26
views
0
recommends
+1 Recommend
1 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Tobacco industry tactics to circumvent and undermine the menthol cigarette ban in the UK

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Introduction Menthol, a type of alcohol (molecular formula C10H20O), can be obtained from mint plants or manufactured.1 2 In addition to flavouring, it has local anaesthetic properties that can conceal the negative sensations of smoking, due to desensitising receptors.1 3 Menthol cigarettes increase overall smoke intake, but mask early respiratory disease symptoms, reducing the chance of quitting.4–6 Smoking menthol cigarettes also may raise nicotine intake, promoting nicotine dependence and the establishment of smoking in youth.4 5 7–9 Thus, banning menthol should reduce smoking prevalence.4 Furthermore, menthol cigarettes are likely to contribute to health inequalities as sociodemographic groups more likely to be of low income (low education, women, African–Americans and young people) are more likely to smoke menthol.10–13 A process for flavouring tobacco with menthol was first patented in the USA in the 1920s,14 but mass distribution and marketing started in the 1960s when a version with a filter was developed.8 15 A more recent innovation for adding flavour is by the addition of a capsule, or ‘crushball’, a small plastic capsule in the filter activated by crushing16 (figure 1). These first appeared on the market in Japan in 2007 and are popular among young people due to the flavour and interactivity.16 17 In the UK the only cigarettes available with capsules are menthol-flavoured.18 Figure 1 Menthol capsule located inside a filter. The EU menthol ban A ban on the sale of cigarettes with a characterising flavour, including menthol, was part of the revised European Tobacco Products Directive (EUTPD) (2014), which has been written into UK law and came into force in May 2016.19 To allow manufacturers and retailers a transitional period to prepare for the ban, implementation of the ban on flavours was delayed until May 2020, for flavours representing at least 3% of a product category European Union (EU)-wide, such as menthol.19 20 The legislation applies to cigarettes and roll-your-own (RYO) tobacco, with cigars, cigarillos and pipe tobacco exempt. Menthol accessories, which are not sold within the same packaging as tobacco or cigarettes, are also excluded.21 22 Unlike the EU, Canada has now banned menthol as an ingredient23; elsewhere, cigarettes not labelled as menthol can contain menthol at subliminal levels to reduce the negative sensations of smoking.24–26 Leaked Philip Morris International (PMI) documents reveal that it opposes flavour bans,27 and our monitoring of industry activity indicates that tobacco companies have been exploiting loopholes in the menthol ban and related legislation in the UK, particularly in the months leading up to the ban. The purpose of the paper is, therefore, to expose these gaps and loopholes that other jurisdictions may need to close when developing similar legislation. Tobacco industry use of the delay to menthol ban implementation Data on market share of menthol and capsule cigarettes show that menthol/capsule median market share across EU countries (excluding UK) declined from 2015, the year after the TPD was announced (figure 2). In the UK, however, market share increased, via growth in capsule cigarettes, from 14% in 2014 to 21% in 2018, approximately twice and four times the EU median, respectively. Growth was steeper in the UK than in other European countries without the ban (figure 2). Therefore, it does not appear that the UK tobacco industry has been using the grace period to prepare for the menthol ban, but has instead used it to prolong and increase menthol sales.28 29 Figure 2 Market share of menthol and capsule cigarettes, WHO Europe region. Sixteen per cent of menthol smokers say they intend to quit after the menthol ban is implemented.30 With sales of six billion menthol cigarette sticks in 2018, this could reduce tobacco industry sales by around one billion sticks (3% of the total cigarette market) in the UK,31 so it is not surprising tobacco companies have looked to circumvent the ban. The derogation delayed implementation until the COVID-19 pandemic. A trade journal reported industry representatives taking advantage of retail closures to request a further deferment32 despite cigarette sales, and thus old stock turnover, spiking rather than declining.33 Product innovation to circumvent and undermine regulation As tobacco accessories sold separately are excluded from the legislation, companies have been introducing various menthol-flavoured accessories. Imperial launched menthol34 and capsule35 RYO filter tips in mid-2017 and January 2019, respectively. Independent RYO and make your own accessories specialist, the Republic Group,36 also introduced a new menthol filter via its Swan brand.37 These products could encourage menthol cigarette smokers to switch to RYO rather than quit. Imperial also announced the launch of ‘menthol chill’ and ‘fresh mint’ ‘Flavour Infusion Cards’ in January 2020, designed to provide a menthol flavour if inserted into factory-made cigarettes or packs of RYO tobacco.38 39 Unlike tobacco products, in England and Wales accessories such as these can be displayed at point of sale (including branding), whereas in Scotland they also need to be hidden from view.40 41 Imperial Tobacco has recommended that retailers use point-of-sale displays to promote the flavour infusion cards.38 About 5 months before the ban, Japan Tobacco International (JTI) launched 10-pack cigarillos with menthol capsules. These closely resemble cigarettes and are placed under its Sterling cigarette brand, and have been promoted to retailers as a way to circumvent the menthol ban.42 The Scandinavian Tobacco Group, a specialist producer of cigars, is also launching a cigarillo with a capsule in the filter called Signature Dual.37 39 Euromonitor data suggest a growth in sales of cigarillos since the EUTPD and associated UK legislation43 were enacted in 2016, reversing a downward trend, unlike the cigar market which continues to fall (figure 3). Figure 3 Expected UK growth in cigarillos and cigars. PMI, which has only a small market share in the UK, is exploiting the opportunity to promote IQOS as an alternative to menthol cigarettes, as its tobacco HEETs sticks are not covered by the ban.37 39 Given that the UK does not allow promotion44 or display41 of tobacco products, the tobacco industry has widely promoted these new and diverse products to retailers via the retail press.21 35 37 38 45 They have also created dedicated websites for retailers and smokers.39 46–49 Although ostensibly set up to provide information, these websites in effect promote next-generation products (NGPs). One encourages retailers to calculate their potential losses from reduced cigarette sales while reassuring them that other menthol products are available.48 Another presents three boxes with options to smokers—quit, heat and vape—and devotes more space and words to NGP options than quitting.47 Conclusions The tobacco industry has introduced diverse new products to the UK that can get around the ban: menthol accessories sold separately from cigarette packs, and RYO pouches and cigarillos with a capsule. It has also used the ban to promote more profitable50 heated tobacco products, which unlike quitting are not risk-free.51–54 Despite claims of a commitment to reducing harm, this provides yet further evidence that the tobacco industry will circumvent and undermine measures with genuine potential to reduce harm. Cigarillos are likely to be particularly attractive to the tobacco industry because they are exempt from EU and UK standardised pack legislation (with the exception of large pictorial warnings), are subject to lower taxes, and their definition is such that they can be sold looking similar to conventional cigarettes except for a brown leaf rather than white stick covering.42 Thus, the tobacco industry may use cigarillos to reintroduce cigarette branding and cheap products which had been removed by standardised packaging.21 55 The EU/UK menthol ban was associated with preceding falls in menthol sales in the EU, but in the UK sales grew up to implementation. This suggests not only that a long implementation period was not needed but that it was misused: menthol sales, which may be particularly harmful,4 were driven up in the UK. The yearlong standardised packaging implementation period in the UK was similarly exploited by the tobacco industry.21 55 As other jurisdictions seek to implement flavour bans, standardised packaging and display bans, we suggest they aim to eliminate the weaknesses the industry exploited in the UK legislation. This could be achieved by including all tobacco products and accessories, encompassing all pack types and flavours. Presenting legislation this way, rather than specifying each product included, also helps future-proof it. Further, as in Canada, banning menthol as an ingredient has the benefit of ensuing the industry cannot continue to include menthol at below observable levels. There should be no derogations or phase-ins, in order to maximise impact and curtail sales quickly.

