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Correspondence to Dr Daniel P Giovenco, Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY 10032, USA; [email protected]
In the face of increasingly restrictive policies regulating how cigarette companies can advertise, the pack itself has become one of the industry’s primary promotional tools.1 2 A large body of research demonstrates that pack features, such as size, colour and descriptors, can implicitly communicate product information and influence perceptions of taste, smoking experience and health risks.1 3 4 To date, 13 countries have fully implemented ‘plain packaging’ laws to reduce the attractiveness of cigarettes, but millions around the globe are still exposed to packaging elements that may increase consumer demand. While exterior pack characteristics and their impact on product appeal have been studied previously,4 the ways in which the tobacco industry may leverage pack interiors to communicate with smokers remain obscure. Prior research has documented the ubiquity of branding on the cigarette itself—another form of marketing ‘real estate’5—but little is known about other forms of communication inside the pack. These direct messages may theoretically influence smoking behaviours, such as brand loyalty, quit attempts and cessation. We conducted a content analysis of the top-selling cigarette packs in the USA to characterise the extent and nature of these ‘under-the-radar’ practices.
Methods
The 50 cigarette packs with the highest unit sales in 2018 (US convenience store market) were identified using Nielsen’s Scantrack data6 and subsequently purchased from convenience stores in the New York City metropolitan area between January and March 2019. All packs contained 20 cigarettes, per US law. Because this project was exploratory, we first used ‘open coding’ to note all observed interior features....