithin175-metersofaschool,72.2%(n=205)soldcigarettes.Theretailertypesincludednewsstands(n=116),smallbarsordrinkshops(n=43),bakeries,luncheonettes,orjuiceshops(n=41)andbeachkiosks(n=5).InRiodeJaneiro,cigaretteswithmentholorotherflavordescriptorswereidentifiedin80.0%(n=164)ofretailers,andtobaccoflavoredcigaretteswereidentifiedin98.5%(n=202)ofretailers.Cigaretteswithflavorcapsuleswereobservedin49.3%ofretailers(n=101).Looseorsinglecigaretteswereforsaleinoverhalfofallretailersobserved(52.0%,n=106).Cigaretteswithmentholorotherflavordescriptorswereobservedin85.3%(n=99)ofnewsstands,62.8%(n=27)ofsmallbarsordrinkshops,82.9%(n=34)ofbakeries,luncheonettesorjuiceshops,and80.0%(n=4)ofbeachkiosks(Figure30).Tobaccoflavoredcigaretteswereavailablein98.3%(n=114)ofnewsstands,100.0%(n=43)ofsmallbarsordrinkshops,97.6%(n=40)bakeries,luncheonettes,orjuiceshops,and100%(n=5)ofbeachkiosks.Figure30.NumberoftobaccoretailersobservedbytypeofcigarettessoldandPOStype

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34 27

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Amongthe164retailersthatsoldcigarettescontainingmentholorotherflavors,99.4%(n=163)ofstoresdisplayedthoseproductsatthePOS.Packsweremostfrequentlyplacedinthecashierzone(78.7%,n=129),behindthecashierzone(64.6%,n=106),andnearsweets,snacks,orsugarydrinks(62.8%,n=103)(Figure31).Someretailersdisplayedcigaretteswithmentholorflavordescriptorsattheeyelevelofchildren(7.9%,n=13)ornearyouthproducts(liketoysorcoloringbooks)(9.1%,n=15).

Thedisplayoftobaccoflavoredpackswassimilartothedisplayofcigaretteswithmentholorflavordescriptors.Amongthe202retailerssellingtobaccoflavoredcigarettes,82.2%(n=166)ofretailersdisplayedtobaccoflavoredpacksinthecashierzone,60.4%(n=122)displayedpacksbehindthecashierzone,and56.4%(n=114)displayedpacksnearsweets,snacks,orsugarydrinks.

Figure31.NumberoftobaccoretailerswithtobaccoproductdisplaysatthePOS

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Figure32.FlavoredcigarettesondisplaybehindthecashierzoneinRiodeJaneiro,Brazil


Advertisingforcigaretteswithmentholorflavordescriptorswasobservedin52.4%(n=86)ofretailerssellingthoseproducts,mostfrequentlythroughtheuseofprintsignage(51.2%,n=84)(Figure33).TobaccoflavoredcigaretteswereadvertisedatthePOSin55.4%(n=112)ofretailerswith52.9%(n=107)displayingprintsignageand5.4%(n=11)displaying3-dimensionalsignage.Only1digitalsignwasobservedforcigaretteswithmentholorotherflavordescriptors.Figure33.NumberoftobaccoretailerswithtobaccoadvertisingsignageatthePOS

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Figure34.SinglecigarettesforsalenexttogumandcandyinRiodeJaneiro,Brazil


Six(3.6%)retailerssellingcigaretteswithmentholorotherflavordescriptorsandsix(3.0%)retailerssellingtobaccoflavoredcigarettesofferedanytypeofpromotion.Specialorlimitededitionpacks,pricediscounts,andcontestsorcompetitionswereobservedforbothproducttypes.Oneofferforfreecigaretteswithmentholorotherflavordescriptorswasobserved.Nopromotionalgifts,loyaltyschemes,mentionofsocialmedia,orbrandstretchingwasobserved.

Productdisplay,advertisingsignageorpromotionsforcigaretteswithmentholorotherflavordescriptorsthatwerevisiblefromoutdoorswereobservedin45.7%ofretailers(Figure35).Displayswerevisiblefromoutsideof39.0%(n=64)ofstores,followedbyadvertisingsignagewhichwasvisiblefromoutsideof25%ofstores(n=41).Figure35.Numberoftobaccoretailerswithtobaccoproductdisplay,advertisingsignage,orpromotionsforcigaretteswithmenthol,flavors,orcapsulesvisiblefromoutdoors(n=164)

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InBrazil,datacollectorsidentified9uniquecigarettebrandsatthePOSthatusedmentholorotherflavordescriptors,althoughtheydidnotrecordanexhaustivelistoftheavailablebrands.LuckyStrikeDoubleClickwasthemostfrequentlyobservedbrand,followedbyFree(boost),MarlboroDoubleBurst,L&MBlackIce,andWinstonExpandExoticMint(Figure36).MostbrandsobservedatthePOSareownedbymultinationaltobaccocompanies,suchasBritishAmericanTobacco(BAT),PhilipMorrisInternational(PMI),andJapanTobaccoInternational(JTI).