          Related collections

          Most cited references32

          • Record: found
          • Abstract: found
          • Article: found
          Is Open Access

          Heat-not-burn tobacco products: a systematic literature review

          Objective To review peer-reviewed evidence on heat-not-burn tobacco products (HnB), their secondhand emissions and use by humans; to identify differences between independent and industry-funded studies. Data sources Medline, Embase, PsycINFO, ProQuest, Scopus and Web of Science databases were searched up to 6 November 2017 for studies on HnB published after December 2009; reference lists were screened and other researchers contacted, yielding 637 records. Study selection Thirty-one publications on HnB secondhand emissions (n=16) or use by humans (n=15) were selected by two reviewers with excellent agreement (k=0.75). Data extraction Data on authors’ affiliations, HnB products, secondhand emissions and human exposure were extracted by one reviewer. Two reviewers assessed the quality of experimental HnB studies using the Effective Public Health Practice Project tool. Data synthesis Twenty out of 31 studies were affiliated with tobacco industry. Studies on secondhand emissions varied by methodology, products and comparators. Compared with cigarettes, HnB delivered up to 83% of nicotine and reduced levels of harmful and potentially harmful toxicants by at least 62% and particulate matter by at least 75%. Experimental HnB use studies were limited to one product, reductions of human exposure to toxicants varied between 42% and 96%. HnB use suppressed urges to smoke, but participants rated HnB less satisfying than cigarettes. While limited by methodological heterogeneity, findings were largely similar for independent and industry-funded studies. Conclusions Studies on HnB secondhand emissions and human use were heterogeneous and largely affiliated with the manufacturers. HnB exposed users and bystanders to toxicants, although at substantially lower levels than cigarettes.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: found
            Is Open Access

