Flavour capsule cigarette use, perceptions, and marketing: findings from two systematic reviews

Contribution presented at the 3^rd Calisia Conference on Family Health, Kalisz, Poland, 18-20 June 2023
Flavour capsule cigarettes contain a liquid-filled capsule(s) in the filter that releases flavour when crushed by the consumer. Over the past decade, the global market of these products has grown substantially. How­ever, research on flavour capsule cigarettes is scant. As such, the aim of this study was to conduct two systematic reviews: (1) to examine prevalence, correlates of use, and perceptions of flavour capsule cigarettes globally, and (2) to identify marketing elements of flavour capsule cigarettes.
The search was conducted by one author (CK) in four databases: Medline, Embase, Web of Science, and Scopus, the first review indexed until 30^th April 2021 and the second one indexed until 13^th December 2021. Boolean language was used to connect variants of both cigarette terms (i.e. Cigar*, Cigarette Smoking/, Tobacco Products/) and capsule terms (i.e Capsul*, Crush*, Convertible*, Click, Burst*, Pop, Duo). One author (CK) also manually searched reference lists of the included articles. Eligibility was not limited by study design, population, year, country, or language. Articles were included if they presented original research on flavour capsule cigarettes. Two authors (CK and MZ) independently screened titles and abstracts, and subsequently assessed full-text articles for eligibility. Discrepancies were resolved through discussion with the third author (FF).
The first review on prevalence and perceptions of flavour capsule cigarettes included 20 studies, published between 2016 and 2021 across eight countries, with most using a cross-sectional or focus group study design. The highest prevalence of flavour capsule cigarette use was observed in Latin American countries (i.e., Chile and Mexico) and among young people. Reasons for use and appeal were associated with positive outcome expectancies, such as pleasant taste and smoothness on the throat, as well as perceptions that these products offer choice of flavours and novelty. These products were consistently perceived to be designed for young people. Misperceptions of relatively reduced harm was consistent across studies in Mexico. The second review on marketing elements included a total of 40 articles, published between 2009 and 2021, and conducted across multiple countries, including several low and middle-income countries. A combined mix of strategies was identified for marketing of flavour capsule cigarettes, including product, price, place, and promotion. Promotion of flavour capsule cigarettes was particularly categorised by its offering consumers a multisensory, innovative, and customisable experience, with marketing avenues dominated by advertising at the point-of-sale and the cigarette packaging and stick itself.
Findings corroborate the rapid global market growth of flavour capsule cigarettes. Marketing features support why these products were found to be most popular among youth and young adults. These reviews have significant policy implications, including the importance of banning flavours, capsules, and other filter technology in tobacco products to reduce appeal of tobacco.

DISCLOSURE

The authors report no conflict of interest.

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