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Research shows that diplomats have been lobbying on behalf of tobacco companies for many years, and that this is part of a broader industry strategy to undermine public health and further the commercial objectives of tobacco companies. There have been multiple instances of lobbying by ambassadors and other diplomats from the UK, as well as […]

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Research shows that diplomats have been lobbying on behalf of tobacco companies for many years, and that this is part of a broader industry strategy to undermine public health and further the commercial objectives of tobacco companies.1

There have been multiple instances of lobbying by ambassadors and other diplomats from the UK, as well as Japan and Switzerland. Much of this lobbying activity has taken place in low and middle-income countries (LMICs).2 These countries are important sources of new customers for tobacco companies as markets in higher income countries where consumption is generally falling.345

Diplomats are also involved in activities which help promote the tobacco industry via local media, such as visiting tobacco farms or factories. Other engagement supports tobacco companies’ product promotions, or corporate social responsibility strategy. These activities help to raise the profile of tobacco companies, enhance their reputations, and support the ‘normalisation’ of the industry.167

Background

Parties to the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) have an obligation to protect public health policies from the “commercial and vested interests of the tobacco industry” and any contact with tobacco industry representatives, or others seeking to further their interests, must be “limited” and “transparent”.8 The implementation guidelines to Article 5.3 of the WHO FCTC recommend that Parties limit interactions with the tobacco industry to those that are absolutely necessary to regulating the industry, and ensure the transparency of those interactions that do occur.8  The guidelines also recommend parties treat state-owned tobacco companies in the same way as any other tobacco company, including avoiding any “preferential treatment”.8

In addition, the guidelines state that “… Whenever possible, interactions should be conducted in public, for example through public hearings, public notice of interactions, disclosure of records of such interactions to the public”.8

However even in countries with a high level of compliance with the WHO FCTC requirements, diplomatic missions rarely achieve this level of transparency. Information on tobacco industry engagement has largely been found through media investigations and Freedom of Information requests (FOIs).

In October 2014, the 6th Conference of the Parties (COP) decided to urge parties: “to raise awareness and adopt measures to implement Article 5.3 and its implementing Guidelines among all parts of government including diplomatic missions.”9 Another decision required governments to “take into account their public health objectives in their negotiation of trade and investment agreements”.10

Nevertheless, diplomats continue to lobby for tobacco companies around the world.1

Countries whose diplomatic representatives have lobbied on behalf of tobacco companies overseas  include the UK, Germany and Japan, who are all Parties to the WHO FCTC,11 as well as the United States and Switzerland. BAT, PMI and Japan Tobacco all have offices in Geneva, Switzerland, the location of the World Health Organization and other key international bodies.

UK

There are specific guidelines covering the engagement of British (UK) officials working overseas designed to limit contact with tobacco companies, and support compliance with Article 5.3. After the UK Ambassador to Panama lobbied on behalf of British American Tobacco (BAT),12 the guidelines were revised in 2013.13 These guidelines state that “Posts must not…Engage with local foreign governments on behalf of the tobacco industry, except in cases where local policies could be considered protectionist or discriminatory”.13

Engagement and lobbying

Despite having guidelines in place to support compliance with the WHO FCTC, FOI requests and media investigations have revealed that British diplomats continue to interact with the tobacco industry more than is necessary. UK diplomats have lobbied for BAT in Bangladesh,1415 Hungary,16 and Pakistan.1217181920

UK officials have also disclosed contact with tobacco companies in Panama and Venezuela,2122 Laos,23 Cuba,24 and Burundi.25

In 2018, UK advocacy organisation Action on Smoking & Health (ASH) called this a “global pattern of engagement” by British officials to defend BAT’s interests.26

Tobacco industry events

UK government guidelines state that staff must not:

“Attend or otherwise support receptions or high-profile events, especially those where a tobacco company is the sole or main sponsor and/or which are overtly to promote tobacco products or the tobacco industry (such as the official opening of a UK tobacco factory overseas)”.13

However, UK staff have attended such events, generating considerable local media coverage.

For example, in 2019 the British ambassador to Yemen opened a cigarette factory in a free trade zone in Jordan, celebrating the expansion of the tobacco company Kamaran which is part-owned by BAT.1272829

In 2020, staff from the UK high commission in Pakistan attended a promotional event for a BAT product in Pakistan.30

  • See UK Diplomats Lobbying for BAT for details.

