Article Text

Who uses rollies? Trends in product offerings, price and use of roll-your-own tobacco in Australia
1. Megan Bayly,
2. Michelle M Scollo,
3. Melanie A Wakefield
1. Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
1. Correspondence to Dr Michelle M Scollo, Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia; mscollo{at}cancervic.org.au

## Abstract

Objective We examined the roll-your-own (RYO) tobacco product market in Australia from 2001 to 2016. Trends in use of RYO tobacco among Australian adults were examined for 2004–2016.

Methods Changes in brand availability, pouch sizes and lowest priced products were noted from trade magazines. Prevalence of smoking of RYO and factory-made (FM) cigarettes among those 18 years and older was obtained from five consecutive waves of a large (n>21 000) nationally representative triennial survey from 2004 to 2016. Trends in cigarette use were examined using logistic regression.

Results Changes in the Australian RYO market from 2001 to 2016 included a doubling in the number of brands, progressively smaller pouch sizes with smaller increases in price than in traditional RYO and comparable FM products. While use of FM cigarettes declined between 2004 and 2016, the proportion of adults exclusively using RYO tobacco linearly increased with each survey wave (OR 1.03, 95% CI 1.02 to 1.05, p<0.001), from 1.2% in 2004 to 1.7% in 2016. Exclusive RYO use among current smokers increased more among females than males, and young adults compared with those aged 30 years or older, but did not differ by socioeconomic status.

Conclusions In contrast to substantial declines in FM cigarette use, exclusive use of RYO cigarettes increased in Australians since 2004, particularly among females and young adults. This has corresponded to a period of substantial changes to the RYO market, including progressively smaller and relatively more affordable products. Policy action to reduce price-related marketing and correct consumer misinformation about RYO tobacco are urgently required.

• non-cigarette tobacco products
• hand-rolled/ryo tobacco
• packaging and labelling

## Introduction

Australia has been described by the international tobacco industry as one of the world’s darkest markets.1 It was the first country in the world to introduce plain packaging of cigarettes and other tobacco products.2 Excise and customs duty on tobacco in Australia is increased two times per year (in March and September) in line with changes in average earnings.3 4 In addition, Australia imposed additional tax increases of 25% in 20105 followed by annual increases of 12.5% from 2013 onwards, resulting in substantial increases in prices of tobacco products. While smoking prevalence has declined markedly in Australia since 2001,6 and the overall volume of tobacco products sold has also declined, sales volume reductions have been driven exclusively by very large reductions in volumes for factory-made (FM) cigarettes. In contrast, the volume of sales of smoking tobacco, predominantly roll-your-own (RYO) tobacco, has increased considerably over the same period. Examination of trends in marketing and use of RYO tobacco in Australia provides valuable insights internationally into the effects of industry strategy and government policy in an environment of advanced tobacco control including aggressive tobacco taxes.

RYO tobacco is a minority habit among smokers in most Western countries, with the notable exception of the UK and the Netherlands.7 Rates of use are also high in France and Germany.7 8 Use of RYO cigarettes historically has been associated with low socioeconomic status (SES) in Australia, New Zealand and other high-income nations.9–16 Analysing data from the International Tobacco Control Four-Country study, Young et al found that use of RYO cigarettes was associated with male gender, younger average age and a higher level of nicotine addiction.15

Young et al have noted that use of RYO is associated with a stronger belief that it is less harmful than other tobacco products, as well as more positive perceptions about use of tobacco generally.15 17 18 Many smokers believe that manufactured cigarettes contain more chemicals than RYO cigarettes,19 though in fact manufactured RYO tobacco contains many of the same additives found in manufactured cigarettes20 as well as additional additives that help to maintain moisture content given the frequent exposure of the tobacco to air when the pouch is opened. In any case, it is not additives that pose the major danger to smokers but rather the inhalation of smoke created when tobacco burns.21 Despite RYO cigarette smokers on average using smaller amounts of tobacco (by weight) than used in FM cigarettes,22 RYO cigarettes may deliver higher levels of nicotine to the smoker than the average FM cigarette.23 RYO smokers tend to smoke more intensely (longer and more puffs per cigarette).22 Smoking RYO cigarettes is at least as risky as smoking any other sort of tobacco product and research based on smoking patterns in the 1980s and earlier suggested that RYO cigarettes may pose a greater risk of oral cancer24 25 and possibly also colorectal cancer26 than that posed by FM cigarettes.

