Slim Cigarette Smoking Prevalence among Canadian Youth Smokers: Implications for Federal Standardized Packaging Legislation

By Minaker, Leia M.; Tait, Hannah et al. | Canadian Journal of Public Health, January 1, 2017 | Go to article overview

Slim Cigarette Smoking Prevalence among Canadian Youth Smokers: Implications for Federal Standardized Packaging Legislation


Minaker, Leia M., Tait, Hannah, Ong, Maple, Nguyen, Nghia, Canadian Journal of Public Health


Tobacco use poses major health risks1 and continues to be the leading cause of preventable death globally.2,3 In Canada, almost 17% of all deaths are attributable to smoking, and over 85% of lung cancer cases are related to smoking.4 Despite dramatic declines in smoking among Canadian youth, 11% of those aged 15-19 in Canada are current smokers.5 Adolescence is a critical time for smoking initiation, and therefore policy interventions targeting and protecting youth are a crucial element of tobacco control efforts.

In Canada, tobacco industry marketing has been curtailed through tobacco control policies such as those that disallow print, radio, and television advertising,6 restrictions on in-store displays (known as point-of-sale displays),6 banning of the terms "light" and "mild" from being associated with cigarette brands, and mandatory warning labels on cigarette packages, which currently take up 75% of the front and back of packages.7 One of the last frontiers in traditional tobacco industry marketing in Canada is the cigarette packaging and product itself, which is central to the tobacco industry's efforts to promote tobacco use.8

Packaging plays an important role in creating and reinforcing brand imagery.9,10 Consumer research by tobacco companies has demonstrated that alternative cigarette packaging and design can reduce risk perceptions and positively affect purchase interest.11 Deviations from standard cigarette packaging and product design have been associated with positive imaging, consumer perceptions of quality, and false health beliefs.11,12 Slim and superslim cigarettes are one such innovation that is used to entice women, reduce perceptions of harm, and attract new smokers.13 Furthermore, youth are attracted to novelty and branded cigarette packs.10,14

Although slim cigarettes have been available in Canada for some time, superslim cigarettes were introduced to the Canadian market as recently as 2007.15 The introduction of slim/superslim cigarettes (hereafter, we refer to slim/superslim cigarettes simply as slim cigarettes) is of concern because they have a smaller diameter than traditional cigarettes and can reduce harm perceptions.16 Borland and Savvas17 found that cigarette rod design features have measurable effects on participant perceptions of product attractiveness, quality, and taste. Slim cigarettes are perceived to be less harmful than regular cigarettes by youth and women,18 and are more likely to be described by consumers as mild or low-tar relative to regular cigarettes.11 Further, slim cigarettes are perceived as more pleasant for beginner smokers.16 In a national sample of US 18-19-year-old women, slim cigarette packages were more likely to be rated as less harmful than regular packages, even when the colour and brand were removed.19 Young women tend to find slim cigarettes attractive and prefer them to standard "fat" cigarettes.11,16,17,20 Appealing qualities include sizes appropriate for fitting easily into hands or purses.11

Tobacco surveillance conducted among adults in Canada, the US, the UK, and Australia revealed that slim cigarette smokers are more likely to believe their own brand to be less harmful than regular cigarettes.18 These misconceptions are worrying, given that slim cigarettes are at least as harmful as regular cigarettes.15,21 Slim cigarettes are specifically promoted to females and youth18,22 using themes and imagery from historic advertisements,18,23 which associate slim cigarette smoking with body weight maintenance.20,12 Evidence from tobacco industry documents suggests that pack structure is used to attract young consumers.11 One experimental study found that the most important feature in determining young women's intention to try cigarettes was pack structure,24 which can be addressed through legislation on plain packaging, as discussed below.

Currently, 4 countries have finalized requirements for plain packaging, and another 14 are formally considering or are in the process of developing plain packaging legislation. …

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