TY - JOUR T1 - Culturally specific health-related features on cigarette packs sold in China JF - Tobacco Control JO - Tob Control DO - 10.1136/tc-2022-057527 SP - tobaccocontrol-2022-057527 AU - Yuxian Cui AU - Zheng Dai AU - Joanna E Cohen AU - Scott Rosas AU - Katherine Clegg Smith AU - Kevin Welding AU - Lauren Czaplicki Y1 - 2022/08/25 UR - http://tobaccocontrol.bmj.com/content/early/2022/08/25/tc-2022-057527.abstract N2 - Background China is the country with the highest burden of tobacco-caused disease. We characterised the extent to which cigarette pack marketing features (eg, imagery, text, pack color) could potentially mislead consumers by suggesting products are healthy.Methods We used two methods: group concept mapping and content analysis. First, we used a group concept mapping approach to generate and sort Chinese consumer responses to an open-ended prompt asking what marketing features suggest a product is ‘healthy’ or ‘good for you’. Second, based on the concept mapping results, we developed a codebook of health-related features on cigarette packs that were relevant to the unique cultural context of product marketing in China. Two trained coders who were native Chinese speakers double-coded a sample of 1023 cigarette packs purchased in 2013 (wave 1) and 2017 (wave 2). We examined differences in the presence of features overall and over time.Results Overall, 83.5% (n=854) of Chinese cigarette packs in our sample contained at least one ‘healthy’ or ‘good for you’ feature, and the presence of health-related features on packs remained constant between wave 1 (83.5%, n=354) and wave 2 (83.5%, n=500; p=1.00). Across both waves, the most common categories of culturally specific health features present related to recycling symbols, rare animal imagery, bright colours (eg, bright yellow) and botanical imagery (eg, bamboo, mint).Conclusion Health-related features on cigarette packs sold in China are common. Enhanced policies to address tobacco packaging, labelling and branding could support and facilitate a reduction in the high tobacco burden in China.Data are available on reasonable request. Data sharing requests can be made to LC (lczapli1@jhu.edu) or Institute for Global Tobacco Control (igtc@jhu.edu). ER -