According to Euromonitor International, in 2016, Imperial Tobacco Group (ITG) controlled 64.8% of the Australian RYO market, British American Tobacco (BAT) just over 25% and the Scandinavian Tobacco Group A/S just under half a per cent.27 The market has been dominated by four brands (Champion, Drum and White Ox produced by Imperial Tobacco) and Winfield produced by BAT. ITG’s lower priced JPS brand is a more recent entrant to the RYO market and is understood to have rapidly gained market share. These five brands are understood to have made up about 85% of the market in 2016.28 Users of RYO tobacco in Australia were traditionally predominantly men from blue-collar backgrounds.29 30 However, as trade journalist White described in a special report for World Tobacco in March 2006,31 a resurgence in marketing of RYO tobacco products has included websites promoting the enjoyment of experimenting with blending various sorts of tobacco,32 the differentiation of new types of tobacco papers of different sizes, colours and flavours, and the packaging of papers featuring designs associated with popular rock bands and best-selling console games.31 A recent examination of the Australian tobacco market following plain packaging implementation in 2012 also found an increase in products using FM cigarette brand names entering the RYO market, and noted the introduction of progressively smaller RYO pouch sizes.33 Innovations that make RYO products more palatable, less unfamiliar, smaller and more affordable are likely to make RYO cigarettes attractive to younger people, including young females who tend to be less experienced smokers and more price sensitive.

Gallus et al reported that use of hand-rolled tobacco increased as a percentage of total use in Italy, in particular following the global financial crisis.34 Young et al found that use of RYO cigarettes increased in the UK and in the USA between 2002 and 200818 but did not detect a parallel increase in prevalence of ‘predominant use’ of RYO in Australia over the same period.18

This study aims to examine time trends in RYO product offerings and RYO use in Australia over a longer period that included several large increases in excise and customs duty. Going by data on sales of RYO tobacco, it appears likely that use of RYO cigarettes in Australia increased following the substantial 25% increase in excise and customs duty on tobacco in Australia at the end of April 2010, and then annual 12.5% increases starting from 2013. On this basis one might expect that the greatest increases in use of RYO cigarettes would have been among smokers of low SES, for whom the financial burden of smoking is most severe.

In the absence of longitudinal data about what products Australian RYO smokers are using (eg, brand, pouch size), this study will examine the characteristics and prices of RYO products on the Australian tobacco market since 2001, as listed in retail trade magazines. Patterns in use of RYO among the Australian population will also be examined using data from a large representative triennial survey of Australian adults from 2004 to 2016.

## Methods

### RYO product characteristics and prices

Brand names (and variant names where available), pouch sizes and recommended retail prices (RRPs) of RYO products listed in the trade magazine Australian Retail Tobacconist were compiled for the month of February every 3 years from 2001 to 2016.35–38 Manufacturers of each product were noted. Brand names were classified as ‘traditional’ (long-standing RYO-only brands), ‘FM cigarette brands’ (brands with both FM and RYO products) and ‘other’ (specialty or novelty). Changes in the distribution of brands, variants and pouch sizes of RYO products were described over time. The average pouch size each year was calculated by summing the number of grams in each pouch listed as available for sale in each year and dividing by the total number of products available.

Prices of tobacco products were examined by pouch and per cigarette, assuming 0.7 g of tobacco per RYO cigarette. The RRPs of the most popular four brands were examined for each of the pouch sizes available and for the price and pouch size of the RYO product with the lowest RRP in each of the 6 years in which national prevalence surveys were conducted (see below). Pack and per stick price dispersion was calculated by dividing the lowest priced product by the highest priced product, giving a percentage by which the lowest priced product was cheaper than the highest. Values closer to 100% represent lower dispersion.