Engaging with industry allies

The links between diplomatic missions and tobacco companies can be more indirect, via funding third party allies of the industry. The UK guidelines state that diplomats should not “endorse projects which are funded directly or indirectly by the tobacco industry”.  However, a 2019 investigation by The Guardian found that the British high commission in Malaysia had given funding to a Kuala Lumpur based think tank (IDEAS) for several years. At the same time the think tank was also receiving money from tobacco companies and was lobbying against plain packaging regulation and tobacco taxes.31  While the UK had already implemented plain packaging regulations, tobacco control was being undermined overseas.

Attending meetings with the tobacco industry

Tobacco companies attend meetings and events organised directly by UK government departments, such as the FCO (now FCDO) or the DIT (now Department for Business and Trade).21  They also attend those held by regional, national or local business organisations such as chambers of commerce.

Responses to FOI requests show that when the attendance of UK government officials at such events is disclosed, there is little detail about the specific purpose or content of these meetings,1416 It may simply be described as relating to ‘doing business’ in the country.22

Business vs public health interests?

The UK guidelines for overseas staff (last updated in 2013) allow for the communication of “basic trade, investment and political information”, although this is not defined.13 One of the activities used to justify interaction by UK diplomats is “resolving business problems that are potentially discriminatory”.1214163233 This has been criticised as running counter to the WHO FCTC guidelines.134

While transparency is required for tobacco industry interactions in 2018, the UK government told Parliament that it “does not catalogue the representations it makes on behalf of companies”.353637  Research by the Tobacco Control Research Group (TCRG) concluded that the stated WHO FCTC goal of “maximum transparency” is not being achieved in the UK.129

Japan

In 2021, the Ambassador of Japan to Bangladesh lobbied the government of Bangladesh on behalf of Japan Tobacco International (JTI).  In a letter to the Bangladesh Finance Minister the Ambassador criticised 2019 taxation changes for their impact on JTI. It also complained about the activities of competitors, and licensing demands.38

  • For details, including the lobbying letter, see Japanese Diplomats Lobbying for JTI

The Japanese Ambassador to Ethiopia was present at the signing of a deal between the Ethiopian government and JTI in 2016,  when the Ministry of Public Enterprise sold 40% of its National Tobacco Enterprise to the Japanese company.39 Japanese diplomats have also toured tobacco farms and JTI factories in Tanzania and Zambia.4041

Japan Tobacco International is the overseas subsidiary of Japan Tobacco (JT), which is one third-owned by the Japanese government.42

Germany

In May 2022, the German ambassador to Beirut visited the offices of Regie, the Lebanese Tobacco and Tobacco Inventory Administration.143

Denmark

The Imani Centre for Policy and Education, a Ghana-based think tank,  received money from the Danish embassy while lobbying against tobacco control.3144

Switzerland

Switzerland is not Party to the WHO FCTC.

In 2019, Swiss diplomats approached the government of the Republic of Moldova on behalf of Philip Morris International (PMI) seeking an opportunity to discuss new tobacco legislation.454647  The proposed legislation included significant tax increases on heated tobacco products, in which PMI has invested.4548

The same year, PMI helped fund an inaugural event for the new Swiss Embassy in Moscow.4950

USA

Although the US is not Party to the WHO FCTC, it has specific laws and guidance that prohibit its diplomats from promoting the sale or export of tobacco, or influencing non-discriminatory restrictions on tobacco marketing.51525354 However, US diplomats have enabled meetings between tobacco companies and government representatives.

The US ASEAN Business Council organises delegations of US businesses, including Philip Morris International (PMI), which meet high level officials in the ASEAN region.51  PMI was at the time a vice chair of its Customs & Trade Facilitation Committee and used this opportunity to meet with government officials from the Ministry of Industry and Trade of Vietnam.5155

Why it matters

The examples above illustrate contraventions of the WHO FCTC, an international treaty, and in many cases breaches of national guidelines. As TCRG research points out, all of these activities also undermine the spirit of these laws, by apparently serving the commercial interests of transnational tobacco companies and helping to ‘normalise’ the industry in the eyes of policy makers and the public.1

The implementation guidelines of Article 5.3 urge Parties to exclude the tobacco industry completely from the public health policy arena.  The guidelines also urge them not to participate in corporate social responsibility (CSR) activities which are used by the tobacco industry and as an alternative means to access policy makers, as well as for public relations and product promotion.1

