Marketing of Menthol Cigarettes and Consumer Perceptions: a Review of Tobacco Industry Documents Stacey J Anderson1,2

Research paper Tob Control: first published as 10.1136/tc.2010.041939 on 19 April 2011. Downloaded from Marketing of menthol cigarettes and consumer perceptions: a review of tobacco industry documents Stacey J Anderson1,2 1Department of Social and ABSTRACT young, inexperienced smokers and/or Africane Behavioral Sciences, University Objective To examine tobacco industry marketing of Americans.3 In addition to youth appeal, the addi- of California, San Francisco menthol cigarettes and to determine what the tobacco tion of ‘medicinal menthol’ to cigarettes may also (UCSF), California, USA 2Center for Tobacco Control industry knew about consumer perceptions of menthol. appeal to established health-concerned smokers Research and Education, UCSF, Methods A snowball sampling design was used to who might otherwise quit.4 California, USA systematically search the Legacy Tobacco Documents Others have investigated the internal tobacco Library (LTDL) (http://legacy.library.ucsf.edu) between 28 industry documents for different but related ques- Correspondence to February and 27 April 2010. Of the approximately 11 Stacey J Anderson, Department tions on how tobacco companies manipulate of Social and Behavioral million documents available in the LTDL, the iterative menthol content in cigarettes to target young Sciences, Box 0612, University searches returned tens of thousands of results from the people5 and consumer perceptions of the sensory of California, San Francisco, CA major US tobacco companies and affiliated organisations. characteristics of menthol.6 This paper analyses 94143-0612, USA; A collection of 953 documents from the 1930s to the internal tobacco industry documents to determine [email protected] first decade of the 21st century relevant to 1 or more of if tobacco companies marketed mentholated ciga- Received 17 November 2010 the research questions were qualitatively analysed, as rettes as public health advocates allege, and how Accepted 29 January 2011 follows: (1) are/were menthol cigarettes marketed with the tobacco industry managed consumer percep- health reassurance messages? (2) What other messages tions of menthol through marketing strategies. come from menthol cigarette advertising? (3) How do This knowledge can help inform the regulatory smokers view menthol cigarettes? (4) Were menthol decisions by the US FDA and comparable agencies cigarettes marketed to specific populations? elsewhere in the world, and can augment public Results Menthol cigarettes were marketed as, and are health’s understanding of why the tobacco perceived by consumers to be, healthier than industry opposed menthol’s inclusion in the list of non-menthol cigarettes. Menthol cigarettes are also banned flavouring additives. marketed to specific social and demographic groups, Academics and government scientists indepen- including AfricaneAmericans, young people and women, dent of the tobacco industry have shown that the and are perceived by consumers to signal social group tobacco industry targets various population groups, http://tobaccocontrol.bmj.com/ belonging. including specific racial and ethnic populations, Conclusions The tobacco industry knew consumers with marketing and advertising generally7 and for perceived menthol as healthier than non-menthol mentholated products specifically.8 A 2006 case cigarettes, and this was the intent behind marketing. study9 of Kool, Brown & Williamson’s best selling Marketing emphasising menthol attracts consumers who mentholated brand, described the company’s use of may not otherwise progress to regular smoking, including music events to promote the brand to young, young, inexperienced users and those who find ‘regular’ particularly AfricaneAmerican, people. Indepen- cigarettes undesirable. Such marketing may also appeal dent research has shown explicit and implicit to health-concerned smokers who might otherwise quit. health messages in advertisements for menthol cigarettes.10 11 Some health messages are explicit, for example, in a 1942 advertisement asking on September 27, 2021 by guest. Protected copyright. ‘Throat sore? Time to give it a rest!’ and directing INTRODUCTION the reader to ‘Change to Spuds. Enjoy their The concentration of menthol in tobacco products soothing coolness!’ (the Spud brand was the first in varies according to the product characteristics and the US to advertise that it was mentholated). It is the perceived flavour desired, but is present in 90% nevertheless important to examine the intentions of all tobacco products, whether the products are behind the creation of such marketing communi- marketed specifically as ‘mentholated’ or not.1 2 cations in the words of tobacco company insiders The Family Smoking Prevention and Tobacco themselves, particularly if marketing shifted from Control Act (FSPTCA) gave the US Food and Drug communicating this type of explicit health message Administration (FDA) regulatory authority over to messages that continue to communicate health tobacco products. On 22 September 2009, the FDA benefits, but less explicitly.10 11 The current study exercised this authority when it announced a rule begins with historical examples and moves forward banning cigarette flavourings specified in the Act. in time, but is not a strictly chronological treat- This ban did not include menthol, however, as it ment of the topic. The results are presented in three was excluded from the list of banned flavourings in overall sections: marketing messages for menthol the Act because of opposition by the tobacco cigarettes, then consumer perceptions of those This paper is freely available industry. The fact that menthol was not included messages, and specific populations targeted by such online under the BMJ Journals in the original list of banned flavours concerned messages. unlocked scheme, see http:// many in the public health arena who argued that A decline in per capita cigarette consumption in tobaccocontrol.bmj.com/site/ e ‘ about/unlocked.xhtml menthol is used by the tobacco industry to attract the US in 1953 1954 resulting from the health ii20 Tobacco Control 2011;20(Suppl 2):ii20eii28. doi:10.1136/tc.2010.041939 Research paper Tob Control: first published as 10.1136/tc.2010.041939 on 19 April 2011. Downloaded from scare’ marked the beginning of changes in health-related relevant to 1 or more of the research questions were qualitatively messages in cigarette marketing materials.12 A decade later, after analysed. Memos were written to summarise the relevant the 1964 US Surgeon General’s Report ‘Smoking and Health’13 documents to further narrow down to the 60 representative and the 1965 Cigarette Act,14 US tobacco marketers continued documents that are cited in this paper. to be faced with the challenge of marketing a product identified as harmful by health authorities while distracting consumers RESULTS from those known harms. These challenges necessitated a move Health reassurance messages in menthol advertising away from explicit health messages and towards other messages Menthol cigarettes were marketed using health reassurance that would appeal to different groups of potential consumers of messages suggesting that menthol cigarettes were safer than ‘full ‘ ’ ‘ ’ low-tar or light tobacco products. Research has elucidated flavour’ or non-menthol cigarettes. The first mentholated ciga- ‘ ’ many of these alternative marketing messages for low-tar and rette is credited to a young man, Lloyd ‘Spud’ Hughes, a chronic ‘ ’ 415 light cigarettes, and has demonstrated that consumers tend cold sufferer, when in the 1920s his mother prescribed a treat- ‘ ’ ‘ ’ to perceive low-tar and light cigarettes to be less harmful than ment of menthol crystals that he surreptitiously added to his ‘ ’ 16e20 regular cigarettes. less is understood about messages for smoking tobacco tin.26 27 Bearing Hughes’s nickname, Spud menthol cigarettes or about how consumers perceive menthol. A cigarettes became the first commercial menthol brand to be ‘ 2010 scholarly commentary stated that the industry has used marketed in the US; B&W followed with Kool Menthol in 1933. ’ menthol s association with cold remedies to infer that smoking Initially Kool Menthol, and menthol in general, was advertised fi menthol cigarettes has some medicinal or health bene t for as being ‘for occasional use’ in order to ‘rest your throat’28 rather ’ 21 more than 70 years . Internal documents can shed light on than a regular, daily-use product. whether consumers have accepted this inference of health Menthol cigarettes were first popularised as a remedy to the fi bene ts. burn, dryness and throat irritation that accompany smoking This paper addresses the following questions on marketing (figure 1). B&W and Lorillard marketed menthols with health- for and consumer perceptions of menthol cigarettes: reassuring slogans such as ‘Breathe easy, smoke clean’, ‘When 1. Are/were menthol cigarettes marketed with health reassurance your throat tells you it’s time for a change.’29 and ‘The ? messages beneficial head-clearing qualities of menthol’.30 Similar claims ? 2. What other messages come from menthol cigarette advertising made were that menthol brands act as a ‘remedy or treatment ? 3. How do smokers tend to view menthol cigarettes for coughs’ and counteract ‘throat irritations due to heavy fi ? 4. Were menthol cigarettes marketed to speci c populations smoking’.31 Tobacco company executives sought to emphasise health METHODS messages in the marketing of menthol products relative to A complete discussion of the general tobacco documents non-menthol products

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