Image source: Nathan Hughes Hamilton/CC BY 2.0 DEED

Key Points

• Indonesia is a country in Southeast Asia, part of the World Health Organization’s South-East Asia Region.
• It is the fourth most populous country in the world, with a population in 2022 of 275.5 million.
• Tobacco use prevalence is high, particularly amongst men. 34.5% of all adults were current tobacco users in 2021, including 65.5% of men.
• Indonesia has neither signed nor ratified the World Health Organization Framework Convention on Tobacco Control. As a non-party, it is ineligible to join the Protocol to Eliminate Illicit Trade in Tobacco Products.
• The Indonesian tobacco market is dominated by local manufacturers PT Gudang Garam Tbk and PT Djarum, as well as Philip Morris International.
• Recent tobacco industry tactics in Indonesia include the use of third parties; the targeting of youth with tobacco marketing, both at point of sale and online, as well as via event sponsorship; and sponsorship of popular sports such as badminton and football.

According to the authors of a 2023 paper, “Indonesia has a high smoking prevalence that has not diminished significantly since 1990”. This has been driven by male smoking rates which remain amongst the highest in the world.¹² It is the only country in Asia to have neither signed nor ratified the World Health Organization Framework Convention on Tobacco Control (WHO FCTC),³ and nor is there any comparable national framework for tobacco control.¹ Industry interference in policymaking is ongoing, as there is no effective legal mechanism to prevent it.⁴⁵ Smoking has long been a part of Indonesian culture, particularly for men, something which tobacco companies have exploited through aggressive marketing tactics that aim to reinforce smoking as a normal or even essential masculine behaviour.⁵⁶ This high degree of social acceptability means that the government treats the industry as a legitimate stakeholder.⁷ One key challenge, therefore, is to de-normalise tobacco use, as part of a comprehensive tobacco control plan.⁷⁸

Tobacco Use in Indonesia

The link between smoking and masculinity is deeply embedded within Indonesian culture.⁸⁹ This has been reinforced by tobacco marketing which associates tobacco products with characteristics traditionally considered masculine, such as strength, heroism and self-control.⁸⁹

In 2021, tobacco use prevalence amongst adults was 34.5%; 70.2 million adults were current users of tobacco.¹⁰ Nearly two-thirds (65.5%) of Indonesian men reported using tobacco, compared to around 3% of women.¹⁰

In 2019, nearly 20% of students aged from 13 to 15 reported tobacco use.¹¹ Around 36% of males in this age group reported current tobacco use compared to 3.5% of females.¹¹

Kreteks – cigarettes consisting of tobacco, cloves and flavourings such as chocolate, dried fruit and coffee – are by far the most popular tobacco product in Indonesia. According to government figures from 2017, kreteks accounted for more than 95% of the cigarettes sold that year.¹² The cloves provide a unique flavour and smell, and also contain eugenol, a chemical compound which reduces the harshness of the smoke.¹³ In 2021, close to 30% of all Indonesian adults – around 60 million of the country’s 70 million adult tobacco users – reported smoking kreteks.¹⁰

There were an estimated 246,000 deaths attributable to smoking in 2019, accounting for nearly 15% of all mortality in Indonesia that year.¹⁴ Research published in 2022 estimated the total cost of smoking to the Indonesian economy in 2019 at between Rp184.36 trillion (US$13 billion) and Rp410.76 trillion (US$29 billion).¹⁵ The same study found that direct healthcare costs accounted for between Rp17.9 trillion (US$1.3 billion) and Rp27.7 trillion (US$2 billion), most of which is covered by the Social Security Agency for Health, equivalent to 57-59% of total direct expenditure on healthcare.¹⁵

Tobacco in Indonesia

Market share and leading brands

In 2022, market research company Euromonitor International put the value of the Indonesian tobacco market at over US$34 billion.¹⁶ It is the second-largest cigarette market in the world.¹⁷

The market leader in Indonesia is the local kretek manufacturer PT Gudang Garam Tbk (Gudang Garam), with nearly one-third of the market in 2022.¹⁸¹⁹

Its closest competitor is Philip Morris International (PMI), with a slightly smaller share.¹⁸ PMI operates in Indonesia via its subsidiaries PT Philip Morris Indonesia and PT HM Sampoerna Tbk (Sampoerna).¹⁸²⁰ At the time of its acquisition by PMI in 2005, Sampoerna was the leading tobacco company in Indonesia.²⁰²¹