In August 2019, in direct response to the exposure of lobbying by Swiss diplomats, the WHO released a statement urging governments to comply with Article 5.3 and to “proactively aspire to reduce the number of people starting and continuing smoking, to promote health and preserve future generations”.56

TobaccoTactics Resources

TCRG Research

A “willingness to be orchestrated”: Why are UK diplomats working with tobacco companies?, R. Alebshehy, K. Silver, P. Chamberlain, Frontiers in Public Health, 17 March 2023, Sec. Public Health Policy, Volume 11 – 2023, doi: 10.3389/fpubh.2023.977713

For a comprehensive list of all TCRG publications, including TCRG research that evaluates the impact of public health policy, go to the Bath TCRG’s list of publications.

References

  1. abcdefghiR. Alebshehy, K. Silver, P. Chamberlain, A “willingness to be orchestrated”: Why are UK diplomats working with tobacco companies?, Frontiers in Public Health, 17 March 2023,
    Sec. Public Health Policy, Volume 11 – 2023, doi: 10.3389/fpubh.2023.977713
  2. World Bank, The World By Income and Region, website, accessed February 2023
  3. A. B. Gilmore, G. Fooks, J. Drope et al, Exposing and addressing tobacco industry conduct in low-income and middle-income countries, Lancet, 2015, Mar 14;385(9972):1029-43. doi: 10.1016/S0140-6736(15)60312-9
  4. A. Gilmore, Big tobacco targets the young in poor countries – with deadly consequences, The Guardian, December 2015, accessed May 2023
  5. Action of Smoking and Health, Tobacco and the Developing World, ASH factsheet, 2019
  6. S. Ulucanlar, G.J. Fooks, A.B. Gilmore, The Policy Dystopia Model: An Interpretive Analysis of Tobacco Industry Political Activity, PLoS Medicine, 2016, 13(9): e1002125, doi:10.1371/journal.pmed.1002125
  7. B.K. Matthes, K. Lauber, M. Zatoński, et al, Developing more detailed taxonomies of tobacco industry political activity in low-income and middle-income countries: qualitative evidence from eight countries, BMJ Global Health, 2021;6:e004096, doi: 10.1136/bmjgh-2020-004096
  8. abcdWorld Health Organization, Guidelines for implementation of Article 5.3 of the WHO Framework Convention on Tobacco Control, 2008
  9. World Health Organization, FCTC/COP6(14) Protection of public health policies with respect to tobacco control from commercial and other vested interests of the tobacco industry, 18 October 2014
  10. World Health Organization, FCTC/COP6(19) Trade and investment issues, including international agreements, and legal challenges in relation to implementation of the WHO FCTC, 18 October 2014
  11. United Nations, Chapter IX Health, 4. WHO Framework Convention on Tobacco Control, treaty record and status
  12. abcK. Stacey, K. Shubber, UK accused over cigarette lobbying abroad. Financial Times, 7 April 2015
  13. abcdDepartment of Health, United Kingdom’s revised guidelines for overseas posts on support to the tobacco industry, December 2013, accessed February 2023
  14. abcDepartment of International Trade, Freedom of Information Act 2000 Request Ref: 1042-17, 29 December 2017
  15. J. Doward, British diplomat lobbied on behalf of big tobacco, The Guardian, 10 September 2017, accessed June 2018
  16. abcForeign & Commonwealth Office, Freedom of Information Act 2000 Request Ref: 1045-17, 8 January 2018
  17. BAT team asks govt to withdraw decision, The Nation, 20 March 2015, accessed June 2015
  18. J. Owen, Health Experts Demand Foreign Office Apology After They Attend Meeting Lobbying for Tobacco Company with Pakistani Ministers, The Independent, 9 April 2015, accessed April 2022
  19. Pakistan: British High Commissioner Lobbies for Tobacco Industry, Worldwide News and Comments, Tobacco Control, 2015;24:213-216
  20. STOP/Vital Strategies, Crooked Nine: Nine Ways the Tobacco Industry Undermines Health Policy,  New York, September 2019. Available from exposetobacco.org
  21. abJ. Doward, UK accused of hypocrisy on overseas tobacco control, The Guardian, 27 January 2018, accessed June 2018
  22. abForeign & Commonwealth Office, FOI release: contact with tobacco manufacturers in Venezuela, June 2018, accessed July 2018
  23. Foreign & Commonwealth Office, Freedom of Information Act 2000- Request Ref: 1047-17, 1 December 2017
  24. Foreign & Commonwealth Office, FOI release:contact with tobacco manufacturers in Cuba, 18 May 2018, accessed June 2018
  25. Foreign & Commonwealth Office, FOI release: contact with tobacco manufacturers in Rwanda and Burundi, 15 May 2018, accessed June 2018