            Menthol cigarettes and the public health standard: a systematic review

            Background Although menthol was not banned under the Tobacco Control Act, the law made it clear that this did not prevent the Food and Drug Administration from issuing a product standard to ban menthol to protect public health. The purpose of this review was to update the evidence synthesis regarding the role of menthol in initiation, dependence and cessation. Methods A systematic review of the peer-reviewed literature on menthol cigarettes via a PubMed search through May 9, 2017. The National Cancer Institute’s Bibliography of Literature on Menthol and Tobacco and the FDA’s 2011 report and 2013 addendum were reviewed for additional publications. Included articles addressing initiation, dependence, and cessation were synthesized based on study design and quality, consistency of evidence across populations and over time, coherence of findings across studies, and plausibility of the findings. Results Eighty-two studies on menthol cigarette initiation (n = 46), dependence (n = 14), and cessation (n = 34) were included. Large, representative studies show an association between menthol and youth smoking that is consistent in magnitude and direction. One longitudinal and eight cross-sectional studies demonstrate that menthol smokers report increased nicotine dependence compared to non-menthol smokers. Ten studies support the temporal relationship between menthol and reduced smoking cessation, as they measure cessation success at follow-up. Conclusions The strength and consistency of the associations in these studies support that the removal of menthol from cigarettes is likely to reduce youth smoking initiation, improve smoking cessation outcomes in adult smokers, and in turn, benefit public health. Electronic supplementary material The online version of this article (10.1186/s12889-017-4987-z) contains supplementary material, which is available to authorized users.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: found
              Is Open Access

              Cigarette brands with flavour capsules in the filter: trends in use and brand perceptions among smokers in the USA, Mexico and Australia, 2012–2014

              Objective To describe trends, correlates of use and consumer perceptions related to the product design innovation of flavour capsules in cigarette filters. Methods Quarterly surveys from 2012 to 2014 were analysed from an online consumer panel of adult smokers aged 18–64, living in the USA (n=6865 observations; 4154 individuals); Mexico (n=5723 observations; 3366 individuals); and Australia (n=5864 observations; 2710 individuals). Preferred brand varieties were classified by price (ie, premium; discount) and flavour (ie, regular; flavoured without capsule; flavoured with capsule). Participants reported their preferred brand varietys ’ appeal (ie, satisfaction; stylishness), taste (ie, smoothness, intensity), and harm relative to other brands and varieties. GEE models were used to determine time trends and correlates of flavour capsule use, as well as associations between preferred brand characteristics (ie, price stratum, flavour) and perceptions of relative appeal, taste and harm. Results Preference for flavour capsules increased significantly in Mexico (6% to 14%) and Australia (1% to 3%), but not in the USA (4% to 5%). 18–24 year olds were most likely to prefer capsules in the USA (10%) and Australia (4%), but not Mexico. When compared to smokers who preferred regular brands, smokers who preferred brands with capsules viewed their variety of cigarettes as having more positive appeal (all countries), better taste (all countries), and lesser risk (Mexico, USA) than other brand varieties. Conclusions Results indicate that use of cigarettes with flavour capsules is growing, is associated with misperceptions of relative harm, and differentiates brands in ways that justify regulatory action.
                Bookmark

                Author and article information

                Journal
                Tob Control
                Tob Control
                tobaccocontrol
                tc
                Tobacco Control
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                0964-4563
                1468-3318
                December 2020
                17 May 2020
                : 29
                : e1
                : e138-e142
                Affiliations
                [1] departmentTobacco Control Research Group, Department for Health , University of Bath , Bath, UK
                Author notes
                [Correspondence to ] Dr Rosemary Hiscock, Tobacco Control Research Group, Department for Health, University of Bath, Bath BA2 7AY, UK; R.Hiscock@ 123456bath.ac.uk
                Author information
                http://orcid.org/0000-0001-9741-9083
                http://orcid.org/0000-0001-7254-569X
                Article
                tobaccocontrol-2020-055769
                10.1136/tobaccocontrol-2020-055769
                7799418
                32418921
                937f887f-1751-461b-8434-95a695f71f6d
                © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:  http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 14 March 2020
                : 28 April 2020
                : 06 May 2020
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100007500, Bloomberg Family Foundation;
                Award ID: Stopping Tobacco Organizations and Products projec
                Funded by: FundRef http://dx.doi.org/10.13039/501100000289, Cancer Research UK;
                Award ID: Harnessing Big Data Alongside Investigative Method
                Categories
                Industry Watch
                1506
                Custom metadata
                unlocked

                Public health
                tobacco industry,prevention,public policy
                Public health
                tobacco industry, prevention, public policy

                Comments

                Comment on this article