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Abstract
Introduction Cigarette consumption has declined in the USA. However, cigar consumption has increased. This may be due in part to some cigarette smokers switching to filtered cigars as a less expensive substitute for cigarettes. Additionally, some cigarette smokers may perceive and consume little filtered cigars as cigarettes. The purpose of this study was to determine how cigarette smokers classify tobacco products when presented with photographs of those products.
Methods An online survey was conducted with a sample of 344 self-identified cigarette smokers. Respondents were presented with pictures of various types of tobacco products, both with and without packaging, and then asked to categorise them as either a cigarette, little cigar, cigarillo, cigar or machine-injected roll-your-own cigarette (RYO). Respondents were also asked about their tobacco use and purchasing behaviour.
Results Overall, respondents had difficulty distinguishing between cigarettes, little cigars, cigarillos and RYO. When presented with images of the products without packaging, 93% of respondents identified RYO as a cigarette, while 42% identified a little cigar as a cigarette. Additionally, respondents stated that they would consider purchasing little cigars as substitutes for cigarettes because of the price advantage.
Conclusions The results of this survey suggest that when presented with photographs of tobacco products, large proportions of current smokers were unable to differentiate between cigarettes, little cigars, cigarillos, RYO and cigars. Findings have implications for existing public health efforts targeting cigarette smokers, and underscore the need to review current definitions of tobacco products and federal excise taxes on such products.
- Advertising and Promotion
- Packaging and Labelling
- Non-cigarette tobacco products
- Public policy
- Taxation
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Background
The prevalence of cigarette smoking has declined for several decades. However, the use of other tobacco products has increased.1–3 This is most evident in the increased consumption of cigars.4 ,5 One factor contributing to this phenomenon is that smokers are substituting less expensive cigars for cigarettes.2 ,3 The Internal Revenue Code of 1986 defines a cigar as “any roll of tobacco wrapped in leaf tobacco or in any substance containing tobacco (other than any roll of tobacco which is a cigarette).”6 A cigarette needs only a small amount of tobacco in the wrapper to be classified as a cigar. Additionally, cigar products are categorised as little cigars or large cigars. The only characteristic distinguishing a little cigar from a large one is weight. A cigarillo is a marketing term used to refer to a mid-size cigar—and is classified as a large cigar for taxation purposes.
Tobacco manufacturers have long promoted cigar products to cigarette smokers by emphasising similarities between cigars and cigarettes in terms of size and taste.7 ,8 There is evidence that some consumers of little cigars perceive them to be cigarettes, and that some individuals have difficulty differentiating between the two types of products.9 ,10 Moreover, research suggests that certain cigars are used by cigarette smokers as replacements.2 ,11–13 The Cigarette Labeling and Advertising Act of 1965 defines a cigarette as “any roll of tobacco wrapped in paper and any roll of tobacco wrapped in any substance containing tobacco which, because of its appearance, the type of tobacco used in the filler, or its packaging and labeling, is likely to be offered to, or purchased by, consumers as a cigarette.”14 Hence, this study was conducted in order to answer the following question: when presented with images of various tobacco products, to what extent do cigarette smokers identify non-cigarette products as cigarettes?
In the mid-2000s, federal and state cigarette excise tax increases in several states effectively doubled the average cigarette tax in the USA. Consequently, given their lower excise tax rate, little cigars were heavily marketed to cigarette smokers as cheap cigarette alternatives and their consumption soared.7
To address these tax disparities, the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) equalised federal taxes on little cigars and cigarettes, but preserved the small/large cigar dichotomy and the overall lower tax rates on large cigars. Subsequent to the changes in CHIPRA, many manufacturers modified the weight of their little cigar product to qualify for the lower tax category of ‘large’ filtered cigars.3 This resulted in a significant market shift, where the sale of little cigars dropped precipitously by 85%, while large cigar sales increased 116% from 2008 to 2011.2 ,3 ,5 Even greater increases occurred in sales of roll-your-own (RYO) pipe tobacco with augmentation of the levy on roll-your-own cigarette tobacco. With the beneficial tax treatment, RYO and cigarette-like cigars continue to maintain significant market share.5
Methods
An online survey was conducted with 18–64-year-old members of the Zoomerang/Survey Monkey Web panel who were invited to participate in the study. Inclusion criteria were respondents who self-identified as current cigarette smokers, and reported smoking at least one cigarette per day. A total of 344 respondents answered questions regarding demographics, smoking behaviour and product perceptions. Questions on smoking behaviour were adapted from the National Health Interview Survey (NHIS), the National Survey on Drug Use and Health (NSDUH) and the Behavioral Risk Factor Surveillance System (BRFSS). To examine tobacco product perception, respondents were initially shown photographs of the products without packaging and later with manufacturers’ packaging, where applicable. For each photograph, respondents were asked to state whether the product was a cigarette, little cigar, cigarillo, cigar or machine-injected RYO cigarette produced in a commercial roll-your-own machine with pipe tobacco. Respondents were also asked whether they had ever purchased a product that resembled the image.
Statistical analyses were performed using SPSS (V.21.0, IBM SPSS Statistics for Windows Armonk, New York, USA). Responses were analysed for frequencies. A significance level of 0.05 was utilised For χ2 analyses examining differences by age and gender. The study was approved by the Institutional Review Board of the University of Medicine and Dentistry of New Jersey.
