cigarette packaging in the philippines: a comparison by ... · cigarette packaging in the...

Johns Hopkins Bloomberg School of Public Health

Cigarette packaging in the Philippines: A comparison by flavor and flavor capsule presence

Jennifer Brown, MPHKatherine Clegg Smith, PhD

Meng Zhu, PhDMeghan Moran, PhD

Connie Hoe, PhDJoanna Cohen, PhD

© 2014, Johns Hopkins University. All rights reserved.©2019, Johns Hopkins University. All rights reserved.

Funding source: This work was supported with funding from Bloomberg Philanthropies’ Bloomberg Initiative to Reduce Tobacco Use (Bloomberg.org).

Industry funding: None

Off label medication uses discussed: None


Background• 22.7% of adult population in the Philippines smokes

• Philippines has a high menthol market share

Source: World Health Organization


Flavored cigarettes• Menthol cigarettes are associated with smoking

initiation and decreased likelihood of quitting and staying quit

• Flavor capsule cigarettes associated with misperceptions of harm and appeal to youth


Marketing• Cigarette packaging is an important marketing tool

• No research has examined difference between menthol and non-menthol cigarette packaging


ObjectiveTo compare and describe the similarities and differences in packaging components being used between packs that vary by flavor and flavor capsule presence that were on the market in the Philippines in 2016.


Research questions• What structural components (pack type, opening style, shape)

are used to package cigarettes?

• What graphic components (color, imagery, descriptors) are used on cigarette packaging?

• Are there differences and/or similarities between groups of packaging that vary by flavor and capsule presence and the structural and graphic components used?


Methods


Methods• Packs coded for structural elements and graphic components

• Quantitative content analysis

• Compared prevalence of structural elements and graphic components across categories of packs (distinguished by flavor and flavor capsule) using Fisher’s exact test


Variable DefinitionNo flavor No indication that pack is flavored and no

distinguishable flavor/taste/aroma other than tobacco is displayed on cigarette pack or stick

Menthol or mint“Menthol” or “mint” appears as a descriptor on cigarette pack or stick

Characterizing flavor other than mint or menthol

A characterizing flavor other than “menthol” or “mint” is displayed as a descriptor on the cigarette packaging or stick, including, but not limited to caramel/vanilla/chocolate, cinnamon/canella or other spice, clove/kretek, fruit or citrus, coffee, alcoholic beverage, energy drink

Non-characterizing flavor

Indication that pack is flavored but no distinguishable flavor/taste/aroma other than tobacco is displayed on cigarette pack or stick

Flavor capsule pack Pack that indicates in any way that the user is able to change the stick flavor (e.g. convertibles, click and roll, activate)


Results (N=75)FLAVOR

CAPSULEFLAVOR

No flavor Menthol or mint Characterizing flavor – not

menthol or mint

Non-characterizing

flavor

No

n/a(n=0)

n/a(n=0)

Yes

n/a(n=0)

Group 1: Non-flavor non-capsule (n=36)

Group 2: Menthol non-capsule (n=23)

Group 3: Menthol capsule (n=10)

Group 4: Non-characterizing or other flavor capsule (n=6)


Results – Structural elementsGroup 1: Non-flavored non-capsule (n=36)

Group 2:Menthol non-capsule (n=23)

Group 3:Menthol capsule (n=10)

Group 4:Non-characterizing or other flavor capsule (n=6)

1 vs 2

1 vs 3

1 vs 4

2 vs 3

2 vs 4

3 vs 4

n (%) n (%) n (%) n (%)Pack type* **

Hard 27 (75.0) 11 (47.8) 10 (100) 6 (100)Soft 9 (25.0) 12 (52.2) 0 (0) 0 (0)

Traditionalshape

36 (100) 23 (100) 10 (100) 6 (100)

Slim pack* 2 (5.6) 1 (4.3) 0 (0) 2 (33.3)

*p<0.05; values are from Fisher’s exact test**p<0.008, adjusted for multiple comparisons; values are from Fisher’s exact tests


Group 1: Non-flavored non-capsule (n=36)



Group 4:Non-characterizing or other flavor capsule (n=6)

n (%) n (%) n (%) n (%)Pack type*

Hard 27 (75.0) 11 (47.8) 10 (100) 6 (100)Soft 9 (25.0) 12 (52.2) 0 (0) 0 (0)

Examples of menthol non-capsule soft packs (group 2) Examples of menthol capsule hard packs (group 3)


Results – Graphic componentsGroup 1:Non-flavored non-capsule (n=36)



Group 4:Non-characterizing or other flavor capsule(n=6)

1 vs 2

1 vs 3

1 vs 4

2 vs 3

2 vs 4

3 vs 4

n (%) n (%) n (%) n (%)Green* 1 (2.8) 21 (91.3) 6 (60) 2 (33.3) ** **

Blue 9 (25.0) 2 (8.7) 5 (50) 2 (33.3)

Purple* 0 (0) 0 (0) 2 (20) 0 (0)

Masculine appeal

1 (2.8) 0 (0) 0 (0) 1 (16.7)

Less harm 1 (2.8) 1 (4.3) 0 (0) 0 (0)“Taste” 3 (8.3) 1 (4.3) 2 (20) 2 (33.3)“Fresh”* 0 (0) 0 (0) 1 (10) 3 (50) ** **

“Cool/ice”* 0 (0) 1 (4.3) 3 (30) 1 (16.7)

“Sensation” 0 (0) 1 (4.3) 2 (20) 0 (0)Technology* 3 (8.3) 1 (4.3) 10 (100) 6 (100) ** ** ** ***p<0.05; values are from Fisher’s exact test**p<0.008, adjusted for multiple comparisons; values are from Fisher’s exact tests






n (%) n (%) n (%) n (%)Green* 1 (2.8) 21 (91.3) 6 (60) 2 (33.3)

Example of green menthol non-capsule pack Example of green menthol capsule pack






n (%) n (%) n (%) n (%)“Fresh”* 0 (0) 0 (0) 1 (10) 3 (50)

Examples of non-characterizing flavor capsule pack displaying “fresh”






n (%) n (%) n (%) n (%)Technology* 3 (8.3) 1 (4.3) 10 (100) 6 (100)

Examples of menthol capsule packs using technology imagery


Non-characterizing or other flavor capsule cigarettes (n=6)

2 other flavor capsule packs: Coffee flavor with ice coffee flavor and coffee flavor with orange coffee flavor

4 non-characterizing flavor capsule packs: “Fresh” and green color could potentially indicate menthol flavoring


Strengths & limitations+ First study to describe differences in packaging between menthol and non-menthol packs

+ Data collected in geographically and culturally diverse areas in the Philippines

- Sample was collected in 2016; likely changes to market

- Not able to confirm meaning of structural elements and graphic components to consumers


Conclusions• Different materials, color (green), descriptors (“fresh”,

technology terms) and imagery (technology) are used on cigarette packaging to distinguish between cigarette types in the Philippines

• Findings highlight the need for a greater awareness of the potential for different packaging components to convey product characteristics to consumers, some that may be misleading or that are attractive to a new generation of smokers

• Can inform future tobacco control policy as the Philippines and other countries consider bans on flavored tobacco and displays at point-of-sale and adoption of plain tobacco packaging


Next steps• Future research will explore consumer perceptions of

menthol and flavor capsule cigarette packaging and assess whether distinguishing marketing features are associated with: Attractiveness Less harm Intention to try


Thank [email protected]

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