Adolescents’ reactions to, and perceptions of, dissuasive cigarettes: a focus group study in Scotland

Abstract

The cigarette stick, as the primary form of packaging and the object of consumption, is an increasingly important marketing tool for tobacco companies. It could, however, also be used to communicate health messaging. We therefore explore adolescents' perceptions of cigarettes designed to dissuade smoking. Eight focus groups were conducted with 16-17 year-olds in Scotland (n=36) between November 2017 and November 2018. Groups were segmented by gender and smoking status. Participants were shown four dissuasive cigarettes; one displaying the warning 'Smoking kills'; one featuring the word 'TOXIC' and a skull and crossbones image; and two unattractively colored cigarettes (darker and lighter green). For comparison, participants were also shown a standard cigarette (white cigarette paper and imitation cork filter). All four dissuasive cigarettes were considered less attractive and more harmful than the standard cigarette, particularly among never-smokers. Some participants considered the green cigarettes to be ugly, and the on-cigarette warnings to be embarrassing and off-putting.Although reactions were mostly negative for all four dissuasive cigarettes, participants considered the on-cigarette warnings more off-putting than the green cigarettes. Participants did not generally believe that the dissuasive cigarettes would encourage cessation among established smokers, but that they may deter uptake among young people.

Reactions to, and trial intentions for, three dissuasive cigarette designs: a cross-sectional survey of adolescents in Scotland

“…Participants were shown four cigarette designs (Figure 1), consistent with those used in developmental focus group research with adolescents in Scotland. 27 The first had an imitation cork filter and white cigarette paper, as this mirrors the 'standard' cigarette design in Scotland.…”

“…[15][16][17][18][19] Secondly, research has explored cigarettes that feature a health warning on the stick, including 'Smoking kills', average minutes of life lost from smoking each cigarette, and the short and long-term harms of smoking. [16][17][18][19][20][21][22][23][24][25][26][27] More recently, research has also explored including both a warning message (smoking kills) and an image (skull and cross bones). 26,27 Irrespective of design, dissuasive cigarettes are generally considered to reduce appeal and increase perceptions of harm, with some research suggesting that they may have the potential to encourage thoughts about quitting or prevent uptake among young people.…”

“…[16][17][18][19][20][21][22][23][24][25][26][27] More recently, research has also explored including both a warning message (smoking kills) and an image (skull and cross bones). 26,27 Irrespective of design, dissuasive cigarettes are generally considered to reduce appeal and increase perceptions of harm, with some research suggesting that they may have the potential to encourage thoughts about quitting or prevent uptake among young people. [15][16][17][18][19][20][21][22][23][24][25][26][27] Only a few studies have examined how adolescents react to dissuasive cigarettes.…”

“…26,27 Irrespective of design, dissuasive cigarettes are generally considered to reduce appeal and increase perceptions of harm, with some research suggesting that they may have the potential to encourage thoughts about quitting or prevent uptake among young people. [15][16][17][18][19][20][21][22][23][24][25][26][27] Only a few studies have examined how adolescents react to dissuasive cigarettes. 17,20,27 Adolescents are a key group because when starting to smoke they often do so with single cigarettes which they have bought, been given or have stolen, and therefore may avoid exposure to the on-pack warnings at the point of consumption.…”

“…[15][16][17][18][19][20][21][22][23][24][25][26][27] Only a few studies have examined how adolescents react to dissuasive cigarettes. 17,20,27 Adolescents are a key group because when starting to smoke they often do so with single cigarettes which they have bought, been given or have stolen, and therefore may avoid exposure to the on-pack warnings at the point of consumption. 28,29,30 Investigation with adolescents is particularly important in Scotland, where longer-term declines in youth smoking have recently begun to stall 31 and because the Scottish Government has expressed a willingness to consider implementing dissuasive cigarettes if supported by the evidence.…”