Global market trends of flavour capsule and menthol cigarettes in 78 countries, 2010-2020

Abstract Background Flavoured tobacco products, including innovative flavour capsule cigarettes (FCCs) and menthol cigarettes, can increase appeal and encourage smoking initiation and use. Global epidemiological data on these products are scarce. Methods This study examined market trends of FCCs and menthol (non-capsule) cigarettes across 78 countries from 2010 to 2020 and assessed ecological-level factors associated with market shares of these products. Market share and retail volume data came from Euromonitor Passport and country-specific sociodemographic data come from the WHO and World Bank. Adjusted linear fixed effects panel regression analyses were used to evaluate the relationship between predictors variables and market outcomes. Results Global total retail volume of FCCs increased over time (0.2% in 2010 to 4.5% in 2020) and market share was associated with year and unemployment rate and inversely associated with % urban population and smoking prevalence (p < 0.001). In contrast, menthol retail volume decreased over time (5.0% to 3.8%) and market share was associated with % urban population (p = 0.001) and inversely associated with year (p = 0.004) and unemployment rate (p = 0.017). The greatest market increase of FCCs was observed in the Americas region and among upper-middle income countries. In Europe, there was a decrease of 0.64 percentage points from 2019 to 2020. Conclusions Overall, FCCs experienced substantial global growth in the recent decade, with the exception of Europe whose slight decrease may be attributable to the European Union ban on flavours in cigarettes. Findings indicate that there is a need for increased efforts to address flavours and innovative features used in tobacco products, which are known to appeal to youth. Key messages • This study contributes to global monitoring of tobacco products. • Findings can be used by advocates and policy makers to support countries in adopting measures to ban flavoured tobacco products.


Background:
The World Health Organization defined smoking as the fastest spreading and longest lasting epidemic globally. It has been reported that two-thirds of all tobacco consumption in the world is in developing countries, and with today's technology, the use of electronic cigarettes (e-cigarettes) has increased rapidly among young people and adults, especially in recent years. The study aimed to evaluate the factors associated with dual use of e-cigarettes (e-cigarette plus one of the tobacco products) in university students.

Methods:
This study was carried out with the participation of 2477 students at Eskiş ehir Osmangazi University in the 2019-2020 academic year, and it was designed as a nested case-control study from a study in which 49 were determined to be dual smokers. A randomized 1:3 for age and gender with 147 nonsmokers (NS) and 147 classic cigarette smokers (CSS) selected by the propensity score matching method was performed, with the final sample consisting of 343 participants. Chi-square and multinomial logistic regression analyzes were used in the study.

Results:
In the multinomial logistic regression, the belief that ecigarettes do not help quit classical cigarette smoking was 4.0 (95% CI; 1.7 -9.6) times higher in NS and 4.1 (1.6 -10.0) times higher in CCS compared to dual smokers, while the belief that e-cigarettes may suppress the desire to smoke was 4.4 (1.7 -11.2) times higher in NS and 6.8 (2.6 -17.6) times higher in CCS.

Conclusions:
The study determined that dual smokers were less likely to believe that e-cigarettes are more innocent than other tobacco products. While dual smokers believed that e-cigarettes might not suppress the desire to smoke, CCS believed e-cigarettes could even increase classical cigarette smoking. Key messages: Since the effects of e-cigarette use on human health are controversial, it is still a significant public health problem in developing countries.
Although it was initially marketed to help quit or reduce the use of classical cigarettes, it should be noted that e-cigarettes are also a type of tobacco product addiction.

Background:
Flavoured tobacco products, including innovative flavour capsule cigarettes (FCCs) and menthol cigarettes, can increase appeal and encourage smoking initiation and use. Global epidemiological data on these products are scarce.

Methods:
This study examined market trends of FCCs and menthol (non-capsule) cigarettes across 78 countries from 2010 to 2020 and assessed ecological-level factors associated with market shares of these products. Market share and retail volume data came from Euromonitor Passport and country-specific sociodemographic data come from the WHO and World Bank. Adjusted linear fixed effects panel regression analyses were used to evaluate the relationship between predictors variables and market outcomes.

Results:
Global total retail volume of FCCs increased over time (0.2% in 2010 to 4.5% in 2020) and market share was associated with year and unemployment rate and inversely associated with % urban population and smoking prevalence (p < 0.001). In contrast, menthol retail volume decreased over time (5.0% to 3.8%) and market share was associated with % urban population (p = 0.001) and inversely associated with year (p = 0.004) and unemployment rate (p = 0.017). The greatest market increase of FCCs was observed in the Americas region and among upper-middle income countries. In Europe, there was a decrease of 0.64 percentage points from 2019 to 2020.

Conclusions:
Overall, FCCs experienced substantial global growth in the recent decade, with the exception of Europe whose slight decrease may be attributable to the European Union ban on flavours in cigarettes. Findings indicate that there is a need for increased efforts to address flavours and innovative features used in tobacco products, which are known to appeal to youth.

Background:
The perinatal period is an optimal time to intervene for achieving smoking cessation in expectant parents and offers multiple health benefits for women and the newborn. While Behavior Change Technique (BCT) interventions are a promising approach to support pregnant smokers to quit smoking, effectiveness of these interventions among expectant and new fathers is not equally well documented. Better understanding of the potential utility of these BCT interventions for this group is important for the development of effective gender-sensitive programmes.

Methods:
This systematic review examines the existing evidence on effectiveness of BCTs on smoking cessation outcomes when offered to expectant and new fathers (child < 1 year) both through individual and/or couple-based interventions. Eight databases were searched for peer-reviewed articles. Studies were subjected to systematic retrieval and quality-assessment by two independent reviewers.

Results:
We identified 9 randomised control trial studies (including 4,681 men) that fulfilled the inclusion criteria. In terms of quit outcome data, 8 studies reported biochemically verified quit rates for men. While 5 BCT interventions targeted expectant/ new fathers, 3 were directed to couples and 1 primarily focused on women with a component directed at men. Though most of the interventions were found to be effective, they showed small significant positive effects on cessation outcomes. Findings are suggestive of gender specific interventions being more likely to have positive outcomes. High heterogeneity across the studies made it difficult to determine the most effective BCT approach.

Conclusions:
This review suggests that use of BCT interventions for smoking cessation among expectant and new fathers is effective in achieving positive quit rates; however, these studies are limited. Further research is needed to determine the most effective BCT approach associated with smoking cessation among this group. Key messages: BCT interventions for smoking cessation among expectant and new fathers are a promising approach to increase quit rates. Future research needs to develop evidence based BCT interventions for smoking cessation specifically targeting expectant and new fathers to inform policy and practice.
1.L. Workshop: Building capacity for a resilient and healthy post-COVID health workforce