### Prevalence of use

Data files were obtained from the triennial National Drug Strategy Household Survey for the years 2004, 2007, 2010, 2013 and 2016. Each survey included a representative sample of between approximately 21 000 and 26 600 Australian respondents, randomly selected from households. All asked identical questions on general tobacco use (‘How often do you now smoke cigarettes, pipes or tobacco products?’), and use of each of FM and RYO cigarettes (‘How often, if at all, do you now smoke manufactured/RYO cigarettes?’). Responses of ‘daily’, ‘at least weekly’ or ‘less often than weekly’ were combined into current use and compared with ‘not at all’ responses. Data from respondents aged 18 years and older were analysed using Stata V.14, with data weighted to the Australian population from each year,39 2004, n=26 568; 2007, n=21 122; 2010, n=24 173; 2013, n=21 747; 2016, n=21 748.

The proportion of all Australians using each type of cigarette, either exclusively or in combination, was calculated for each survey year. Univariable logistic regressions were used to examine linear changes in prevalence over time. Further analyses examined patterns of RYO use just among current cigarette smokers. The linear effect of survey year on current smokers’ exclusive use of RYO was examined by gender, age group (18–29 years, 30–59 years and 60 years and older), and SES group (low, mid and high SES). SES was defined using a national index of postal codes coded for relative advantage and disadvantage applicable in each year,40 with low SES representing the lower two quintiles (most disadvantaged), mid-SES representing the third and fourth quintiles, and high SES representing the fifth quintile (least disadvantaged). The adjusted proportion of exclusive RYO smokers was first examined overall, and then interaction terms were added to separate main effects models to test for differences in rate of change in exclusive RYO use by year and subgroup. Where interactions were indicated by follow-up Wald tests, logistic regression models were then performed for each subgroup to examine linear changes in exclusive RYO use over time. All stratified models adjusted for gender, age group and SES group (as applicable).

## Results

### RYO product characteristics

The number of RYO brands available in Australia more than doubled from 2001 to 2016, increasing from 15 in 2001 and 2004 to 19 in 2007, 23 in 2010, 26 in 2013 and 33 in 2016. Figure 1 shows that the number of ‘traditional’ RYO brands did not decline over time, while the number of RYO brands using FM cigarette brand names increased steadily (from 3 in 2001 to 13 in 2016), and the number of ‘other’ brands remained relatively low from 2004 to 2013, jumping to 8 in 2016. As a result, the proportion of all RYO brands that were considered traditional decreased from 80% to 36% over this period.

Figure 1

Number of RYO brands with traditional, FM cigarette and ‘other’ brand names–2001–2016. FM, factory made; RYO, roll your own.

In 2001, there were no RYO products that were smaller than 30 g per pouch, and approximately two-thirds of products on the market were 50 g or larger. Five 25 g products were available in 2004, but it was not until 2013 that numerous 25 g pouches (n=11) were observed. In 2016, several 20 g products were available, and overall, pouches less than 30 g (n=33) were just as common as pouches of 50 g or more (n=32), with new product offerings evident both from ITG and BAT. Consequently, the average weight per pouch remained at about 43 g from 2001 to 2010, declining to 38.5 g in 2013 and 36.3 g in 2016—see figure 2.

Figure 2

Number of RYO products by pouch size category, and average weight per pouch in grams*—2001 to 2016. *No data are publicly available in Australia on the volume of sales by each product or even product category. The average here is simply the average listed weight of all products listed in the price lists published by the major retail traders group. RYO, roll your own.

