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Dissuasive cigarettes as a tobacco control measure: a scoping review
  1. Abdulmohsen Hamdan Al-Zalabani1,
  2. Sarah S Monshi2,
  3. Ahmed Fahd Al-Ahmadi3,
  4. Ahmed Khalid A Ali3,
  5. Ghazal Assaad Mirdad4,
  6. Manal Muteb Alanazi5,6,
  7. Mawada Qabl Alsaedi4,
  8. Abdullah M Alanazi5,6
  1. 1Department of Family and Community Medicine, Taibah University, Al-Madinah, Saudi Arabia
  2. 2Department of Health Services Management, College of Public Health and Health Informatics, Umm Al-Qura University, Makkah, Saudi Arabia
  3. 3Model of Care, Al-Madinah Health Cluster, Al-Madinah Al-Munawarah, Saudi Arabia
  4. 4Saudi Board Preventive Medicine Program, Al-Madinah Al-Munawarah, Saudi Arabia
  5. 5Respiratory Therapy, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
  6. 6King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
  1. Correspondence to Dr Abdulmohsen Hamdan Al-Zalabani, Department of Family and Community Medicine, Taibah University, Al-Madinah 42317, Saudi Arabia; aalzalabani{at}


Objective The aim was to identify and review the research literature on dissuasive cigarettes, including key concepts, types, sources of evidence and research gaps.

Data sources PubMed, Scopus and Web of Science databases were searched up to January 2023 with no language or date restrictions. All study designs were included. Reference lists of the identified studies were manually searched. Studies on tobacco products other than cigarettes or on external cigarette packaging alone were excluded.

Study selection Two reviewers screened titles and abstracts independently using eligibility criteria. The full text of the selected articles was subsequently screened independently by two reviewers to confirm eligibility.

Data extraction Two reviewers independently extracted data from all studies using data abstraction forms. Results were reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist.

Data synthesis We identified 24 original studies, 3 review articles and 4 commentary articles. Research on dissuasive cigarettes was reported from Australia, New Zealand, Europe and North America. We presented results in four themes: the concept of dissuasive cigarettes; approaches and types; potential benefits, barriers and concerns; and current research gaps.

Conclusions Dissuasive cigarettes represent a promising strategy that could be used in tobacco control. Parallel implementation with plain packaging would be feasible and synergistic.

  • Public policy
  • Advertising and Promotion
  • Packaging and Labelling
  • Tobacco industry
  • Prevention

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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  • Contributors Conceptualisation and guarantor: AHA-Z. Refinement of study design and protocol: all authors. Title, abstract, full-text screening and data extraction: AHA-Z, AFA-A, AKAA, GAM, MMA and MQA. First draft of manuscript: AHA-Z, SSM and AMA. Revision of manuscript: all authors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

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

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.