  26. Action on Smoking and Health, How British diplomats have defended BAT’s overseas activities, ASH website, 26 April 2018, accessed June 2018
  27. Kamaran, The opening of Kamaran factory in Jordan [in Arabic] 9 December 2019, accessed June 2022
  28. Yemen-TV, Follow-ups – The opening of the Kamaran factory in Jordan 12-12-2019, accessed December 20195758Tobacco Control Research Group, Are diplomats promoting tobacco over public health? Press release, 20 March 2023, accessed March 2023
  29. abM. Safi, UK ambassador to Yemen took part in opening of Jordanian cigarette factory, The Guardian, 19 March 2023, accessed March 2023
  30. Foreign, Commonwealth & Development Office, Freedom of Information Act 2000 – request ref: FOI2021/01726, 23 February 2021
  31. abJ. Glenza, How diplomatic missions became entangled with the tobacco industry, The Guardian, 24 January 2019, accessed April 2022
  32. Hansard, Parliament debate, UK Parliament website, Hansard column 334, 18 May 1999, accessed June 2018
  33. House of Commons, Diplomatic Service: Tobacco: Written question 105761, UK Parliament website, 6 October 2017, accessed June 2018
  34. D. Arnott, Britain’s shame in Panama: Trade interests allowed to trump health, FCA_Daily_Bulletin_Issue_111, 29 March 2012, accessed January 2021
  35. House of Lords, Tobacco: Written question HL5324, UK Parliament website, 1 February 2018, accessed June 2018
  36. House of Commons, Diplomatic Service: Tobacco: Written question 105761, UK Parliament website, 6 October 2017, accessed June 2018
  37. House of Commons, Tobacco: Written question 127795, UK Parliament website, 8 February 2018, accessed June 2018
  38. I. Noki, Ambassador of Japan, Re: Japan International’s (JTI) Landmark Investment in Bangladesh and Repeated Challenges Posed Due to Policy Shifts and Anti-Competitive Activities, Letter from Ito Noki to Finance Minister Mustafa Kamal, 19 January 2021
  39. Japan Tobacco Seals $510m Monopoly Shares Deal, Addis Fortune, 19 July 2016, archived July 2016, accessed October 2022
  40. Embassy of Japan in Tanzania, Ambassador visiting Tanzania Cigarette Company, Facebook post, 6 November 2015, accessed October 2022
  41. Embassy of Japan in the Republic of Zambia, Press Tour on Japan’s Development Assistance in Zambia, press release, 29 March 2017, archived July 2017, accessed October 2022
  42. M. Nakamoto, Japan to raise up to $10bn from tobacco share sale, Financial Times, 25 February 2013, accessed May 2023
  43. Lebanese Tobacco and Tobacco Inventory Administration (Reggie), The visit of the German ambassador to the Regie, website, 18 May 2022, archived 24 May 2022, accessed June 2022
  44. Think tank database, The Guardian, 23 January 2019, accessed March 2023
  45. abE. Bluulle, D. Buhler, Diplomatie im Dienst des Weltkonzerns, Republik, 31 July 2019, accessed August 2019
  46. R. Etwareea, La diplomatie Suisse, entremetteur pour Philip Morris (Paywall), Le Temps, 9 August 2019, accessed August 2019
  47. Philip Morris Row: Swiss diplomats placed request for tobacco firm in Moldova, Swissinfo.ch, 11 August 2019, accessed August 2019
  48. F. Nedzelschi, Lobby sau ba? În pragul votării unei legi care ar scumpi și ar restricționa produsele IQOS apar articole și petiții care o condamnă. Explicațiile companiei, Agora, 02 July 2019, accessed August 2019
  49. Ministry rebuked for taking tobacco money, Swissinfo.ch, 22 July 2019, accessed August 2019
  50. Opening of Swiss embassy in Moscow sponsored by Russian oligarch, Swissinfo.ch, 20 July 2019, accessed August 2019
  51. abcSouth East Asia Tobacco Control Alliance (SEATCA), Vietnam: Philip Morris used US-ABC & US Embassy to access top Vietnamese officials, website, 17 March 2017, accessed June 2022
  52. U.S. Government, Doggett Amendement, 17 January 2014, available from tobaccocontrollaws.org
  53. U.S. Government, Executive Order 13193: Federal Leadership on Global Tobacco Control and Prevention, 18 January 2001, available from govinfo.gov
  54. U.S. Government, Guidance for U.S. Diplomatic and Consular Posts on Trade and Commercial Issues, 2009, available from tobaccocontrollaws.org
  55. US-ASEAN Business Council, Customs and Trade Facilitation, website, undated, archived April 2017, accessed June 2020
  56. World Health Organisation, WHO statement urging governments to ban tobacco advertising, promotion and sponsorship at international expositions, WHO press release, 15 August 2019, accessed March 2021