Prices of pouches of 50 g of tobacco increased substantially over time, with the average RRP of the four most popular brands used in Australia (ITG’s Champion Ruby, BAT’s Winfield and ITG’s Drum and White Ox) increasing from about $A18.70 in 2001 to over$A56.60 per 50 g pouch in 2016. The RRP of a 30 g pouch of the third most popular brand (Drum) increased from just over $A11 in 2001 to$A33.95 by 2016. Competitor brands Champion Ruby, Winfield and White Ox marketed similarly sized and priced products for several years but by 2016 had all introduced products in a 25 g pouch size that were substantially cheaper than Drum 30 g—$A28.75,$A24.80 and $A28.20 respectively. In 2013, an Imperial product (JPS 25 g) became the cheapest on the market at$A17.50. In 2016, BAT released a 20 g pouch of Winfield (the second most popular brand) and budget brand Rothmans as a 20 g pouch with a RRP of $A19.45. While the price of a pouch of 50 g of tobacco in the four most popular brands increased between 2001 and 2016 by 200% (mean increase=$A38), the price of the cheapest pouch available on the market increased over the same period by only 75% ($A8)—refer figure 3. Figure 3 Recommended retail prices of four major RYO products sold in Australia and cheapest available product in smallest pouch size on the market. Source: NSW Tobacco Retailers Association, Australian Retail Tobacconist price lists, February/March editions 2001, 2004, 2007, 2010 and 2016. *No data are publicly available in Australia on the sales price of each product. The prices presented here are recommended prices listed in the price lists published by the major retail traders group. RYO, roll your own. ### RYO prices compared with prices of FM cigarettes Figure 4 compares the lowest priced FM cigarette and RYO products on the Australian tobacco market from 2001. It can be seen that the lowest priced RYO pouch has always been substantially higher than the lowest priced FM cigarette pack, but that pack/pouch price dispersion has decreased over time. In 2001, the cheapest FM cigarette pack was almost half (55%) of the price of the cheapest RYO pouch, shrinking to 84% in 2016. This is due to lowest prices of RYO pouches increasing less from 2001 to 2016 (75% increase) than FM cigarette packs (172%). Conversely, the per stick price of the lowest priced FM and RYO cigarettes has diverged over time. In 2001, RYO cigarettes (assuming 0.7 g of tobacco) were 85% of the price of FM cigarettes, widening to 70% in 2016. The price of the cheapest available FM cigarette increased by 156% from 2001 to 2016, compared with 111% for RYO cigarettes. Figure 4 Price per pouch/pack and per stick*, of the lowest priced factory made cigarette (FMC) and roll-your-own (RYO) products—2001 to 2016. *Cigarettes and cigarillos in Australia that weigh less than 0.8 g have been taxed since 1999 at a rate that is equivalent to the tax on an RYO cigarette when it is rolled using 0.8 g of tobacco. Cigarettes heavier than 0.8 g are taxed by weight, as are RYO tobacco and cigars (if heavier than 0.8 g). In 2017, in recognition that the vast majority of cigarettes weighed less than 0.7 g and that most smokers used substantially less than 0.8 g of tobacco in RYO cigarettes, the government legislated to reduce the threshold to 0.7 g. This is being done in four stages over a 4-year period to 2020 (from 0.8 to 0.775 in 2017 to 0.750 in 2018 to 0.725 in 2019 to 0.700 in 2020). For consistency over time, this analysis assumes 0.7 g per stick as the basis for determining number of cigarettes that can be made from each pouch. It is recognised, however, that many smokers may use substantially less tobacco than this, and that amounts used have varied across time.53 ### Trends in RYO use among the Australian population The prevalence of exclusive and any use of RYO and FM cigarettes in the Australian adult population is shown in figure 5. Univariate logistic regression analyses found a significant linear decline (OR 0.96, 95% CI 0.96 to 0.97, p<0.001) in any FM cigarette use, with prevalence declining from 18.4% in 2004 to 12.1% in 2016. Linear decline was also observed for exclusive FM cigarette use (OR 0.95, 95% CI 0.95 to 0.96, p<0.001), with the percentage of adults who only used FM cigarettes declining from 14.7% in 2004 to 8.7% in 2016. The apparent decline in dual use of FM and RYO cigarettes from 2004 (3.7%) to 2016 (3.4%) did not reach statistical significance (OR 0.99, 95% CI 0.98 to 1.00, p=0.067), and there was no linear effect of survey year for any use of RYO tobacco, with the prevalence of adults using RYO observed at around 5% in 2004 and again in 2016 (OR 1.00, 95% CI 1.00 to 1.01, p=0.342). In contrast, exclusive use of RYO tobacco significantly increased linearly each survey among the total adult population (OR 1.03, 95% CI 1.02 to 1.05, p<0.001) from 1.2% in 2004 to 1.7% in 2016. Figure 5 Prevalence of use of FM and