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You're Made to Feel Like a Dirty Filthy Smoker When Research paper Tob Control: first published as 10.1136/tobaccocontrol-2014-052049 on 25 February 2015. Downloaded from “You’re made to feel like a dirty filthy smoker when you’re not, cigar smoking is another thing all together.” Responses of Australian cigar and cigarillo smokers to plain packaging Caroline L Miller,1,2 Kerry A Ettridge,1 Melanie A Wakefield3 1SAHMRI Population Health ABSTRACT cigar tubes must display text only warnings.2 For Research Group, South Objective To explore experiences of cigar and cigarillo further details see Scollo et al.3 Australian Health and Medical Research Institute, Adelaide, smokers under Australian laws requiring plain packaging In Australia, cigars have been subject to the same South Australia, Australia (PP) and strengthened graphic health warnings (GHWs). marketing restrictions as other types of tobacco with 2School of Population Health, Methods In February/March 2014, we conducted: prohibitions on advertising in mainstream broadcast University of Adelaide, in-depth interviews with 10 regular premium cigar media, retail displays and, in 2012, regulation of Adelaide, South Australia, smokers; two focus groups with occasional premium cigar online ‘point-of-sale’ for Australian-based providers. Australia 3Centre for Behavioural and premium cigarillo smokers (n=14); four focus groups The prevalence of cigar smoking in Australia is low Research in Cancer, Cancer with non-premium cigarillo smokers (n=28); and a and has not risen in recent decades. It is much lower Council Victoria, Melbourne, national online survey of cigar and/or cigarillo smokers than other forms of tobacco smoking. The latest Victoria, Australia (n=268). national Australian data from 2010 found the com- Correspondence to Results Premium cigar smokers had limited exposure to bined percentage of survey participants smoking Dr Caroline L Miller, SAHMRI PP, with many purchasing fully branded cigars in boxes cigars and/or pipes among those who were smokers Population Health Research duty free or online and singles in non-compliant (aged 14+ years) was 8%, or approximately 1% of Group, South Australian Health packaging. Those who were exposed noticed and were all participants.4 and Medical Research Institute, concerned by the warnings, tried to avoid them and felt Despite strong regulation of cigar promotion PO Box 11060, Adelaide, ‘ ’ SA 5061, Australia; more like dirty smokers . Changes in perceived taste, within Australia, Australian legislation does not cover [email protected] harm and value were minimal for experienced premium promotion of cigars and other forms of tobacco in copyright. cigar smokers. Occasional premium cigar and premium imported magazines, online marketing from provi- Received 24 September 2014 cigarillo smokers with higher PP exposure (gained by ders outside Australia, product placement in movies, Accepted 5 December 2014 purchasing boxes rather than singles) perceived cigar/ or promotion via social media, all of which expose package appeal and value had declined and noticed the the Australian market to cigar promotion. GHWs. Non-premium cigarillo smokers reported high PP Many international jurisdictions, including the exposure, reduced perceived appeal, quality, taste, USA, have fewer restrictions than Australia on tobacco enjoyment and value, somewhat increased perceived marketing, including cigars. The rise in the popularity harm, greater noticeability of GHWs and concealment of of cigar smoking in the USA and elsewhere has led to packs and more contemplation of quitting. Online survey a focus on the influencing factors, including the http://tobaccocontrol.bmj.com/ participants reported increased noticeability of GHWs increased frequency of cigar content in popular media (33%), decreased appeal of packaging (53%) and and the ways in which cigars have been portrayed.5 reduced consumption of cigars (42%) and cigarillos A number of studies observed increases in cigar mar- (44%) since PP implementation. keting starting in the 1990s, increasing the visibility Conclusions Non-premium cigarillo smokers appear to and normalisation of cigar smoking, with associated – have been most exposed and influenced by PP, with cigar increases in prevalence of use.6 10 Cigar marketing smokers less so, especially regular premium cigar smokers proliferated in print media, social media and other who have maintained access to fully branded products. online platforms. Cigars have been consistently posi- tioned as a luxury good, a status symbol and a sign of affluence and power, and as part of a successful, – on October 1, 2021 by guest. Protected sophisticated lifestyle.11 13 Cigars have been pro- INTRODUCTION motedwitharangeofhistoricalandcontemporary fi 611–13 Open Access Australian