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Flavoured and Menthol Tobacco in LMICs https://tobaccotactics.org/article/flavoured-and-menthol-tobacco-in-lmics/ Wed, 27 Apr 2022 12:44:13 +0000 https://tobaccotactics.org/?post_type=pauple_helpie&p=12393 Key Points Menthol and flavoured cigarettes are widely available in low and middle-income countries (LMICs) many of which have high smoking rates LMICs have young populations – flavours appeal to young people, who may not understand the harms of flavoured tobacco Recently high-income countries have put bans in place; at the same time there has […]

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Key Points
  • Menthol and flavoured cigarettes are widely available in low and middle-income countries (LMICs) many of which have high smoking rates
  • LMICs have young populations – flavours appeal to young people, who may not understand the harms of flavoured tobacco
  • Recently high-income countries have put bans in place; at the same time there has been marked growth of menthol market share in some LMICs
  • There is a lack of regulation to reduce the appeal of flavours e.g. plain packs and advertising bans at point-of-sale or near schools
  • Targets for new and improved bans include flavour capsules, and flavour references on packaging and cigarette sticks
  • A ban on all flavourings may be easier and more effective in preventing product substitution
  • A lack of data, especially in low-income countries, hinders the development of good regulation
  • Multinational tobacco companies can threaten income from tobacco exports if governments attempt to put tobacco controls in place

This page covers flavoured tobacco, including menthol cigarettes, in low and middle-income countries (LMICs).6162

Background

Flavoured tobacco products are available in various forms around the world, including products previously only used in particular regions or countries. For example in Indonesia, the vast majority of smokers use kretek, clove-flavoured cigarettes,6364 and they are now available in other countries.6566

Flavoured tobacco is used in waterpipe, a device which originated in middle-eastern countries and is increasingly popular elsewhere, including among young people.67

Here we focus on what are often called ‘conventional’ products, like cigarettes and cigarillos, which are sold by large transnational tobacco companies (TTCs): Philip Morris International (PMI), British American Tobacco (BAT), Imperial Brands (IMB, previously Imperial Tobacco) and Japan Tobacco International (JTI) (JTI also owns Nakhla in Egypt, which produces flavoured waterpipe) We summarise findings from Tobacco Control Research Group (TCRG) research on the extent of flavoured and menthol cigarette use in LMICs and the development of the market for ‘capsule’ products (cigarettes with flavour capsules in the filter).

We describe specific challenges for LMICs, including flavour regulation and evidence gathering. We then summarise flavour market evidence and research, first relating to LMICs in general and then by World Health Organization (WHO) region and individual countries (where available).

  • For general background and evidence, including information on the global market, and details of specific bans and associated industry interference, see Flavoured and Menthol Tobacco.

For details of product regulation at country level, see the searchable database on the Tobacco Control Laws website, published by the Campaign for Tobacco Free Kids (CTFK). For countries that are parties to the WHO Framework Convention on Tobacco Control (FCTC) progress towards implementation of relevant articles, including newer products, is detailed in the FCTC implementation database

Specific challenges for LMICs

LMICs with no ban often have other major tobacco control policy gaps that are not necessarily menthol/flavour related but worsen the negative impact of menthol/flavours.68 One such policy is plain, or standardised, packaging,  which can include restrictions on flavour descriptors as well as colours on packaging which are known to signify flavour (e.g. green for menthol).69 However, plain packaging policies have yet to be implemented in many countries, including some high-income countries, so this would be a significant challenge in LMICs. Another relevant policy is the prohibition of marketing, especially near schools.70

