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

• Published in: Tobacco control Vol. 30; no. 6; pp. 623 - 629
• Main Authors: Mitchell, Danielle, Critchlow, Nathan, Moodie, Crawford, Bauld, Linda
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd 01.11.2021; BMJ Publishing Group LTD
• Subjects: Adolescent; Adolescents; Bans; Bones; Cigarettes; Cross-Sectional Studies; Data collection; Demography; Electronic Nicotine Delivery Systems; Humans; Intention; Original research; packaging and labelling; Polls & surveys; prevention; Product Labeling; Schools; Scotland - epidemiology; Smoking; social marketing; Teenagers; Tobacco; Tobacco Products; Warning; Scotland; United Kingdom > UK; Australia; France; Norway; packaging and labelling; prevention; social marketing
• ISSN: 0964-4563; 1468-3318
• DOI: 10.1136/tobaccocontrol-2020-055842

ObjectivesThere has been growing academic and policy interest in opportunities to decrease the appeal of cigarette sticks, such as making them an unattractive colour or requiring them to display a health warning. We therefore explored reactions to, and trial intentions for, three ‘dissuasive’ cigarette designs among adolescents in Scotland.MethodsA cross-sectional survey with 12–17 year olds in Scotland (n=594) was conducted between November 2017 and November 2018. Participants were shown one ‘standard’ cigarette (imitation cork filter with white paper casing) and three dissuasive cigarettes: (1) a cigarette with the warning ‘smoking kills’; (2) a cigarette with the warning ‘toxic’ and a skull and cross-bones image and (3) a dark green cigarette. Participants rated each cigarette on nine five-point reaction measures (eg, appealing/unappealing or attractive/unattractive). A composite reaction score was computed for each cigarette, which was binary coded (overall negative reactions vs neutral/positive reactions). Participants also indicated whether they would try each cigarette (coded: Yes/No). Demographics, smoking status and smoking susceptibility were also measured.ResultsMore participants had negative reactions to the dark green (93% of adolescents), ‘smoking kills’ (94%) and ‘toxic’ (96%) cigarettes, compared with the standard cigarette (85%). For all three dissuasive designs, Chi-square tests found that negative reactions were more likely among younger adolescents (vs older adolescents), never-smokers (vs ever smokers) and non-susceptible never-smokers (vs susceptible never-smokers). Most participants indicated that they would not try any of the cigarettes (range: 84%–91%).ConclusionDissuasive cigarettes present an opportunity to further reduce the appeal of smoking among adolescents.