PT Djarum (Djarum), another local kretek producer, has the third-largest market share, around half that of the two leading companies.¹⁸²²

Like PMI, other transnational tobacco companies have sought to expand into Indonesia by acquiring local companies. In 2009, British American Tobacco (BAT) bought an 85% stake in PT Bentoel Internasional Investama Tbk (Bentoel) – at the time the fourth largest tobacco company in the country.²¹ In 2011, the South Korean company Korea Tobacco & Ginseng (KT&G) – which has a partnership with PMI for its newer nicotine and tobacco products – bought a controlling share of Indonesia’s sixth-largest tobacco company, PT Trisakti Purwosari Makmur.²¹²³ Similarly, Japan Tobacco International (JTI) acquired two Gudang Garam subsidiaries, Karyadibya Mahardhika and its distributor, PT Surya Mustika Nusantara, in 2017.²¹ However, BAT, JTI and KT&G each had market shares of less than 2% as of 2022.¹⁸

In 2022, the top four brands of cigarette in Indonesia were all kreteks. Gudang Garam has around one-third of the market. Djarum, A Mild and Dji Sam Soe (the latter two both PMI/Sampoerna brands) each have around a one-tenth share. Others, including PMI’s premium cigarette Marlboro, have smaller shares.²⁴

• For more information on the tobacco industry in Indonesia, see the Tobacco Supply Chain Database.

Tobacco farming and child labour

Tobacco is grown in Indonesia almost entirely on small, family-run farms, and 90% of production comes from just three provinces: East Java, Central Java, and West Nusa Tenggara.²⁵

In 2021, Indonesia reported production of over 237,000 tonnes of raw tobacco, making it the fourth largest producer in the world after China, India and Brazil.²⁶ Production has varied since 2010, from a low of less than 127,000 tonnes in 2016 to a high of nearly 270,000 tonnes in 2019. However, the overall trend in recent decades has been upwards, as shown in the graph below:

Figure 1: Tobacco production, 1980 to 2021.²⁷ Source: UN Food and Agriculture Organization/Our World in Data | CC BY

The area harvested under tobacco crop also increased by over 30% between 2000 and 2020, to nearly 220,000 hectares.²⁸

A 2017 report by the World Bank found that poverty was widespread amongst tobacco farmers in Indonesia. Nearly three-quarters of tobacco farmers were poor compared to around one-tenth of the general population.²⁹ Most tobacco-farming households received some form of government social assistance, and more than 60% reported food insecurity.²⁹

Research published in 2020 found that Indonesian tobacco farmers would be better off economically if they grew other crops or pursued alternative, non-agricultural livelihoods.³⁰ Tobacco is also vulnerable to adverse weather conditions in comparison to other crops. In 2016, a period of much higher-than-average rainfall, while non-tobacco farmers made a modest income, tobacco farmers’ income was almost zero.³⁰

Tobacco-farming households had significantly higher labour costs than those growing other crops.³¹ Tobacco farmers also used child labour, both hired and household, more frequently compared to those growing other crops.³⁰ Similarly, more children from tobacco farms missed school.³⁰ Farmers reported using child labour because tobacco growing does not usually pay enough to hire adult workers.³⁰

An investigation by The Guardian in 2018 visited the village of Beleke, on the island of Lombok, where it found almost all children above the age of four doing tobacco work during harvest season.³² This followed a report by Human Rights Watch (HRW) in 2016, which stated that thousands of children work in tobacco farming in Indonesia. HRW found children engaged in dangerous work in four Indonesian provinces, interviewing more than 130. They reported serious health and safety issues, including acute nicotine poisoning as a result of handling tobacco leaves (also known as green tobacco sickness) and contact with pesticides and other chemicals.²⁵

HRW’s interviews with tobacco farmers and traders revealed a lack of human rights due diligence in the tobacco supply chain in Indonesia, particularly regarding child labour.²⁵ The farmers and traders interviewed supplied large Indonesian and transnational companies including Gudang Garam, Sampoerna, Djarum and Bentoel.²⁵

• For more information on the tobacco industry and child labour, please see the pages on CSR: Child Labour and the Eliminating Child Labour in Tobacco-Growing Foundation (ECLT).