RYO cigarettes, exclusively and in combination, in the Australian adult population—2004 to 2016. ‘Any’ use: smoked either exclusively or in combination with other tobacco cigarettes. FM, factory made; RYO, roll your own. ### Trends in exclusive RYO use among smokers While remaining only a small segment of the population relative to FM smokers, the significant increase in exclusive RYO use during a period of substantial decline in FM cigarette use warranted further investigation. Additional analysis was undertaken to examine changes in the demographic characteristics of exclusive RYO users among current smokers over time. The proportion of current smokers that were exclusive RYO users approximately doubled from 5.7% in 2004 to 10.9% in 2016, adjusting for gender, age group and SES group. Significant interactions were found between year and gender (F(4,22355)=2.71, p=0.028) and year and age group (F(8,22351)=4.75, p<0.001), but there was no interaction between year and SES group (F(8,22351)=1.37, p=0.205). The adjusted proportion of current adult smokers that were exclusive RYO users in each survey year was calculated overall, and then stratified by gender, age group and SES group—see table 1. Linear effects of survey year were then examined for each subgroup, controlling for demographics (as applicable). Table 1 Adjusted prevalence of exclusive RYO smoking among current smokers from 2004 to 2016, overall, and stratified by demographic subgroup Significant increases in exclusive RYO use were also seen among both male and female smokers, however, the rate of increase was much higher among females. Exclusive RYO use in males was 63% higher in 2016 compared with 2004, whereas a 168% increase was observed among females. Smokers aged 60 years and older were the only subgroup in which a significant increase in RYO use was not observed. Exclusive RYO use increased almost threefold (283%) from 2004 to 2016 among smokers aged 18–29 years. A more moderate increase (72%) among those aged 30–59 years was observed. In 2004, exclusive RYO use was lowest among the youngest age group and highest among those aged 60 years and older, but this pattern had reversed by 2016. Significant increases over time in exclusive RYO use were seen among all SES groups, and were similar in magnitude among low SES (103% increase) and high SES (109%), and slightly lower among mid-SES. In both 2004 and 2016, a significantly higher proportion of low-SES smokers than mid-SES and high-SES smokers used RYO tobacco exclusively. Within almost all demographic subgroups, large increases were seen from 2010 to 2013 relative to other years. Overall, the relative increase in 2010–2013 was 41%, compared with 10%–11% in all other survey years. This was particularly seen among younger adult smokers and mid-SES and high-SES smokers. In addition, prevalence of exclusive RYO among young adult smokers more than doubled between 2007 and 2010. ## Discussion Exclusive use of RYO cigarettes increased between 2004 and 2013, in contrast to falling prevalence of use of FM cigarettes. Within the current smoker population, substantial increases in exclusive RYO use were seen for females and younger adults, while, contrary to expectations, equally large increases were seen across SES groups. The largest observed changes occurred from 2010 to 2013, after the large increase in tobacco duty in April 2010. Over this period, numerous new offerings emerged in the Australian market both from ITG and BAT, in particular products in small pouch sizes and with names identical to the names of FM cigarette products. Exclusive use of RYO more than doubled among young adult smokers between 2007 and 2010, substantially increasing again in 2013. Increasingly in Australia, variants of RYO brands are being introduced in smaller pouch sizes (30 g or less) which—having much lower upfront purchase prices—are more affordable particularly for young smokers and comparably priced to small FM cigarette packs. By introducing products in progressively smaller pouch sizes, tobacco companies in Australia were able to ensure that—after each major tax increase (2010, and then annually since December 2013)—at least one product on the market was available at the same upfront price as the previously lowest priced pouch available prior to the tax increase. Until the 2013 December tax increase, prices of 30 g pouches in all major brands retailed for less than$A20 (an important price point in the Australian market).41 In 2013 ITG released JPS in 25 g for well under $A20, however after three further 12.5% tax increases (in December 2013, September 2014 and 2015) by 2016 the RRP for this product had increased to$A24.3. BAT was able to counter with Rothmans 20 g which, containing 20% less tobacco, it managed to price at just under the critical \$A20 price point. In 2018, even smaller packs (12.5 g) have been noted for sale in Australia.

