Introduction: Cigarettes with flavor-changing capsules in the filter have experienced phenomenal global growth in the last decade. We explore sociodemographic and smoking-related factors associated with using capsule cigarettes, how frequently users burst the capsule, and reasons for using them. This analysis focuses on factory-made cigarette smokers, aged 18 years and over, who had smoked in the past month.
The Center for Tobacco Products recently provided an update on its ongoing work of conducting the premarket review of ENDS and other tobacco product applications, and has issued warning letters to ENDS product manufacturers and retailers who continue to sell products that are illegally on the market.
The FDA has also made a significant investment in a multimedia e-cigarette public education campaign. The campaign targets nearly Today, the FDA granted a citizen petition requesting that the agency pursue rulemaking to prohibit menthol in cigarettes, affirming its commitment to proposing such a product standard. The Tobacco Control Act TCA did not include menthol in its ban on characterizing flavors in cigarettes, leaving menthol cigarettes as the only flavored combusted cigarettes still marketed in the U.
The law instructed the FDA to further consider the issue of menthol in cigarettes. Since then, the FDA sought input from an independent advisory committee as required by the TCA , and further demonstrated its interest by issuing an Advance Notice of Proposed Rulemaking , undertaking an independent evaluation and supporting broader research efforts—all to better understand the differences between menthol and non-menthol cigarettes and the impact of menthol on population health.
In the U. In addition, among youth, from to , declines in menthol cigarette use were observed among non-Hispanic White youth but not among non-Hispanic Black or Hispanic youth. Cigarettes with capsules in the filter that can be burst to change the flavor have experienced remarkable growth since being introduced in , but little is known about how and why smokers use these products.
Thirteen percent of factory-made cigarette smokers in our sample smoked a brand with a capsule in the filter, with approximately two-thirds crushing the capsule all or most of the time. Capsule use was more likely among younger participants. The main reasons for smoking capsule cigarettes were related to how they taste, having a choice of flavors, and enjoyment of clicking the capsule interactivity. With most countries having implemented comprehensive bans on tobacco advertising, promotion, and sponsorship, packaging has taken on a more prominent marketing role.
Tobacco companies do not have full control over the appearance of the pack, however, with more than countries requiring pictorial warnings on packs, 1 and a growing number of countries planning to introduce plain or standardized packaging, with Australia, France, the United Kingdom, New Zealand, and Norway having already done so.
However, even in these countries, tobacco companies continue to promote their products, with the head of business development for British American Tobacco BAT explaining that innovation, and the product itself, become more important as a result of legislation requiring large pictorial warnings or plain packaging. The use of rupturable capsules within cigarettes dates back to the s, although at that time capsules contained water, rather than flavoring properties, as the water was intended to soften the filter material when the cigarette was lit.
BAT, for instance, reported selling capsules in markets in Since the first menthol capsules were brought to market, tobacco companies have introduced a panoply of new flavors, for instance, green tea flavor in China and whisky flavor in Japan, 6 double capsules two different flavor capsules within one filter , and also mixed packs four or five different flavors within one pack.
The capsule segment grew more than fourfold between and 8 and now has approximately 1. Despite the global success of capsule cigarettes, only a handful of studies have explored use of these products. Three focus group studies have been conducted in Scotland 11 , 12 and the United States.
It was suggested that capsule cigarettes would encourage nonsmokers to experiment with smoking and discourage smokers from quitting.
Four surveys have also explored the use of capsule cigarettes. In the Australian School Students Alcohol and Drug Survey with 12—year olds, more than half of past month smokers reported trial of a capsule cigarette Preference for flavor capsules was much higher among younger than older adults in Australia and the United States and those who smoked capsule cigarettes perceived greater stylishness, taste, and relatively lower harm for their brand compared with those who smoked noncapsule cigarettes.
Unlike previous research in the United States, 16 capsule smokers were not less likely than noncapsule smokers to perceive their usual product as less harmful than other products. In this study, we explore sociodemographic and smoking-related factors of capsule and noncapsule cigarette smokers in the United Kingdom and how and why capsule smokers use these products.
The survey was undertaken by YouGov using a sample recruited from their panel of people aged 16 and over. YouGov panel members are recruited from various sources, including advertising and partnerships with websites. The sample was weighted by age, gender, government office region, and tobacco consumption to represent the national profile of smokers aged 16 and over in the United Kingdom, which was based on the Opinions and Lifestyle Survey and Integrated Household Survey.
Table 1 shows the full sample before and after weighting. The unweighted sample matched the national profile of smokers in terms of ethnicity, Heaviness of Smoking Index HSI , and quit intentions, but males and young adults aged 16—35 years were under-represented. Weighting brought the sample in line with national profiles in terms of gender and age.
Participants reported their age, gender, social grade occupation of chief income earner within household , and ethnicity. Ethnicity was coded against 15 categories, but with few participants endorsing many of these, it was recoded into three categories White British, White non-British, other for analysis see Table 1.