Tobacco and the economy

Given its high level of tobacco consumption, Indonesia has long been a net importer of tobacco leaf, despite also being a major producer.³¹ In 2022, it imported over US$617 million in raw tobacco, compared to around US$266 million in exports.³³³⁴

However, it is a net exporter of cigarettes: over US$913 million in 2022, compared to US$118 million in imports.³⁵³⁶

In 2020 the WHO reported that the contribution of the tobacco industry to the Indonesian economy was relatively small; tobacco manufacturing generates just 0.6% of total employment, while tobacco farmers represent only 1.6% of the agricultural workforce. Most families involved in tobacco growing and kretek rolling also receive some form of social assistance – meaning that the Indonesian state is essentially subsidising poorly-paid employment in the tobacco industry.³⁷

Illicit trade

A study published in 2019, which collected packs of cigarettes from respondents in Indonesia, found that 20% of the 1,440 smokers surveyed reported ever smoking illicit cigarettes. However, among the 1,201 packs researchers collected, only 20 (i.e. 1.6%) had no excise stamp, a fake excise stamp, or no graphic health warning – and hence were potentially illicit. Price appears to be a factor, with people on lower incomes more likely to purchase illicit cigarettes, though consumption of illicit cigarettes was not found to be a long-term behaviour.³⁸ However, a 2021 study estimated that the share of illicit cigarette consumption in the country increased from 5% in 2013 to 19% in 2018.³⁹

Globally, Free Trade Zones (FTZs) are well known to facilitate the illicit tobacco trade.⁴⁰ There are four FTZs in Indonesia, where cigarette production and trade are exempted from excise duties, making the price much lower. Cigarettes leak from these FTZs, becoming illicit in the process, as the packs bear no excise stamps.⁴¹ In August 2023, Indonesia’s Corruption Eradication Commission announced that a senior official from the Bintan Free Trade and Port Zone had been arrested on charges of data manipulation and receiving bribes from cigarette companies, to allow greater flows of duty-free cigarettes through the zone.⁴²

Internal industry documents suggest that historically, BAT has been involved in illicit trade in Indonesia and the broader region.⁴³ A 1994 internal BAT document points to Indonesia – along with Malaysia – as a conduit of illicit products to the Philippines.⁴⁴ A BAT-commissioned study from the 1980s also documented Indonesian consumers’ preference for its smuggled products.⁴⁵

As part of the third round of the Philip Morris International initiative PMI IMPACT, PMI is funding the Institute for Development of Economics and Finance, an Indonesian think tank, to “examine the market for NTHRPs [nicotine and tobacco harm reduction products] and how to prevent illicit trade in this growing sector, with research to include surveys and limited group discussions”.⁴⁶

• For more information on PMI IMPACT, please see the following pages: PMI IMPACT, List of Successful PMI IMPACT Applicants and Organisations linked to PMI IMPACT.

Tobacco and the environment

Indonesia is the world’s second-biggest contributor to marine plastic pollution after China, responsible for 1.29 million tonnes of debris entering the ocean annually.⁴⁷ Of this waste, cigarette butts are the most commonly-littered item.⁴⁸ The Global Center for Good Governance in Tobacco Control has estimated the cost of tobacco-related marine pollution and waste management in Indonesia at Rp49 trillion (US$3.1 billion) per year.⁴⁹

• For more information, please see the page on Tobacco and the Environment and the long read on Plastics, the Environment and the Tobacco Industry.

Roadmap to Tobacco Control

Indonesia is not a party to the WHO FCTC, and is therefore ineligible to join the Protocol to Eliminate Illicit Trade in Tobacco Products. As of 2023, there appears to be little political will either to ratify the WHO FCTC or to create a comparable national framework for tobacco control. This has led to a fragmented approach across different government departments and prevented the development of coherent tobacco control policies.¹

However, Indonesia has committed to an Association of Southeast Asian Nations (ASEAN) five-year plan on health, under which it has pledged to reaffirm collective positions against industry interference and for implementation of control measures, for both tobacco and alcohol.⁵⁰

In 2009, the passage of Law No. 36 authorised the Ministry of Health to introduce tobacco control regulation, including on tobacco advertising, promotion and sponsorship (TAPS); smoke-free spaces; and packaging and labelling of tobacco products.⁵¹ This was followed in 2012 by Indonesia’s principal tobacco control law, Government Regulation 109 (PP 109/2012).⁵¹ These laws prohibit smoking on public transport, and in educational facilities and places of worship, though other types of enclosed public spaces, including workplaces, restaurants and government facilities, may provide smoking areas.⁵²⁵³ More stringent regulations at the subnational level are permitted.⁵² As of June 2023, 456 (around 86%) of Indonesia’s 520 cities and districts had adopted smoke-free policies, though implementation remains a challenge.⁵⁴

