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‘It has candy. You need to press on it’: young adults’ perceptions of flavoured cigarettes in the Philippines
  1. Jennifer Brown1,
  2. Meng Zhu2,
  3. Meghan Moran1,
  4. Connie Hoe3,
  5. Ferdie Frejas4,
  6. Joanna E Cohen1
  1. 1 Department of Health, Behavior & Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
  2. 2 Johns Hopkins University Carey Business School, Baltimore, Maryland, USA
  3. 3 International Health Department, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
  4. 4 GoodThinking Research, Inc, Manila, Philippines
  1. Correspondence to Jennifer Brown, Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA; jbrow212{at}


Background The Philippines has a high smoking prevalence and one of the largest tobacco menthol market shares in the world. Flavour capsule cigarettes were introduced to the Philippines in 2013, most of which are menthol flavoured, and their market share is increasing. We explored perceptions of flavoured cigarette packaging among young adult Filipinos.

Methods We conducted eight focus groups with 63 young adults ages 18–24 years in Manila in 2019, stratified by gender and smoking status. We conducted a thematic analysis of the transcripts.

Results Most participants assessed relative harm of cigarettes based on strength, mainly determined by colour of the packaging. Menthol cigarettes with primarily blue packaging were considered less harmful than menthol cigarettes with primarily green packaging. Many participants considered flavour capsule packs most attractive, compared with non-flavoured and traditional menthol cigarettes, due to the colouring of the packs and expectations regarding taste. Some participants likened the capsules and the taste of flavour capsule cigarettes to candy, and many participants thought flavour capsule cigarettes would most likely be smoked by teenagers or young adults.

Conclusions Young adult Filipinos believe that some menthol-flavoured cigarettes are less harmful than other flavoured cigarettes and non-flavoured cigarettes and find flavour capsule cigarettes attractive. A tobacco flavour ban and implementation of plain packaging might help reduce misperceptions of risk and make cigarettes less appealing.

  • global health
  • low/middle income country
  • packaging and labelling
  • advertising and promotion

Data availability statement

No data are available. n/a.

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  • Contributors All authors made a substantial contribution to this research. All authors contributed to the conceptualisation of the study and design of data collection tools. JB and FF led data collection. JB conducted the analyses and wrote the initial draft of the manuscript. MZ, MM, CH, FF and JEC contributed to revisions and finalisation of the manuscript. All authors approved the final version.

  • Funding JEC holds the Bloomberg Professorship of Disease Prevention at the Johns Hopkins Bloomberg School of Public Health; the earnings from that endowment helped to support this work.

  • Competing interests None declared.

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