This study describes patterns from two distinct repeated cross-sectional data sources over the same time period. It is not possible to determine the extent to which increase in exclusive use of RYO results from increased uptake of smoking among young people exclusively using RYO tobacco, from less cessation among exclusive users or from a shift from mixed use to exclusive use of RYO. Neither can firm conclusions about causation be drawn from these patterns of change in products and smoking behaviour. While smoking prevalence data comes from a large, robust survey, the lack of information about what brands and pack sizes FM and RYO smokers used mean that we can only speculate as to the contributing factors to these population-level changes in exclusive RYO use. Further, data describing the RYO product market for such an extended period could only be obtained from retail trade publications, which may have excluded some products from smaller importers.

A study in Ireland found that RYO tobacco did not operate as a substitute for FM cigarettes, with increases in the price of RYO resulting in declining use despite increases in the price of FM cigarettes.16 This might be a result of the high availability of illicit cigarettes in Ireland, which would be substantially cheaper than both tax-paid FM cigarettes and RYO tobacco. In line with findings from Tait et al in New Zealand,42 our results suggest that RYO tobacco has been operating as a less costly substitute for FM cigarettes. In both countries, aggressive taxation strategies on tobacco have resulted in reductions in affordability, particularly for young smokers.19 Rises in the upfront price of RYO tobacco products have been less in absolute terms than rises in FM cigarettes.

In Australia, manufacturers appear to be attempting not just to make RYO more affordable but also to change its status as an ‘inferior good’. Most popular brands of FM cigarettes in Australia are now also available in RYO form. The progressive introduction into the RYO market of brands previously only available as FM cigarettes may have further encouraged some FM smokers to switch to RYO. Capitalising on well-established brand names when introducing new products—known as umbrella branding—can impart intrinsic brand associations to the new product and increase likelihood of trial.43 44

ITG has been particularly successful in Australia at providing a range of low-cost tobacco products acceptable to smokers, with JPS cigarettes rapidly overtaking BAT’s Winfield (market leader for more than 40 years) as Australia’s no. 1 brand.45 46 It has also made JPS available in RYO form, a move previously explored by both Philip Morris and BAT, and has emphasised the value of its 25 g offering by using the value-connoting variant names Eternal Red Endless Blue and Abundant Gold.

Other trends observed in Australia include marketing of ‘slim’ filters, and ‘natural’-sounding rolling papers and filters33 likely to appeal to young people and women in a similar manner to ‘slim’ cigarettes, small packs and ‘naturally’ branded FM cigarette products.47 48 Other research suggests RYO smokers hold substantial misconceptions about the health effects of RYO cigarettes. In a New Zealand qualitative study, RYO smokers erroneously thought there were fewer additives in RYO tobacco than in FM cigarettes, and RYO was thought to be more natural, as evidenced by its moistness compared with FM cigarettes. The ability to roll very thin cigarettes (facilitated by the availability of filters with small diameter and smaller rolling papers) may also be contributing to the misperception that this form of smoking is low risk.

