Study Examines Influence of Flavored Cigarette Packaging on Filipino Young Adults

Packaging and flavors can influence the way young adults in the Philippines judge the appeal and harmfulness of cigarettes, according to recent research from the Institute for Global Tobacco Control.

The study included young adults ages 18-24 in Metro Manila in 2019. The participants, a mix of smokers and non-smokers, were shown 26 cigarette packs to assess their thoughts on cigarettes based on the packaging. Menthol cigarettes with primarily blue packaging were considered less harmful by the participants than menthol cigarettes with primarily green packaging. They also considered flavor capsule cigarette packs – those containing cigarettes with a small capsule in the filter that can be crushed to release flavor – more attractive than other packs. Some young adults compared the capsules in cigarettes to candy.

"It is concerning that participants found flavor capsule cigarettes attractive and likened the capsule to candy. It is also problematic that young adults still perceive some menthol cigarettes to be less harmful than other cigarettes," said lead author Jennifer Brown, Assistant Scientist in the Department of Health, Behavior and Society at Johns Hopkins Bloomberg School of Public Health. "Plain packaging regulations and flavor bans could make cigarettes less appealing to younger generations and reduce misperceptions of product harm."

This study focused on the Philippines because of the country's high rate of smoking and large menthol cigarette market share. The market share of flavor capsule cigarettes, introduced to the country in 2013, is on the rise. Only a few study participants acknowledged at the beginning that all cigarettes are harmful.

The paper was published online by Tobacco Control and is available open access at https://tobaccocontrol.bmj.com/content/early/2020/05/23/tobaccocontrol-2019-055524.abstract.

The Institute also recently published a global review of tobacco product flavor policies in Tobacco Control. The paper looked at the policies of 11 countries and the European Union, described the stated policy rationale, terms and definitions of flavors, tobacco products covered and restrictions on the use of flavor imagery and terms on tobacco product packaging. and identified possible gaps and opportunities for these and other countries to address.