Written by: Ashley Grant, MPH Caitlin Weiger, MHS Mark Spires, MPH Joanna Cohen, PhD Produced June 2017 by: Institute for Global Tobacco Control Johns Hopkins Bloomberg School of Public Health 2213 McElderry St., Fourth Floor Baltimore, MD 21205 USA www.jhsph.edu/igtc www.globaltobaccocontrol.org Acknowledgements The Institute for Global Tobacco Control (IGTC) at the Johns Hopkins Bloomberg School of Public Health (JHSPH) wishes to acknowledge Aliança de Promoçao da Sáude, Comisión Nacional Permanente de Lucha Antitabáquica, Educación Popular en Salud, Fundación InterAmericana del CoraZón Argentina, and the Fundación InterAmericana del CoraZón Bolivia for their assistance with data collection, and the Campaign for Tobacco-Free Kids for facilitating work between IGTC and the organiZations listed above and for providing background information. IGTC also thanks Teresa DeAtley for leading the training in Chile and Joanna LopeZ for leading the trainings in Bolivia and Peru. This work was supported with funding from Bloomberg Philanthropies’ Bloomberg Initiative to Reduce Tobacco Use (www.bloomberg.org). Copyright 2017 Institute for Global Tobacco Control Suggested Citation: Institute for Global Tobacco Control. Technical Report on Flavored Cigarettes at the Point-of-Sale in Latin America: Availability and Marketing around Primary and Secondary Schools in Five Countries. Baltimore, MD: Johns Hopkins Bloomberg School of Public Health; June 2017. For more information, please contact: [email protected] Flavored Cigarettes at the POS in Latin America 1 Table of Contents Table of Contents ............................................................................................................................................................................................ 2 Executive Summary ....................................................................................................................................................................................... 3 Introduction ...................................................................................................................................................................................................... 4 Flavored Tobacco Products .................................................................................................................................................................. 4 Marketing Flavored Tobacco Products ............................................................................................................................................ 6 The Framework Convention on Tobacco Control ....................................................................................................................... 7 Country Markets and Regulations ...................................................................................................................................................... 7 Argentina ................................................................................................................................................................................................. 8 Bolivia ....................................................................................................................................................................................................... 8 BraZil ......................................................................................................................................................................................................... 9 Chile ........................................................................................................................................................................................................... 9 Peru ......................................................................................................................................................................................................... 10 Methods ........................................................................................................................................................................................................... 10 Sampling Approach ............................................................................................................................................................................... 10 Survey Instrument ................................................................................................................................................................................. 11 Data Collection Protocol ...................................................................................................................................................................... 12 Training ...................................................................................................................................................................................................... 13 Results .............................................................................................................................................................................................................. 15 Marketing for Cigarettes with Menthol or Other Flavor Descriptors Across 5 Countries ...................................... 16 Argentina ................................................................................................................................................................................................... 21 Bolivia .......................................................................................................................................................................................................... 29 BraZil ............................................................................................................................................................................................................ 35 Chile .............................................................................................................................................................................................................. 44 Peru .............................................................................................................................................................................................................. 53 Discussion ....................................................................................................................................................................................................... 61 Limitations ...................................................................................................................................................................................................... 61 Conclusions .................................................................................................................................................................................................... 61 Key Terms and Definitions ...................................................................................................................................................................... 62 Appendix A: Cigarette Packs Purchased in Argentina ................................................................................................................. 64 Appendix B: Cigarette Packs Purchased in Bolivia ........................................................................................................................ 66 Appendix C: Cigarette Packs Purchased in BraZil .......................................................................................................................... 66 Appendix D: Cigarette Packs Purchased in Chile ........................................................................................................................... 70 Appendix E: Cigarette Packs Purchased in Peru ............................................................................................................................ 72 References ...................................................................................................................................................................................................... 72 Flavored Cigarettes at the POS in Latin America 2 Executive Summary The tobacco epidemic kills more than six million people worldwide each year and is projected to kill one billion people this century. In Latin America, total cigarette sales are declining, but the sales of flavored cigarettes are climbing. This report describes a study that examined cigarette retailers within a radius of 100-250 meters around schools in Argentina, Bolivia, BraZil, Chile, and Peru. The results of this study show that cigarette packs carrying flavor descriptors were frequently displayed and advertised at the point-of-sale near schools. Most of the flavored cigarettes observed are sold by large, multinational companies such as British American Tobacco, Japan Tobacco International, and Philip Morris International. Flavored products appeal to young and inexperienced smokers, potentially leading to a lifetime of addiction and disease. In order to maintain profits, tobacco companies must attract young smokers to replace the millions of customers that die from tobacco-caused diseases or quit each year. Most flavored cigarettes observed contained mint flavoring or menthol – a substance that also makes it easier to inhale cigarette smoke and absorb nicotine thus accelerating the addiction