Governments have more conflicts of interest in tobacco growing areas as they receive much needed foreign currency for tobacco exports,  and multinational companies can threaten this income stream if governments attempt to put tobacco controls in place.6871  However, apart from rare exceptions the tobacco industry contributes little overall to the balance of payments.7273

Regulatory challenges

The WHO published brief guidance on the regulation of menthol and flavoured tobacco which summarised some regulatory options including restrictions on: the sale of menthol branded products,  the use of menthol at noticeable levels (giving a ‘characterising flavour’),  or banning any menthol ingredients.74  The report points to likely opposition from the tobacco industry in countries or regions with an established menthol market.74 This was the case with the European Union (EU) menthol ban which only came into full force in 2020, after the tobacco industry had successfully lobbied for a delay. Testing for characterising flavour is more difficult and expensive than a ban on ingredients; this makes banning menthol as an ingredient particularly efficient for LMICs.

The WHO noted that:

“A ban on all flavour agents that increase tobacco product attractiveness, rather than focusing on menthol exclusively, can provide an alternate route to restricting menthol, and may prevent the unwanted introduction of menthol substitutes.”74

Research and data

As of 2021, when TCRG researchers conducted a review of evidence on menthol/flavour in LMICs,75 there were very few research papers from countries in Eastern Europe, the Eastern Mediterranean region, and Africa.

Lack of data means that it is hard to monitor markets and company shares in specific countries.  Market research service Euromonitor (which receives project funding from Philip Morris International) includes no low-income countries and is proprietary, making it expensive and hard to access even for the middle-income countries which are included.

More research is needed on menthol and flavour in LMICs to help governments monitor the tobacco industry and its products, as recommended by the WHO: “An evidence base using data collected from the region of interest can provide more direct support for regulation.”74

Market in LMICs

Evidence suggests menthol and flavoured tobacco products are widely used in LMICs.  Data from the International Tobacco Control (ITC) Policy Evaluation Project suggests that menthol is smoked by more than 20% of smokers in several middle-income countries. Although the dates vary (see the note above on data challenges) this research gives an indication of the scale of the problem. The highest rates were found in Zambia (42% in 2014) and Thailand (35% in 2012). Kenya and India also had over 20% menthol smokers, with China just under just under that level.76

A study from Johns Hopkins University, between 2015 and 2017, found a range of flavoured and capsule cigarettes on the market in those LMICs with the highest number of smokers: Bangladesh, Brazil, China, India, Indonesia, Philippines, Russia, Thailand, and Vietnam.77

The main TTCs operating in these countries (PMI, JTI, and BAT) mostly sold menthol or mint flavours. China National Tobacco Corporation (CNTC) sold  a mix of flavours.77

There is also evidence from a number of studies that menthol and flavour tobacco use is rising, either as a proportion of the market or substantively.  Evidence from TCRG research shows that after the implementation of the European Union (EU) menthol ban in 2020, there was a marked increase in the share of menthol/flavoured products in some LMICs.75 A study of cigarette packs in Brazil, Indonesia, the Philippines, Russia, Thailand, and Vietnam, between 2013 and 2016, found that the number of flavour capsule variants on the market was growing.78 Most were mint and menthol flavour but with others the flavour was unclear from the product name.78

A number of studies have identified related marketing activities.  Marketing strategies for flavour capsules are likely driving their global growth particularly among young people in LMICs.79

TCRG’s review  of tobacco industry strategies underpinning the growth of menthol/flavoured tobacco use in LMICs  highlighted widespread marketing in stores (including retailers near schools), on billboards, on TV, online and via brand ambassadors. The packaging of flavoured and menthol products, legally displayed in stores, was  found to be colourful with non-conventional, appealing names for flavours.75

Tobacco companies also use symbols on cigarette sticks to indicate that they contain capsules.80 Researchers studying this form of marketing in LMICs have described the space on a cigarette as “valuable communicative real estate” for tobacco companies, which could be better used to display public health messages.80

 

Research and data from specific regions and countries is summarised below. We refer in many places to TCRG research based on 2019 cigarette market data from Euromonitor. In this data ‘high market share’ means 20% or more of the total cigarette market in that country in 2019. ‘High market share growth’ means that the share doubled between 2005-19 and was growing from 2017.75 We link to regional and country profile pages on TobaccoTactics, where available.

