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Shedding ‘light’ on cigarette pack design: colour differences in product perceptions, use and exposure following the US descriptor ban
  1. Melissa Mercincavage1,
  2. Benjamin Albelda1,
  3. Darren Mays2,
  4. Valentina Souprountchouk1,
  5. Daniel P Giovenco3,
  6. Janet Audrain-McGovern1,
  7. Andrew A Strasser1
  1. 1Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
  2. 2Department of Oncology, Georgetown University Medical Center, Washington, District of Columbia, USA
  3. 3Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
  1. Correspondence to Dr Melissa Mercincavage, Psychiatry, University of Pennsylvania, PA 19104, Pennsylvania, USA; melmer{at}upenn.edu

Abstract

Introduction Many countries removed misleading descriptors (eg, ‘light,’ ‘mild’) from cigarette packaging because they falsely conveyed messages of reduced risk. It is unclear if relabelled products currently promote misperceptions or differences in product use and toxicant exposure. We compared product perceptions, use and exposure between a US sample of Marlboro Gold (formerly ‘light’) and Red smokers.

Methods 240 non-treatment-seeking adult daily Marlboro smokers (70% male, 71% White, mean cigarettes/day=16.4 (SD=8.3)) completed two laboratory sessions over a 5-day period. During sessions, participants smoked two cigarettes through a topography device to capture their puffing behaviour, provided precigarette and postcigarette carbon monoxide (CO) assessments, and completed risk perception and subjective rating questionnaires. Self-reported cigarettes per day were verified via daily filter collection; urine collected at the end of the period was assayed for nicotine metabolites.

Results Gold (n=49) smokers were more likely than Red (n=191) to incorrectly believe their cigarettes had less nicotine and tar than regular cigarettes (ps<0.001), and rated them as weaker, less harsh, and mild tasting (ps<0.05). Differences between Red and Gold smokers in cigarettes per day and puffing behaviours trended towards significance (ps<0.1). Notably, there were no group differences on CO boost or total nicotine equivalents (ps>0.1).

Conclusions Misperceptions about nicotine and tar exist years after rebranding Marlboro Lights as Marlboro Gold. Biological results support that Gold smokers do not have lower toxicant exposure. The US should consider comprehensive packaging or product design regulations to properly inform smokers of product risks.

Trial registeration number

NCT02301351.

  • packaging and labelling
  • advertising and promotion
  • nicotine
  • public policy
  • smoking topography
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Footnotes

  • Twitter @melmercincavage, @dannygiovenco

  • Contributors AAS designed, received funding for and oversaw implementation of the larger randomisd trial. AAS and MM together conceptualised the present secondary analysis of baseline data from the larger trial. MM analysed the data and wrote the initial paper draft, with subsequent contributions from all authors. BA and VS monitored and collected data for the larger trial. All authors contributed to paper revisions and have approved of the final version of the manuscript.

  • Funding This research was supported by the National Institutes of Health and FDA Center for Tobacco Products (P50CA179546 to Lerman/Hornik; U54CA229973 to Strasser/Delnevo) and the National Institutes of Health (K07CA218366 to Mercincavage).

  • Disclaimer The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or the FDA.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The university institutional review board approved all procedures.

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

  • Data availability statement Data are available on reasonable request. Deidentified data and a measures codebook will be made available on request.

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