n %LuckyStrikeDoubleClick 79 48.2%Free(boost) 55 33.5%MarlboroDoubleBurst 52 31.7%L&MBlackIce 27 16.5%WinstonExpandExoticMint 26 15.9%LuckyStrikeFresh 2 1.2%DunhillDouble 2 1.2%LuckyStrikeSwitch 1 0.6%DerbyClick+ 1 0.6%


InBrazil,datacollectorspurchased128packsofcigarettes:65withmentholorotherflavordescriptors,and63tobaccoflavoredpacks.Allpackscontained20sticksofcigarettesand71.1%(n=91)ofthepackswereduplicates(seeAppendixC).Theaveragepriceofthecheapestpackswithmentholorotherflavordescriptorswas7.74reais,andtheaveragepriceofthecheapesttobaccoflavoredpackswas6.07reais.Mentholwasmentionedon58ofthe65packswithflavordescriptors(typicallyinthelistofingredients),and13ofthepacksmentionedadouble-mentholproductfeature.Sixtypacksusedflavorcapsules,19ofwhichhadtwocapsulesineachstick,and41ofwhichhadasingleflavorcapsule.

Non-conventionaldescriptorswereobservedon92.3%(n=60)ofpacksthatcarriedanyflavordescriptor,followedbydescriptorsformintormenthol(36.9%,n=24),spicesornuts(4.6%,n=3),andsweets(4.6%,n=3)(Figure37).


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Languageorimageryindicatingaflavorchange(92.3%,n=60)werethemostfrequentlyobserveddescriptorsamongallflavoredpackspurchasedinBrazil,followedbydescriptorsfortechnologicalfeatures(80.0%,n=52),anddescriptorssuchascool,fresh,andice(49.2%,n=32)(Figure38).


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ChileDatacollectorsvisited81ofthe107schoolsamplingareasweselected,andidentifiedcigaretteretailerswithin96.3%(n=78)ofthoseareas.Threehundredandseventy-tworetailerswereidentifiedwithin250metersofaschool,49.2%(n=183)ofwhichsoldcigarettes.Theretailertypesincludedalmacenesdelbarrio(n=68),botillerias(n=37),mini-markets(n=39),kioskos(n=23),andsupermercados(n=16).Norestaurantsorbarswereobserved.InSantiago,cigaretteswithmentholorotherflavordescriptorswereidentifiedin85.2%(n=156)ofcigaretteretailers,andtobaccoflavoredcigaretteswereidentifiedin95.1%(n=174)ofretailers.Cigaretteswithflavorcapsuleswereobservedin74.3%ofretailers(n=136).Looseorsinglecigaretteswereforsalein21.8%(n=40)ofallretailersobserved.Cigaretteswithmentholorotherflavordescriptorswereavailablein75.0%(n=51)ofalmacenesdelbarrio,94.6%(n=35)ofbotillerias,87.2%(n=34)ofmini-markets,86.9%(n=20)ofkioskos,and100%(n=16)ofsupermercados(Figure39).Tobaccoflavoredcigaretteswereavailablein94.1%(n=64)ofalmacenesdelbarrio,97.3%(n=36)ofbotillerias,92.3%(n=36)ofmini-markets,95.6%(n=22)ofkioskos,and100%(n=16)ofsupermercados.Figure39.NumberoftobaccoretailersobservedbytypeofcigarettessoldandPOStype

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Supermercado(n=16) Kiosko(n=23) Mini-market(n=39) Botilleria(n=37) Almacendelbarrio(n=66)



Cigaretteswithmentholorotherflavordescriptorswereondisplayin82.7%(n=129)ofretailersthatsoldflavoredcigarettes,andtobaccoflavoredcigarettesweredisplayedin74.7%(n=130)ofretailersthatsoldtobaccoflavoredcigarettes(Figure40).Cigaretteswithmentholorotherflavordescriptorsweremostfrequentlyplacedinthecashierzone(57.7%,n=90),nearsweets,snacks,orsugarydrinks(50.6%,n=79),behindthecashierzone(42.9%,n=67)oronabrandedstandorcabinet(32.1%,n=50).Tobaccoflavoredcigaretteswerealsoplacedinthecashierzone(52.3%,n=91),nearsweets,snacks,orsugarydrinks(42.0%,n=73),andbehindthecashierzone(39.7%,n=69).Figure40.NumberoftobaccoretailerswithtobaccoproductdisplaysatthePOS

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Figure41.DisplayofcigarettesinthecashierzoneatthePOSinSantiago,Chile


Advertisingforcigaretteswithmentholorotherflavordescriptorswasobservedin38.5%(n=60)ofretailers,whileonly6.9%(n=12)ofretailersadvertisedtobaccoflavoredcigarettes(Figure42).Cigaretteswithmentholorotherflavordescriptorswereadvertisedusingprintsignage(37.2%,n=58),3-dimensionalsignage(16.0%,n=25)anddigitalsignage(2.6%,n=4).Tobaccoflavoredcigaretteswerealsoadvertisedusingprintsignage(5.7%,n=10)and3-dimensionalsignage(4.0%,n=7).Figure42.NumberoftobaccoretailerswithtobaccoadvertisingsignageatthePOS