Please note cigarettes refer to those that are factory-made packet and also those that are hand-rolled rolling tobacco. Cigarettes do not include electronic cigarettes or vaping devices. The HSI 18 was used to assess time to first cigarette and daily consumption. To measure consumption, smokers were asked how many cigarettes either factory-made or hand-rolled they smoked in a typical day, week, or month, depending on their response to questions on frequency of smoking.
Participants could check all reasons that applied. YouGov employ an active sampling method, drawing a subsample from their panel that is intended to be representative of the target sample.
Randomly selected panel members were invited by e-mail to participate in this survey, with a link provided to do so; only those invited to participate could do so, and they were not informed in the e-mail invite about the topic area so as to minimize opt-out on this basis. A total of invitations were sent to smokers whose profiling data matched the recruitment criteria.
Of the who clicked on the survey link, were screened out as they indicated that they did not meet the inclusion criteria, ie, that they smoked cigarettes in the last 3 months. Of the who completed the survey, there were noncompleters, and were removed by YouGov for data quality issues eg, straight-lining, or completing the survey in less than half the average median time , leaving participants.
An information page was provided at the start of the survey, and explicit consent was required before participation. For characteristics of the analytic sample, see Table 2. Descriptive data were weighted by age, gender, government office region, and tobacco consumption to reflect smokers in the United Kingdom.
Logistic regression was used to estimate associations between preference for brands with capsules [smoke a capsule brand 1 vs. For smokers of capsule brands, logistic regression assessed associations between frequency of crushing the capsule [always or most of the time 1 vs. Variables included in each model were gender, age, social grade, ethnicity, HSI, and plans to quit in the next 6 months.
This enabled each category of the predictor variable, with the exception of the first, to be compared with the average effect of the previous categories. For example, 25—year olds were compared with 18—year olds, 35—year olds were compared with 18—year olds, etc. Logistic regression was run on unweighted data as the models controlled for demographic and smoking-related variables.
A Mann—Whitney U test was used to examine whether capsule users differed from noncapsule users in their perceptions of the harm from their brand of cigarettes.
This was run on weighted data as no other variables were being controlled for. Table 2 shows the characteristics for the analytic sample. The overall mean HSI was 1. Thirteen percent indicated that they smoked a capsule brand. When demographic and smoking-related variables were controlled for, prevalence of capsule use did not differ significantly by gender, social grade, or HSI Table 2. Introduction: Tobacco use is a major public health problem in the Philippines.
Menthol flavored and flavor capsule cigarettes are independently associated with increased smoking initiation and appeal to youth and young adults. Packaging is an important tobacco marketing tool.
Methods: Tobacco packs were systematically collected in the Philippines in and categorized as non-flavored non-capsule, menthol non-capsule, menthol capsule, and non-menthol capsule. Structural elements e. Results: Menthol capsule packs were significantly more likely to be hard packs than menthol non-capsule. Menthol packs were more likely to be colored green than non-flavored packs.
Capsule packs were more likely to display technological appeals than non-capsule packs. Conclusions: Menthol and flavor capsule cigarettes are packaged differently most notably, in terms of color and technological appeals than non-menthol and noncapsule packs. Packaging and labeling policy should take this into consideration. Importance of packaging as a marketing tool Packaging is a key marketing strategy. Marketing of menthol and flavor capsule cigarettes The tobacco industry has historically targeted youth and minorities with menthol cigarette advertisements Objectives Given how integral packaging is to marketing, it is important to understand how menthol and non-menthol cigarettes are presented via packaging.
Coding A codebook was developed based on the literature on cigarette marketing, branding, and audience segmentation and existing coding systems for tobacco packaging. Table 1 Definitions of key variables. Sample The sample of packs included in this study was limited to legal cigarettes displaying a Philippines health warning label in rotation at the time of data collection. Data analysis Data analyses were conducted using Stata Figure 1 Examples of groups of packs by flavor and capsule presence.
Structural elements Overall, the groups of packs did not vary much with regard to structural elements Table 2. Table 2 Structural elements of cigarette packaging by packaging category, as distinguished by flavor and flavor capsule presence. Table 3 Graphic components of cigarette packaging by packaging category, as distinguished by flavor and flavor capsule presence.
Figure 2 Examples of graphic components. Less harm descriptors Two packs displayed descriptors that indicate less harm e. Feminine appeal No packs were identified as having a specific feminine appeal. Technological appeal Twenty packs Strengths and limitations There are several strengths and limitations in this study.
The authors have each completed and submitted an ICMJE form for disclosure of potential conflicts of interest. The authors declare that they have no competing interests, financial or otherwise, related to the current work.
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Cigarette brands with flavour capsules in the filter: trends in use and brand perceptions among smokers in the USA, Mexico and Australia, Recall, appeal and willingness to try cigarettes with flavour capsules: assessing the impact of a tobacco product innovation among early adolescents. Use of cigarettes with flavour-changing capsules among smokers in the United Kingdom: An online survey.
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