Results
Respondents were predominantly white non-Hispanic (90%), female (55%) and had some college education (76%). Seventy-nine per cent of respondents smoked at least 10 cigarettes per day. Men were more likely than women to report smoking in excess of 10 cigarettes per day (54% vs 47%), and to have ever smoked a cigar (83% vs 30%, p<0.001).
Product perceptions
Over 90% of respondents were able to identify commercial cigarettes, whether presented with or without packaging. As shown in table 1, the exception was a Nat Sherman Black and Gold cigarette, displayed without packaging, which only 40% labelled accordingly, while 37% categorised it as a cigarillo and 20% categorised it as a little cigar. Women were more likely to classify this product as a cigarette than men (43% and 37%, respectively). Twelve per cent of respondents indicated that they had purchased the product.
Percentage of respondents who identified tobacco products as cigarettes and have ever purchased the products
The overwhelming majority of respondents (93%) identified the RYO as a cigarette, while only 5% categorised the product as RYO. When asked whether they had ever purchased a similar product, 88% of respondents stated that they had.
When presented with a photograph of a Black and Mild filtered cigar without packaging, 49% of respondents categorised the product as a little cigar (56% of women compared with 40% of men). Further, 29% of respondents categorised the product as a cigarillo (42% of men vs 19% of women). Only 13% of respondents identified it as a cigarette.
The study featured three cigar products with filters: Winchester Little Cigar, Black & Mild and Santa Fe filtered cigars. A Santa Fe filtered cigar, when presented without packaging, was identified as a cigarette by 34% of respondents. When respondents were shown a Winchester Little Cigar, also without packaging, 42% categorised it as a cigarette, 34% categorised it as a cigarillo and only 21% categorised the product as a little cigar. Women were more likely than men to categorise the product as a cigarette (p=0.01). Men were more likely to state that they would consider purchasing the product in the future.
While younger respondents were significantly more likely to identify the Winchester Little Cigar and Santa Fe filtered cigar as a cigarette (p<0.05), no other differences by age group were observed.
Discussion
The current study found that when presented with photographs of tobacco products without packaging, large proportions of current smokers were unable to differentiate between cigarettes, little cigars, cigarillos, cigars and RYO. This was especially true for cigarettes of non-traditional lengths and/or colours, RYO and cigars with filter tips. The Internal Revenue Code of 1986 does not specify distinguishing physical characteristics between cigarettes and cigars.6 Results indicate that this lack of physical distinction between cigarettes and certain lower-taxed non-cigarette tobacco products directly influences smokers’ perception and purchasing behaviour.
The fact that most respondents reportedly purchased a machine-injected RYO is further cause for concern and suggests smokers are not only substituting lower-priced cigars for cigarettes, they are also replacing RYO cigarette tobacco with pipe tobacco. Meanwhile, these products continue to grow in popularity.5
Increases in tobacco excise taxes have proven to be one of the most effective strategies in decreasing tobacco use, especially among adolescents.15–17 However, the taxation effect is diminished if smokers are able to find functional equivalents that allow them to avoid the taxes.2 Indeed, respondents reported that they were willing to try the Winchester Little Cigar after they learned of the price difference.
Findings contribute to the emerging body of literature supporting the assertion that current cigarette smokers have purchased cigar products and would consider doing so in the future. This is consistent with previous research.4 ,18–21 The data highlight the need for further research with larger, more ethnically and racially diverse populations—to better understand tobacco product perceptions among groups and to evaluate their impact on purchasing behaviour. Given how cigarettes are classified by the Cigarette Labeling and Advertising Act, this study underscores the need to review the current definition of tobacco products and federal excise taxes on such products.
The current study has several limitations. The majority of respondents were white non-Hispanic. There is evidence that minorities are more likely to be consumers of cigar products, especially little cigars and cigarillos.18 However, lack of racial/ethnic diversity within the sample did not allow for the exploration of perceptions among those groups. Second, as the sample was derived from a web panel, not using a random sampling method, the results may not be broadly generalisable to all cigarette smokers.
Third, participants’ familiarity with the tobacco products may have affected their responses. For example, men were more likely to have ever smoked a cigar compared to women. An age effect was observed with older respondents better able to discern tobacco products. Their familiarity with cigar products may explain their ability to distinguish a greater number of items.
Nevertheless, the data provide evidence for making the case that little cigars meet the statutory definition of a cigarette. Such a designation would allow for more stringent regulation of these products by the USA Food and Drug Administration. Additionally, this study has research implications for the potential use of photographs as a tool in designing internet surveys, especially when examining product perception and the impact of marketing on behaviour.
What this paper adds
Results of this study suggest that cigarette smokers have difficulty accurately distinguishing between cigarettes and non-cigarette tobacco products.
This paper contributes to the literature supporting the assertion that current cigarette smokers have purchased cigar products and would consider doing so in the future.
Given that the Cigarette Labeling and Advertising Act of 1965 classifies a cigarette by its appearance, the type of tobacco used in the filler, its packaging and labelling and the likelihood that it will be offered to, or purchased by, consumers as a cigarette, this study underscores the need to review the current definition of tobacco products and federal excise taxes on such products.
Acknowledgments
The authors thank Center for Tobacco Studies staff Carol Rayside for her contribution to this study.
References
Footnotes
Contributors JG designed the study and collected data. MC conducted the data analysis. MC drafted and revised the manuscript. CDD reviewed the data analysis. MH and CDD reviewed drafts and materially contributed to the manuscript.
Competing interests None declared.
Ethics approval The Institutional Review Board of the University of Medicine and Dentistry of New Jersey (now Rutgers University).
Provenance and peer review Not commissioned; externally peer reviewed.