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Specialpromotionsforcigaretteswithmentholorotherflavordescriptorswereobservedin14.1%(n=22)ofretailers,typicallyintheformofspecialorlimitededitionpacks(10.3%,n=16)(Figure43).Onlyoneretailerofferedanyspecialpromotion(aspecialorlimitededitionpack)fortobaccoflavoredcigarettes.Figure43.NumberoftobaccoretailerswithtobaccopromotionsatthePOS

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Cigaretteswithmentholorotherflavordescriptorswerevisibleondisplayfromoutsideof6.4%(n=10)ofretailers(Figure44).Advertisementsfortheseproductswerevisiblefromoutsideof7.1%(n=11)ofretailers.Figure44.Numberoftobaccoretailerswithtobaccoproductdisplay,advertisingsignage,orpromotionsforcigaretteswithmenthol,flavors,orcapsulesvisiblefromoutdoors(n=156)

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InChile,datacollectorsidentified18uniquecigarettebrandsatthePOSthatusedmentholorotherflavordescriptors,althoughtheydidnotrecordanexhaustivelistoftheavailablebrands(Figure45).PallMallwasthemostfrequentlyobservedbrandusingmentholorotherflavordescriptors,followedbyseveralvariantsofLuckyStrikecigarettes,PallMallBoost,KentiBoostandKentiSwitch.AllbrandsobservedatthePOSareownedbymultinationaltobaccocompanies,suchasBritishAmericanTobacco(BAT),PhilipMorrisInternational(PMI),R.J.ReynoldsTobaccoCompany(RJR).


n %PallMallClickOn 139 89.1%LuckyStrikeFresh 121 77.6%LuckyStrikeDoubleClickCrisp 113 72.4%LuckyStrikeDoubleClickWild 113 72.4%PallMallBoost 108 69.2%KentiBoost 77 49.4%KentiSwitch 75 48.1%PhilipMorrisCaps 53 34.0%MarlboroIceblast 42 26.9%MarlboroDoubleFusion 17 10.9%LuckyStrikeIndigo 12 7.7%CamelFreshness 1 0.6%DunhillClick 1 0.6%LuckyStrikeClickandRoll 1 0.6%MarlboroFusionBlast 1 0.6%PallMallDaiquiriNights 1 0.6%LatinoFreeze 1 0.6%LatinoFresh 1 0.6%


InChile,datacollectorspurchased195packsofcigarettes:121withmentholorotherflavordescriptors,and74tobaccoflavoredpacks.Allpackscontained20cigarettesand86.5%(n=166)ofthepackswereduplicates(seeAppendixD).Theaveragepriceofthecheapestpackswithmentholorotherflavordescriptorswas2,970pesos,andtheaveragepriceofthecheapesttobaccoflavoredpackswas2,520pesos.Fifty-fiveofthepackswithflavordescriptorsmentionedmentholonthepack.All121packswithmentholorotherflavordescriptorscontainedcigaretteswithcapsules;32ofthosepackscontainedcigaretteswithtwocapsulesperstick,and89hadasingleflavorcapsule.Non-conventionaldescriptorswereobservedonallpacks(100.0%,n=121)thatcarriedanyflavordescriptor,followedbydescriptorsformintormenthol(45.5%,n=121)(Figure46).


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Languageorimageryindicatingaflavorchange(100.0%,n=121)wasobservedonallflavoredpackspurchasedinChile,followedbytechnologicaldescriptors(93.4%,n=113),anddescriptorssuchascool,fresh,andice(18.2%,n=22)(Figure47).


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PeruAmongthe50schoolsamplingareasselectedinLima,datacollectorsvisited43areasandidentifiedcigaretteretailerswithin95.3%(n=41)ofthoseareas.Datacollectorsvisited112retailers,89.3%(n=100)ofwhichsoldcigarettes.Retailertypesincludedbodegas(n=109)andsupermercados(n=3).Cigaretteswithmentholorotherflavordescriptorswereidentifiedin95.0%(n=95)ofretailers,andtobaccoflavoredcigaretteswereidentifiedin93.0%(n=93)ofretailers.Cigaretteswithflavorcapsuleswereobservedin89.0%ofretailers(n=89).Looseorsinglecigaretteswereforsalein60.0%(n=60)ofallretailersobserved.Cigaretteswithmentholorotherflavordescriptorswereobservedin85.3%ofbodegas(n=93)and66.7%(n=2)ofsupermercados(Figure48).Tobaccoflavoredcigaretteswereavailablein83.5%ofbodegas(n=91)and66.7%(n=2)ofsupermercados.Figure48.NumberoftobaccoretailersobservedbytypeofcigarettessoldandPOStype