While a voluntary agreement sees tobacco companies providing lists of ingredients used in manufacturing each brand and brand variant of cigarettes49 unlike in neighbouring New Zealand where detailed information on both types of products is required and regularly analysed,50 no such information is provided or publicly available on ingredients in RYO tobacco sold in Australia. Public education to correct misperceptions about the harms of RYO tobacco—namely, that inhaling smoke from any type of tobacco product is dangerous—is urgently required, and could potentially be delivered through mass media campaigns and pack warnings, with evidence suggesting a multimodal approach is likely to be most effective.51

Legislation in all states and territories in Australia prohibits sale of e-cigarettes containing nicotine. Had e-cigarettes been more widely available as they are in other countries, it is possible that different patterns of use of RYO may have emerged. Further research is needed to understand the increasing appeal of exclusive RYO use among Australians, particularly among young people and females. The similar increase in use across SES groups, and increase in exclusive use but not combined use, suggests that this is not motivated purely by cost. Young people may be particularly price sensitive, but they also tend to be image conscious and influenced by their peers.52 Smoking of RYO tobacco may have become a signifier of belonging to particular cultural subgroups in Australia. Sharing of tobacco and engaging together in the ritual of rolling might be reinforcing this trend.19 The role of RYO among particular subcultures needs to be better understood.

For younger smokers and for women, use of RYO tobacco in Australia may be becoming more prevalent in response not just to increasing taxes on tobacco products but also to increased efforts by tobacco companies to exploit brand naming and package sizing, the only forms of promotion along with pricing available to tobacco companies in the Australian market after the introduction of plain packaging. Public education campaigns and consumer information on pouches that is specific to RYO tobacco are required to address misperceptions about health. Flavouring bans should cover RYO tobacco and variant names that suggest lower harmfulness should be banned.

In most countries and until recently in Australia, RYO tobacco was available only in pouch sizes of 30 or 50 g. In Australia as in many other countries, cigarettes may not be sold in packs containing any fewer than 20 cigarettes, however, no restrictions are currently in place in most Australian states on the minimum size of RYO pouches. Similarly, in some states departmental orders that ban sale of tobacco products with fruit or confectionary flavours extend only to cigarettes and do not cover RYO tobacco products. This loophole and the rapidly increasing availability of RYO in very small pouch sizes which are much more affordable to young smokers needs to be addressed as a matter of urgency. While the European Union and several other jurisdictions have introduced minimum sizes for cigarettes and pouches, the Australian experience suggests that non-standard pouch and pack sizes and having a range of sizes available on the market is also problematic. Dispersion of prices confuses price signals and offers a range of upfront and per stick purchase prices. Standardisation of pouches to a single size presentation (30 g) and minimum pricing to make RYO pouches comparable in price to a pack of 25 cigarettes would greatly reduce the affordability of this form of tobacco, increase the effectiveness of tax increases and complement educational approaches.

• Previous studies have demonstrated that use of hand-rolled/roll-your-own (RYO) tobacco is increasing in many countries.

• Higher taxes on tobacco products encourage greater use of this product, and it is likely that greater affordability in comparison to factory-made cigarettes is the driving trend. However, price is not the only factor.

• Whereas RYO tobacco has traditionally been used by older, heavier and predominantly male smokers, this paper shows an increase in use among young inexperienced smokers and among females.

• This would appear to be associated with marketing of smoking tobacco in progressively smaller pouches, with smaller diameter filters allowing thin cigarettes to be rolled.

• Emphasis on so-called natural qualities may result in consumers erroneously believing their smoking is less harmful and risky than it actually is.

• Policy-makers need to move urgently to ban small pouch sizes, and to improve consumer information on pouches to address these self-exempting beliefs. Bans on misleading descriptors and public education campaigns could also help to correct misinformation and to discourage sharing of pouch tobacco.

## Acknowledgments

The authors acknowledge assistance of Meghan Zacher with preliminary analysis undertaken on data provided up to 2013.

## Footnotes

• Contributors MMS designed the study. MB collected the data on product trends, conceptualised and undertook the data analysis and drafted the manuscript. All three authors contributed to editing and finalisation of the manuscript.

• Funding This study was supported by funding from the Cancer Council Victoria.

• Disclaimer The content is the sole responsibility of the authors and does not reflect the views of the administrators of the source data used in analysis.

• Competing interests None declared.

• Patient consent Not required.

• Ethics approval This study involved only secondary analysis of published data.

• Provenance and peer review Not commissioned; externally peer reviewed.

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