Africa

Nigeria has high menthol/flavour market share and high market share growth.75

Cameroon has high market share, the only other country in the region for which this data was available. (For Egypt see Eastern Mediterranean region below.)75

Tanzania

JTI sells a menthol cigarette called Sweet Menthol through its subsidiary in Tanzania. It describes this product as “the leading local mainstream menthol brand”.81

Zambia

JTI owned brand Sweet Menthol is the third most popular cigarette in Zambia.  It is cheap and is usually sold as single sticks.82  On its webpage for Zambia, JTI describes itself  as a leaf farming company, and does not mention that it sells cigarettes in the country. A locally owned company, Roland Imperial,  also sells menthol cigarette brands.83

ITC survey data showed a high prevalence of menthol smokers in Zambia, with 43% of smokers choosing the product.84 Menthol was most commonly used among younger smokers, those with a middle income, and those that don’t smoke every day. Over a third of smokers indicated that they thought menthol cigarettes were less harmful than non-menthol.84

Kenya

ITC survey data from Kenya also suggests a high prevalence of menthol smokers.8485 In 2018, 21% of smokers with a regular cigarette brand smoked menthol or sweet menthol (although Euromonitor estimates that only 7% of cigarette sales are menthol).75  More women smoke menthol than men in Kenya, and two thirds of smokers believed that menthol is less harmful than other cigarettes.8485

Ethiopia

In 2015, Ethiopia enacted a total flavour ban on all forms of tobacco.

This was a pre-emptive ban as flavour sales were low. However there has been a lack of enforcement at the retail level.68 Flavoured products are not made in Ethiopia and more collaboration with customs is needed to prevent illicit importation.68 There is also a lack of awareness that the ban includes waterpipe products.74

Since 2017, two years after the ban was enacted, JTI has owned 70%  the state owned tobacco company, NTE.86

Latin America

Menthol cigarettes are popular in Latin America, and increasingly so in some countries.75 Guatemala and Peru have high market share and high market share growth. There is high market share in Columbia and the Dominican Republic, and high market share growth in Argentina, Bolivia and Costa Rica.75

Use of flavour capsule cigarettes is particularly high in Chile and Mexico.87  According to BAT’s annual report in 2014,  sales of  flavour capsule cigarettes had increased in the region despite price rises, while overall cigarette sales were down.88

A study of over 1,000 retailers located close to schools in Latin American cities (Argentina, Bolivia, Brazil, Chile and Peru) found that the majority (85%) sold flavoured cigarettes, and most (71%) sold capsule versions.70 (Similar findings were reported in Uruguay, a high income country, immediately before the implementation of plain pack regulations in 2020.)89

These products were frequently displayed near the point of sale, or confectionary. Some stores also had advertisements and price promotions.70 Unconventional flavour descriptors such as “fusion blast” and “ruby ice” were very common.90

Brazil

Survey data from 2016-2017 among adult smokers in Brazil found that over 50% supported a ban on menthol and over 60% supported a ban on all additives.91 Support did not vary across sociodemographic groups. When menthol smokers were asked what they would do if menthol cigarettes were banned, a third reported they would quit, around 20% would reduce the amount they smoked and a similar number would switch to non-menthol cigarettes. Slightly fewer said they would still find a way to get menthol cigarettes.91

ITC survey data from the same period suggested that 8% of smokers with a regular cigarette brand smoked menthol.92 13% believed that menthol cigarettes were less harmful than non-menthol cigarettes, and over a third reported that they were smoother on the throat and chest.  Nearly two thirds  of surveyed smokers supported a complete ban on all cigarette additives, including flavourings.92

An online sample of women aged 16- 26 (smokers and non-smokers) preferred packs with flavour descriptors.93

Chile

In 2013, Chile sought to implement a law banning substances that cause higher levels of addiction, harm or risk, leading to tobacco industry resistance and interference.74

Mexico

Studies of retailers in Mexican cities, found that the majority sold menthol and flavoured products, and more than half of stores situated near schools sold flavour capsule cigarettes.9495 Many flavoured cigarettes have descriptors which suggest there is a flavour, but the type of flavour is unclear: chemical analysis of dual flavoured cigarettes suggested flavours were menthol and another flavour, for example fruit.96

A study in Mexico City found that colour and flavour descriptors on cigarette packs made the products more appealing, and some smokers believed they would taste better.97

Guatemala

A study of convenience store retailers in Guatemala found that all sold flavoured tobacco products.98