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Cigaretteswithmentholorotherflavordescriptorswereondisplayin85.3%(n=81)ofretailersthatsoldflavoredcigarettes,andtobaccoflavoredcigaretteswereondisplayin87.1%(n=81)ofretailersthatsoldtobaccoflavoredcigarettes(Figure49).Cigaretteswithmentholorotherflavordescriptorsweremostfrequentlydisplayedinthecashierzone(72.6%,n=69),onabrandedstandorcabinet(50.5%,n=48),behindthecashierzone(43.1%,n=41),andnearsweets,snacks,orsugarydrinks(39.0%,n=37).tobaccoflavoredcigaretteswerealsodisplayedinthecashierzone(74.1%,n=69),onabrandedstandorcabinet(51.6%,n=48),behindthecashierzone,(44.0%,n=41),andnearsweets,snacks,orsugarydrinks(39.8%,n=37).Figure49.NumberoftobaccoretailerswithtobaccoproductdisplaysatthePOS

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Figure50.FlavoredcigarettesplacednearsweetsandsnacksatthePOSinLima,Peru

Cigaretteswithmentholorotherflavordescriptorswereadvertisedin46.3%(n=44)retailers,andtobaccoflavoredcigaretteswereadvertisedinonly12.9%(n=12)ofretailers(Figure51).Cigaretteswithmentholorotherflavordescriptorsweretypicallyadvertisedusingprintsignage(33.7%,n=32)ordigitalsignage(15.8%,n=15).Tobaccoflavoredcigaretteswerealsoadvertisedusingdigitalsignage(7.5%,n=7)andprintsignage(6.5%,n=6).

Figure51.NumberoftobaccoretailerswithtobaccoadvertisingsignageatthePOS

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Figure52.PrintadvertisementsforflavoredcigarettesatthePOSinLima,Peru

Only12.6%(n=12)ofretailersofferedanypromotionforcigaretteswithmentholorotherflavordescriptors,mostfrequentlywithspecialorlimitededitionpacks(6.3%,n=6)(Figure53).Tobaccoflavoredcigaretteswereonlypromotedin3.2%(n=3)ofretailers.Figure53.NumberoftobaccoretailerswithtobaccopromotionsatthePOS

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Marketingforcigaretteswithmentholorotherflavordescriptorswasvisiblefromoutsidethestoreat29.5%(n=28)ofretailers,mostfrequentlyintheformofproductdisplay(27.4%,n=26)andadvertisingsignage(15.8%,n=15)(Figure54).Figure54.Numberoftobaccoretailerswithtobaccoproductdisplay,advertisingsignage,orpromotionsforcigaretteswithmenthol,flavors,orcapsulesvisiblefromoutdoors(n=95)

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Datacollectorsidentified15uniquecigarettebrandvariantsatthePOSthatusedmentholorotherflavordescriptors,althoughtheydidnotrecordanexhaustivelistoftheavailablebrands.HamiltonFreshwasthemostfrequentlyobservedbrandusingmentholorotherflavordescriptors,followedbyLuckyStrikeDoubleClickWildCrispandLuckyStrikeIndigo,andotherbrandsusingnon-conventionalflavordescriptorssuchas“Switch”,“BlueIce”,“RubyIce”,and“DoubleFusion”(Figure55).AllbrandsobservedatthePOSareownedbymultinationaltobaccocompanies,suchasBritishAmericanTobacco(BAT),PhilipMorrisInternational(PMI),R.J.ReynoldsTobaccoCompany(RJR).


n %HamiltonFresh 92 96.8%LuckyStrikeDoubleClickWildCrisp 88 92.6%LuckyStrikeIndigo 83 87.4%LuckyStrikeSwitch 82 86.3%MarlboroBlueIce 40 42.1%MarlboroRubyIce 36 37.9%MarlboroDoubleFusion 17 17.9%MarlboroDoubleBurst 4 4.2%CamelFreshness 1 1.1%DunhillClick 1 1.1%LuckyStrikeClickandRoll 1 1.1%MarlboroFusionBlast 1 1.1%PallMallDaiquiriNights 1 1.1%L&MForward 1 1.1%MarlboroKretekMint 1 1.1%


InPeru,datacollectorspurchased71packsofcigarettes:33withmentholorotherflavordescriptors,and38tobaccoflavoredpacks.Thenumberofsticksperpackrangedfrom10to20,withmostpackscontaining10sticksperpack.Onlyonetobaccoflavoredpackcontained20sticks(Figure56),and74.6%(n=53)ofthepackswereduplicates(seeAppendixE).Theaveragepriceofthecheapestpackswithmentholorotherflavordescriptorswas$6.56soles,andtheaveragepriceofthecheapesttobaccoflavoredpackswas$4.31soles.Twoofthepackswithmentholorotherflavordescriptorsmentionedmentholonthepack,andoneofthepacksmentionedadouble-mentholproductfeature.All33oftheflavoredpackscontainedcigaretteswithflavorcapsules,14ofwhichhadtwocapsulesineachstick,and19ofwhichhadasingleflavorcapsule.Figure56.Numberofsticksperpackbycigarettetype

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20sticks 10sticks



Non-conventionalflavordescriptorswereobservedon100.0%(n=33)ofpacksthatcarriedanyflavordescriptor,followeddescriptorsformintormenthol(48.5%,n=16)(Figure57).