Indonesia is one of the few countries that still permits tobacco advertising on television, though it may not be broadcast until after 9:30pm.⁵²⁵¹ While Law No. 36 and PP 109/2012 also introduced graphic health warnings (GHWs) on tobacco packaging and banned misleading terms such as “light” and “low-tar”, the law was not retroactive for tobacco products that already had these words in their branding, and other misleading features – such as colours, numbers and symbols – are still permitted.⁵²⁵¹

As of 2024, various other limitations remain. There are no restrictions on internet sales or the sale of individual cigarettes (single sticks); there is no national law regulating the sale, use, advertising, promotion, sponsorship, packaging or labelling of e-cigarettes; and tobacco industry corporate social responsibility (CSR) is still permitted.⁵¹⁵³ Cigarettes in Indonesia also remain relatively cheap. In 2022, the price of the bestselling brand of cigarettes was just over US$2.⁵³

In 2018, President Widodo issued a decree containing a list of government regulations to be revised, which included PP 109/2012.⁵⁵ Tobacco control advocates have seen this as an opportunity to push for stronger regulations, such as larger GHWs, higher excise taxes on cigarettes and a comprehensive ban on TAPS.⁵⁵ However, this process has stalled, amidst conflict between different government ministries and opposition from farmers’ associations and other groups (see section “Use of third parties”).⁵⁵ As of March 2024, the revision of PP 109/2012 had yet to advance.

For more details, please see the following websites:

• Legislation by Country/Jurisdiction – Indonesia, Tobacco Control Laws, Campaign for Tobacco-Free Kids
• Country profile – Indonesia, World Health Organization, WHO report on the global tobacco epidemic 2023

Interference in Indonesia by Tobacco Industry and Allies

Tobacco industry tactics in Indonesia include the use of third parties; the targeting of youth with tobacco marketing, both at point of sale and online, as well as via event sponsorship; and sponsorship of popular sports such as badminton and football.

Use of third parties

The tobacco industry has long used third parties and front groups to advance its interests, as a means of achieving greater credibility and overcoming public mistrust.

The Indonesian Tobacco Farmers’ Association (Asosiasi Petani Tembakau Indonesia, APTI), a lobby group, opposes the WHO FCTC, and has urged the Indonesian government not to ratify the treaty.⁵⁶ It has also frequently lobbied against increases in excise taxes on tobacco products. In 2019, APTI held a rally in front of the Ministry of Finance, to demand the repeal of an increase in excise and the retail price of cigarettes, and the revision of a regulation requiring at least 50% of the Tobacco Excise Revenue Sharing Fund to be allocated to health purposes.⁵⁷

APTI has also opposed the proposed revision to Indonesia’s main tobacco control law, PP 109/2012. In 2022, in Temanggung, a major tobacco-growing region in Central Java, APTI representatives were seen at a public event displaying banners asking the local government for support in opposing the proposal.⁵⁸ APTI also sent official letters to President Widodo opposing the revision, stating that it would negatively affect the livelihoods of people working in the tobacco sector, particularly farmers.⁵⁵

Another lobby group which has opposed of any revision of PP 109/2012 is the Indonesian Tobacco Community Alliance (Aliansi Masyarakat Tembakau Indonesia, AMTI), a coalition of tobacco industry stakeholders – including cigarette manufacturers – established in 2010.⁵⁹ It reportedly has close links to the PMI subsidiary Sampoerna.⁶⁰⁶¹ AMTI has sought to portray tobacco control as an agenda imposed on Indonesia by foreign actors who do not understand the local context – a common tobacco industry tactic in the country.⁶²⁶³

Both APTI and AMTI are affiliates of the International Tobacco Growers Association (ITGA), a global front group funded and run by the ‘Big Four’ transnational tobacco companies (TTCs), as well as two major leaf merchants.⁶⁴⁶⁵⁶⁶ Though ITGA claims to defend the interests of tobacco farmers and their communities around the world, it uses tobacco farmers as a means of opposing tobacco control regulations and protecting the interests of the TTCs.⁶⁶