The majority (88%) of indoor tobacco advertisements in Guatemala were found to be for capsule cigarettes.98

South East Asia & Western Pacific

There is high market share of menthol/flavour in India, Malaysia, Philippines and Thailand, and high market share growth in Vietnam.75  A 2010 study noted that governments in the region had no legislation banning exotic flavours of cigarettes and cigarettes with new flavours had appeared in Cambodia, Indonesia, Malaysia and the Philippines.99

Philippines

Menthol has been advertised to appeal to young women in the Philippines since the 1970s with menthol brands common for many decades.100 PMI, JTI, BAT and Korea Tobacco & Ginseng (KT&G) all sell flavoured capsule cigarettes in the Philippines.101

Menthol packs studied in the Philippines were harder than non-menthol (for capsule protection) giving a quality feel. Flavoured capsule brands had a greater technological appeal,101 and packs were rated as more attractive by young adults.102

Blue and white packs were perceived to be less harmful than other colours, as were the descriptors ‘light’ and ‘cool’, whereas the term ‘strong’ was perceived as more harmful.102  Researchers called for greater action and support for banning flavour additives.

Malaysia

In Malaysia, menthol cigarette marketing has been aimed at young people and women.  In the 1980s Brown and Williamson’s Newport menthol cigarettes were marketed in Malaysia with youthful American images and were sold at a cheap price point.103 An internal document from 1993 reveals how the company was developing sweet and fruit flavours for the Malaysian market. 103104 A 2003 study noted that the menthol variant of Cartier Vendome (a BAT brand at the time) was described as ‘pearl tipped’ so likely to appeal to women.105

In 2013, vanilla, mint and fruit flavoured cigarettes were on sale, and strawberry cigarette packs with pink packaging were documented.106

China

In China ‘flavour capsule’ was found to be one of the most common cigarette terms used in online tobacco marketing.  One website explicitly linked flavour capsules with female smokers.107

Indonesia

In Indonesia the dominant cigarettes are kreteks which are flavoured with cloves.  Industry attempts to introduce their own cloved flavoured products had failed at least to 2004.108  In 2009 PMI and BAT acquired two domestic manufacturers which allowed them access to the kretek market.109 In 2009 PMI launched the first super slims kretek for women and Marlboro black menthol for young men.  By 2012 BAT had launched several kretek brands. Both companies were aware that kreteks  are particularly carcinogenic due to the presence of toxic chemical compounds: Anethole, Coumarin and Eugenol.109

In Indonesia the flip lid of the cigarette packet was used by Esse (owned by Korean Tobacco & Ginseng, KT&G) to promote the brand with phrases evoking flavour, like “sweet surprise” and “its honey”.  Research found seven cigarette brands with capsules.  Flavours included mint, menthol, berry and honey.110

Eastern Mediterranean

There is high market share growth in in Pakistan and Egypt .75

  • See also Waterpipe for information on the role of flavours in promoting these products.

Eastern Europe

Data shows that in Russia menthol/flavour has both a high market share and high market share growth.75

Other LMICs in the region with high market share growth are Ukraine, Bosnia Herzegovina, Belarus, Azerbaijan, Kazakhstan and Uzbekistan.75

Relevant Links

WHO Advisory note: banning menthol in tobacco products (2016)

WHO Case studies for regulatory approaches to tobacco products: menthol in tobacco products (2018)

WHO FCTC decision on banning waterpipe flavour (2016)

A global map of menthol bans is available on Tobacco Atlas: Product Sales

TobaccoTactics Resources

TCRG Research

A growing menace: menthol and flavoured tobacco products in LMIC, M. Zatonski, K. Silver, S. Plummer, R. Hiscock, Tobacco Induced Diseases, 2022;20(April):39, doi:10.18332/tid/146366
STOP research summary (May 2022)

Marketing of flavour capsule cigarettes: a systematic review, C. Kyriakos, M. Zatonski, F. Filippidis, Tobacco Control, Published Online First: 18 January 2022, doi: 10.1136/tobaccocontrol-2021-057082[/ref]

Flavour capsule cigarette use and perceptions: a systematic review, C.N. Kyriakos, M.Z. Zatoński, F.T. Filippidis, Tobacco Control, Published Online First: 04 October 2021, doi: 10.1136/tobaccocontrol-2021-056837

For a comprehensive list of all TCRG publications, including research that evaluates the impact of public health policy, go to TCRG publications.

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