Figure57.Flavordescriptorsonpurchasedcigarettepacks(N=33)

Languageorimageryindicatingtechnologicalfeatures(100.0%,n=33),oraflavorchange(100.0%,n=33)werethemostfrequentlyobserveddescriptorsamongallflavoredpackspurchasedinPeru,followedbydescriptorssuchascool,fresh,andice(48.5%,n=16)(Figure58).


0 0 0 0

16

33

0

5

10

15

20

25

30

35

Alcohol Fruit Spicesornuts Sweets Mintormenthol Non-conventional

0

5

16

33 33

0

5

10

15

20

25

30

35

Alphanumeric Lexicalcolors Cool,fresh,ice Flavorchange Technological


DiscussionCigaretteswithmentholorotherflavordescriptorsweresoldin77.4%-95.0%ofcigaretteretailersobservedineachofthefivecountries,whereproductdisplaywasthemostprevalentmarketingtactic.AlthoughArgentina,Bolivia,andPeruprohibittheuseofmisleadingadvertisingthatisaimedatminorsorsuggeststhatanytobaccoproductsislessharmfulthananother,cigaretteswithmentholorotherflavordescriptorsthathavebeenshowntoappealtoyouthandcreateafalseperceptionofreducedriskfromtobaccouseweresoldinthesecountries.Theproductswereconsistentlyplacedinandbehindthecashierzone,aprominentlocationwithintheretailenvironment.Cigaretteswithmentholorotherflavordescriptorswerealsodisplayednearsweets,snacks,orsugarydrinksinallfivecountries,therebynormalizingtheseharmfulandaddictiveproductsinthecontextofproductsthatattracttheattentionofchildren;thiscontradictsthecompanypoliciesthatarepubliclypromotedbysuchentitiesasPhilipMorrisInternational(PMI),BritishAmericanTobacco(BAT),andJapanTobaccoInternational(JTI).InBrazilandChile,wheremostformsofPOSmarketingareprohibited,weobservedtheuseofpriceliststhatfunctionedasadvertisingsignage.Theuniformityandprofessionalproductionqualitysuggestthatthetobaccocompanieslikelyprovidedthepricesignagetotheretailers.Thehighprevalenceofcigarettepacksandmarketingmediathatuseflavordescriptorsformentholormintfurtherdemonstratethesignificanceofthisparticularflavoranttoattractingcustomers.Thehighfrequencyofnon-conventionalflavordescriptorsoncigarettepacksandmarketingmediasuggeststhatthetobaccoindustrymaybeattemptingtocircumventoranticipateexistingorfuturelawsthatprohibittheuseorpromotionofflavorantsintobacco.

LimitationsThisstudyusedapurposivesampleofschoolsandaconveniencesampleofretailersinonecityineachofthefivecountries.Theresultsmaynotberepresentativeofalltypesoftobaccoretailersorgeneralizabletoallareasofeachcountryorregion.

ConclusionsThisstudydemonstratesthatharmfultobaccoproductsusingmisleadingpackagingandpredatorymarketingstrategiesareprevalentandaccessibleinretailerssurroundingschools(inBuenosAires,Argentina,LaPaz,Bolivia,RiodeJaneiro,Brazil,Santiago,Chile,andLima,Peru).Thestudyalsodemonstratesthatmisleadingandpredatorymarketingstrategiesareemployedbymultipletobaccocompanies,includingBritishAmericanTobacco,PhillipMorrisInternational,JapanTobaccoInternationalandtheiraffiliates,amongothers.TheFCTCanditsimplementingguidelinesarebasedonrigorousscientificevidence.Partialregulationsthatallowexceptionsforcertainmarketingpractices(suchasproductdisplay)allowthetobaccoindustrytocircumventthelawbyredirectingtheirresourcestowardunregulatedtactics(suchasproductdisplayorelaboratepriceliststhatfunctionasadvertisements).EnactingmeasuresthatalignwiththeFCTCanditsimplementingguidelineswillfacilitatecompliance,deternoncompliance,andenablegovernmentstotakeappropriatelegalactionsagainstviolations.Inordertoprotectandsavelives,countriesshouldadoptandeffectivelyimplementpoliciesthatprohibittheuseoftobaccoproductflavorings,prohibittheuseofmisleadingpackagingandlabeling,andprohibitallformsofdirectandindirectadvertising,promotion,andsponsorship,includingthedisplayoftobaccoproductsat


retailpointsofsale.

KeyTermsandDefinitionsTerm Definition

Advertising(signage) Brandedprintordigital/electronicmediasuchasposters,backgrounds,banners,flyers,shelfliners,andtelevisionorcomputerscreens-thatareintendedtopromoteawarenessandfavorableopinionsofatobaccobrandorproduct.

Branded Elementssuchasbrandname,logo,slogan,colorschemes,orpatternsthatallowcustomerstorecognizeaparticularbrand.Forthepurposesofthismonitoring,“branded”referstotobaccobrandsonly.

Cashierzone Theareaimmediatelysurroundingthecashregister(ontopof,above,totheleft/rightof,orinfrontofthecounterwherethecashregisterislocated).