legislation requiring all tobacco products celebrities and public gures. Analyses of print Scan to access more to be sold in drab dark brown plain packaging media content have also consistently found that the free content from 1 December 2012, also includes specific health effects of cigars have been downplayed and requirements for cigars and cigarillos.1 Like cigar- minimised.12 ettes, the new provisions for cigar and cigarillo In 2011, qualitative research examined the boxes and packs, and bags for packaging of single smoking behaviour, attitudes and perceptions of cigars for sale prohibit logos, brand imagery and Australian cigar smokers to assist development of design. They require standardised package colour plain packaging provisions and GHWs.14 Australian and standardised font colour and size for brand cigar smokers reported viewing cigar smoking as a To cite: Miller CL, and variant names. All cigar packaging, other than luxury and an indulgence, with higher status attribu- Ettridge KA, Wakefield MA. cylindrical tubes in which cigars can be packaged ted to premium cigars. Tob Control 2015;24: for sale, are required to display expanded and This research identified differences between cig- – ii58 ii65. updated graphic health warnings (GHWs), while arillo smokers and lower and higher frequency ii58 Miller CL, et al. Tob Control 2015;24:ii58–ii65. doi:10.1136/tobaccocontrol-2014-052049 Research paper Tob Control: first published as 10.1136/tobaccocontrol-2014-052049 on 25 February 2015. Downloaded from consumers of premium cigars. More frequent premium cigar all qualitative study participants completed a consent form prior smokers were found to be extremely knowledgeable about the to participation. different types of cigars, regularly smoking different cigar We first conducted in-depth interviews of 40–50 min duration brands. These cigar smokers were also reported to judge the with premium cigar smokers (n=10), defined as those who quality of a cigar on criteria including: the type of tobacco; the smoked a premium cigar (costing $A25+) at least once a week. roll; the age; and the country and region of origin. The brand We then ran two sets of focus groups. The first set consisted of name was taken as a sign of authenticity or legitimacy of the occasional (fortnightly or monthly) premium cigar smokers product. This information was reported to have been included and/or premium cigarillo smokers (2 groups, total n=14). The on the cigar band where more frequent cigar smokers looked second set included non-premium cigarillo smokers (4 groups, for these indications of quality. total n=28). All focus groups were 1 h in duration. All qualita- Less frequent smokers of premium cigars reportedly viewed tive research was conducted in Sydney and Melbourne in cigar smoking as an occasional pleasure, associated with particu- February 2014. lar social occasions or celebrations. They were less knowledge- Finally, in March 2014 we conducted an online survey (5– able than more frequent cigar smokers about premium cigars. 10 min duration) of a general national sample of current cigar These cigar smokers reported taking a stronger interest in the and cigarillo smokers (n=268). This sample was recruited from branding and packaging of cigars than did more frequent cigar an existing national online panel who had expressed their will- smokers. The branding and packaging was reported to have a ingness to be contacted for the purpose of research. This panel strong effect on their perceptions of quality. Similar patterns develops their database from a number of sources including were also reported for smokers of premium and non-premium advertising and ‘word-of-mouth’. A total of 56 589 email invita- cigarillos, with smokers of non-premium cigarillos reporting tions describing the nature of the study (ie, to gather information being more likely to associate appeal and quality with packaging. regarding people’s views and experiences about smoking cigars The current research sought to assess, among different seg- and other tobacco products) were sent out to randomly selected ments of cigar consumers: (1) current cigar and cigarillo members of the online panel, of which 5761 started the survey smoking behaviour and consumers’ exposure to new packaging (response rate of 10%). Only 283 of these participants (ie, 5% of changes; (2) perceived changes relating to the specific objectives the people who started the survey) met the eligibility criteria as of the plain packaging legislation, namely, reduced appeal, assessed by screening questions at the beginning of the survey, increased GHW effectiveness and reduced extent to which con- that is, they were aged 18 years or older and reported that they sumers are misled about harms; and (3) more ‘downstream’ per- currently smoked
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