Cigaretteswithmentholorotherflavordescriptors

Cigarettesthatinclude,somewhereonthecigarettepackortheassociatedmarketingmedia,languageorimagerythatimpliesthepresenceofadditives,includingmenthol,thatwouldchangetheflavorofthetobaccowhichisnoticeablebythesmoker,orthattheflavorofthetobaccoisdifferentinsomewayfromtobaccoflavoredcigarettes.

Conventionalflavordescriptors

Termsorimagerydescribingarecognizableflavor,suchas:fruit,alcohol,coffee,sweets,spices,andmintormenthol.

Flavorcapsule Asmallbeadinthecigarettefilterthatconsumersbreaktoreleaseaflavoringagentthatflavorsthetobaccosmoke.

Flavordescriptors Words,numbers,orimagerythatareincorporatedintothebrandnameofthetobaccoproductorothertextdescribingthetobaccoproductthatcanbeusedtodenoteflavorandtaste.

Flavoredcigarettes Cigarettesthatinclude,somewhereonthecigarettepackortheassociatedmarketingmedia,languageorimagerythatimpliesthepresenceofsubstances,includingmenthol,thatwouldchangetheflavorofthetobacco,orthattheflavorofthetobaccoisdifferentinsomewayfromtobaccoflavoredcigarettes.

Flavoringagents Anaturalorsyntheticsubstanceormixtureofsubstancesthatimparts,modifies,enhances,orintensifiestheflavoroftobaccoproducts,whichcanbeaddedtocigarettestocreateflavoredcigarettes.

Loyaltyscheme Rewardsprogramsorpointssystemsthatcustomerssubscribetoforspecialbenefits.

Mentholcigarette Cigarettesthatincludementhol,eitherinthetobaccoorinaflavorcapsule.

Non-conventionalflavordescriptors

Termsorimagerythatdonotcorrespondtoatypicallyrecognizableflavor,andcaninclude:lexicalcolordescriptors(purplecrush,rubyburst),descriptorsindicatingafresh,chill,orcooltaste,technologywordsorsymbols(pressplay),flavorchangedescriptors(clicktoactivate),andalphanumericdescriptors(MX12).


Powerwall Adisplayoftobaccoproductsbehindthecashierzone,withmultipleshelvesandmultiplepacks.

Productdisplay Specialpresentationsofastore'scigaretteproductsintheactualsizewhichtheyareforsalesuchasanexhibitioncaseorpowerwall.

Promotions Specialorlimitedtimeoffersthatareintendedtoresultinthepurchaseofatobaccoproduct.

TAPS Tobaccoadvertising,promotion,andsponsorship-typesofmarketingstrategies.

Tobaccoflavoredcigarettes

Cigarettesthatdonotinclude,somewhereonthecigarettepackortheassociatedmarketingmedia(suchasprintsignage),languageorimageryindicatingacharacterizingflavor,suchasmentholorchocolate,thatwouldchangetheflavorofthetobaccoinamannerthatisnoticeablebythesmoker.


AppendixA:CigarettePacksPurchasedinArgentina

Manufacturer BrandName BrandVariantNumberofPacks

Purchased

AveragePrice

RangeofPrices(ARS–Pesos)

BritishAmericanTobacco(BAT)

LuckyStrike LuckyStrikeClick(Blue)_12 2 25.00 25.00-25.00

LuckyStrike LuckyStrikeClick(Blue)_20 1 50.00 50.00-50.00

LuckyStrikeLuckyStrikeDoubleClickCrisp_12

3 25.00 25.00-25.00


4 50.00 45.00-55.00

PallMallPallMallMojitoNightsDoubleClick_20

1 47.00 47.00-47.00

Richmond Richmond_20 3 20.00 15.00-25.00Rothmans Rothmans_11 2 20.00 20.00-20.00

Viceroy ViceroyRed11s_12 8 19.50 18.00-20.00

Viceroy ViceroyRed_20 4 35.25 34.00-37.00

Viceroy ViceroySwitch11s_11 1 19.00 19.00-19.00



DoradosCigarritos Dorados Dorados_20 2 15.00 15.00-15.00

EspertSociedadAnonima Melbour Melbour

Classic_20 3 25.00 25.00-25.00

PhilipMorrisInternational(PMI)

Chesterfield ChesterfieldFreshCap_10 4 18.75 18.00-20.00

Chesterfield ChesterfieldFreshCap_20 4 40.25 38.00-45.00

Chesterfield ChesterfieldRed_10 5 18.60 18.00-20.00

Chesterfield ChesterfieldRed_20 1 32.00 32.00-32.00


L&M L&MForward2&1_20 1 46.00 46.00-46.00

Marlboro MarlboroFusionBlast_10 6 27.70 25.00-29.00

Marlboro MarlboroFusionBlast_20 4 45.50 40.00-52.00

Marlboro MarlboroIceBlast_10 1 25.00 25.00-25.00

Marlboro MarlboroIceBlast_20 1 47.00 47.00-47.00

Marlboro MarlboroRed_20 1 45.00 45.00-45.00

PhilipMorris PhilipMorrisCaps20 4 48.50 45.00-50.00

PhilipMorris PhilipMorrisCapsDuo_10 3 22.70 22.00-24.00

PhilipMorris PhilipMorrisCapsDuo_20 6 48.50 47.00-50.00

PhilipMorris PhilipMorrisCaps_10 11 24.50 22.00-30.00

PhilipMorris PhilipMorris_10 5 23.80 22.00-25.00TabacaleraSarandi

RedPoint

RedPointMentholTheAmericanBlend_20

3 28.00 24.00-30.00

RedPointRedPointTheAmericanBlend_20

8 28.50 25.00-30.00


AppendixB:CigarettePacksPurchasedinBolivia


Purchased

AveragePrice

RangeofPrices(BOB

-Bolivianos)


LuckyStrike LuckyStrikeConvertible 2 7.50 7.50-7.50

LuckyStrike LuckyStrikeDoubleClick 2 8.00 8.00-8.00

CompaniaIndustrialDeTabacosS.A.

Astoria Astoria_20 1 5.00 5.00-5.00BigBen BigBen_20 1 10.00 10.00-10.00Derby Derby(Gold)_10 7 5.50 5.00-6.00Derby Derby(Gold)_20 3 9.67 8.00-11.00

Derby Derby(Orange)_20 1 8.00 8.00-8.00

Derby Derby(Red)_10 5 5.30 5.00-6.00Derby Derby(Red)_20 1 11.00 11.00-11.00Derby DerbyCool_10 1 5.00 5.00-5.00Derby DerbyCool_20 2 10.50 10.00-11.00

DjarumDjarum Djarum

Menthol_10 1 7.50 7.50-7.50

GodfreyPhillipsJaisalmer Jaisalmer

Menthol_20 1 6.00 6.00-6.00

JapanTobaccoInternational(JTI)

Camel Camel(Yellow)_10 1 7.50 7.50-7.50

CamelCamelActivateDoublePurple_10

2 7.75 7.50-8.00

CamelCamelActivateDoublePurple_20

1 8.00 8.00-8.00

Camel CamelActivateFreshness_10 5 8.60 8.00-9.00

Camel CamelActivateFreshness_20 1 15.00 15.00-15.00

Camel CamelBlue_10 1 7.00 7.00-7.00PhilipMorrisInternational(PMI)

L&M L&MBlueLabel_10 6 5.83 5.00-6.00

L&M L&MBlueLabel_20 1 10.00 10.00-10.00

L&M L&MFORWARD2IN1_10 1 9.00 9.00-9.00


L&M L&MFORWARD2IN1_20 3 14.00 13.00-15.00

L&M L&MKretekMint_20 5 14.60 12.00-18.00

L&M L&MMentholLabel_10 4 5.63 5.00-6.00

L&M L&MMentholLabel_20 3 11.00 10.00-13.00

L&M L&MRedLabel_10 8 5.69 5.00-6.50

L&M L&MRedLabel_20 1 11.00 11.00-11.00

Marlboro MarlboroKretekMint 1 16.00 16.00-16.00


AppendixC:CigarettePacksPurchasedinBrazil


Purchased

AveragePrice

Rangeofprices(BRL–Reais)

BritishAmericanTobacco/SouzaCruz(BAT)

Derby (blue) 2 7.37 7.25-7.50Derby (red) 1 7.25 7.25-7.25Derby (silver) 1 7.25 7.25-7.25Derby Click+ 1 7.25 7.25-7.25

Derby PremiumMenthol 1 7.50 7.50.7.50

Dunhill CarltonBlend 5 8.50 8.50-8.50

Dunhill Double(pinkandblue) 4 8.31 8.00-8.50

Dunhill Switch(blue) 1 8.50 8.50-8.80Free Boost 7 7.98 7.00-9.00Free Taste+Filter 1 7.50 7.50-7.50Hilton AuthenticSlims 1 missing missingHollywood Blue 1 7.50 7.50-7.50Hollywood Mint 4 7.37 7.00-7.50Hollywood Original(red) 1 7.50 7.50-7,50LuckyStrike Blue 2 7.75 7.50-8.00

LuckyStrikeConvertiblesClickandRollFresh

13 7.50 7.50-7.50

LuckyStrikeConvertiblesSwitchClickandRoll

7 7.50 7.50-7.50

LuckyStrike DoubleClickCold 13 8.25 7.50-9.00

LuckyStrike Red 1 7.50 7.50-7.50Minister Special 12 5.46 5.00-7.75Minister Unique(red) 8 5.53 5.00-6.50


Dallas Classic(bluestripe) 1 5.00 5.00-5.00

Dallas Classic(redblockwithcrest) 1 5.00 5.00-5.00

Dallas Classic(redstripe) 1 7.25 7.25-7.25

L&M BlueLabelFineCutTobacco 1 7.00 7.00-7.00


Marlboro BlueIceIceball 5 7.59 7.00-8.00

MarlboroDoubleBurstDoublecapTechnology

1 8.50 8.50-8.50

Marlboro Gold 2 7.75 7.50-8.00Marlboro Red 7 7.84 7.00-8.50

Djarum L.A. Cereja(Cherry) 3 8.32 8.00-9.00L.A. KretekMenthol 1 8.00 8.00-8.00

JapanInternational(JTI)

CamelBlueInternationalBlend

1 8.00 8.00-8.00

Camel DoubleMintPurple 1 8.50 8.50-8.50

Camel Filters(yellow) 1 missing missing

Winston BlueInternational 3 5.33 5.00-5.50

Winston ClassicInternational 3 5.63 5.00-6.50

Winston ExpandExoticMint 3 5.83 5.50-6.00

Notlisted Gift Gift 6 3.52 2.50-4.00


AppendixD:CigarettePacksPurchasedinChile


Purchased

AveragePrice

RangeofPrices(CLP–Pesos)


Belmont BelmontRojo 1 4,500.00 4,500.00-4,500.00

Kent KentBelmontBlend 3 2,550.00 1,850.00-

3,000.00

LuckyStrike LuckyStrikeClick 3 2,870.00 1,900.00-

3,400.00

LuckyStrike

LuckyStrikeConvertiblesFlowFilterIndigo

13 3,220.00 2,000.00-5,000.00

LuckyStrikeLuckyStrikeDoubleClickCrisp

5 4,100.00 3,500.00-5,000.00

LuckyStrikeLuckyStrikeDoubleClickWild

22 3,420.00 1,900.00-5,000.00

LuckyStrike LuckyStrikeFresh 4 3,450.00 3,400.00-

3,500.00

PallMall PallMall(GraySpecialEdition) 1 2,650.00 2,650.00-

2,650.00

PallMall PallMallAzul 35 2,410.00 1,500.00-2,700.00

PallMall PallMallClickOnFreshTaste 13 2,630.00 1,700.00-

3,000.00

PallMall PallMallClickOnMentholBoost 52 2,650.00 1,400.00-

4,800.00

PallMall PallMallGris 1 2,600.00 2,600.00-2,600.00

PallMall PallMallRojo 9 3,310.00 2,000.00-4,500.00

MarcaKT&GPine PineBlue 1 1,100.00 1,100.00-

1,100.00PhilipMorrisInternational(PMI)

L&M L&MRedLabel 1 2,600.00 2,600.00-2,600.00

MarlboroMarlboroCrushIceball&Purpleball

5 3,240.00 3,200.00-3,400.00

Marlboro MarlboroGoldOriginal 1 3,400.00 3,400.00-

3,400.00


PhilipMorris PhilipMorris(Blue) 3 2,470.00 2,400.00-

2,500.00

PhilipMorris PhilipMorris(Red) 5 2,500.00 2,400.00-

2,600.00

PhilipMorris PhillipMorrisCaps 3 2,800.00 2,700.00-

3,000.00SaigonTobaccoCompany-Vietnam

Nirvana Nirvana 1 1,100.00 1,100.00-1,100.00

TabacaleraHernandariasS.A.Paraguay

Fox Fox 5 1,600.00 1,200.00-2,000.00

TobacosApoloS.A. Latino Latino(Blue) 2 2,100.00 2,100.00-

2,100.00

Latino Latino(Red) 1 2,200.00 2,200.00-2,200.00

Latino LatinoFreeze 1 2,300.00 2,300.00-2,300.00

Latino LatinoKingSize(Blue) 1 1,100.00 1,100.00-

1,100.00

Latino LatinoKingSize(Red) 2 4,050.00 1,100.00-

7,000.00

Pacific PacificFilterLong(Red) 1 2,200.00 2,200.00-

2,200.00


AppendixE:CigarettePacksPurchasedinPeru


Purchased

AveragePrice

Rangeofprices(PEN

-Sol)BritishAmericanTobacco(BAT)

Hamilton HamiltonFresh_10 4 5.25 5.00-6.00

Hamilton Hamilton_10(bluecolor) 3 5.83 5.00-7.00

LuckyStrike LuckyStrikeBlue_10 1 8.00 8.00-8.00


6 7.17 7.00-7.50

LuckyStrikeLuckyStrikeDoubleClickWild_10

8 7.25 7.00-8.00

LuckyStrike LuckyStrikeFresh_10 3 6.83 6.50-7.00

LuckyStrike LuckyStrikeIndigo_10 4 7.00 6.50-7.50

LuckyStrike LuckyStrikeSwitch_10 4 7.00 6.50-7.50

PallMall PallMallClickonFreshTaste_10 6 4.88 3.50-8.50

PallMall PallMall_10(bluecolor) 19 3.78 3.00-7.50

PallMall PallMall_10(green) 6 3.72 3.50-4.00

PallMall PallMall_10(redcolor) 1 3.00 3.00-3.00

PallMall PallMall_20(Green) 1 7.50 7.50-7.50

WinstonWinstonAmericanFlavor_10

1 6.50 6.50-6.50


L&M L&MForward2in1_10 1 3.00 3.00-3.00

Marlboro MarlboroBlueIce_10 1 6.00 6.00-6.00

Marlboro MarlboroGold_10 1 3.80 3.80-3.80

Marlboro MarlboroRed_10 1 5.50 5.50-5.50


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