Controversial marketing strategies: targeting youth

The tobacco industry has long seen young people as a vital target market; tobacco use generally starts in adolescence. In Indonesia, the mean age of smoking initiation amongst males is 18.3 years, while smoking prevalence amongst Indonesian adolescents (aged 10 to 18) increased from 7% in 2013 to 9% in 2018.⁶⁷⁶⁸

In Indonesia, there is a high concentration of tobacco retailers, high exposure to point-of-sale advertising and no restriction on the display of cigarette packs in retail outlets – all of which are associated with increased tobacco use amongst adolescents.⁵³⁶⁸⁶⁹ In addition, many retailers are located close to schools; enforcement of the ban on sales to minors is very weak; while sales of single sticks, which make smoking more accessible to young people, are still permitted.⁶⁹⁶⁸⁷⁰ Retailers therefore have an important role in recruiting new, young smokers, and maintaining growth of the market.⁶⁸

Indonesia’s incomplete TAPS regulations have also allowed the tobacco industry to switch to less regulated forms of advertising such as event sponsorship and internet marketing, often targeting young people.⁷¹

For example, the popular music festival SoundrenAline, which has been running in Indonesia since 2002, was founded by Sampoerna.⁷² Following a visit to SoundrenAline 2016, researchers reported that Sampoerna branding and the slogan “Go Ahead” were found throughout the festival site. Sampoerna A brand cigarettes were widely sold, including by cigarette girls and boys – a form of direct one-on-one marketing.⁷¹⁷³ Cigarettes that were not a Sampoerna brand were confiscated at the entrance.⁷¹ As of 2022, Sampoerna was still the sponsor of the event and owner of the registered trademark for “SoundrenAline”.⁷²

With over 111 million users, Indonesia has one of the world’s largest Instagram audiences, over half of whom are aged between 13 and 24.⁷⁴ According to the Tobacco Enforcement and Reporting Movement (TERM), as of 2023, around 70% of online tobacco marketing in Indonesia took place on Instagram.⁷⁵⁷⁶ Most of this marketing is indirect and community based. Rather than display their products directly, the tobacco companies build online communities of followers with a common interest such as music, travel or sport, as a means of improving brand visibility and indirectly promoting their products.⁷⁶⁷⁵

Controversial marketing strategies: sponsorship of popular sports

Tobacco industry sponsorship of sport is as old as professional athletic competition itself.⁷⁷ It aims to create links between pre-existing associations people may have with sports (such as fun, excitement, strength, etc.) with tobacco branding and products; promote an image of tobacco use as normal and healthy; and appeal to young people.⁷⁸

In Indonesia, TAPS has historically been very widespread in popular sports.⁷⁹ Badminton, for instance, which the New York Times has described as part of Indonesia’s “national identity”, has long been a vehicle for tobacco industry sponsorship.⁸⁰ From 2006, Djarum was the corporate sponsor of the national badminton trials for children and adolescents aged from 5 to 18.⁸¹ The trials were shown on national television, and participants were required to wear clothing which displayed the Djarum logo.⁶⁸⁸¹

Ten civil society organisations reported Djarum to the National Commission on Child Protection, arguing that the sponsorship violated Indonesia’s child protection law.⁸¹ In 2019, Djarum agreed to remove its logos from the badminton trials.⁸²⁸³ It also withdrew its sponsorship from future trials, which critics argued would undermine development of young talent. However, in 2021 the state-owned telecommunications firm Telkom replaced Djarum as sponsor.⁸¹

Djarum owns the PB Djarum badminton club in Kudus, Central Java, which has a youth academy, as well as a club in Jakarta.⁸⁰⁷⁵⁸⁴ The company also continues to market itself and its products indirectly via Djarum-associated social media accounts which focus on badminton-related content.⁷⁶⁷⁵

An investigation into tobacco marketing on social media in Indonesia, India and Mexico around the 2022 FIFA World Cup found that 92% of the football-themed tobacco marketing originated from Indonesia, with 81% being produced by Djarum alone.⁷⁹

Both Gudang Garam and Djarum, via their respective brands Intersoccer and Super Soccer, sponsored live World Cup viewing parties. Super Soccer, which describes itself as the “home of soccer fans in Indonesia”, promotes its activities on social media to hundreds of thousands of followers.⁷⁹ It developed a “Soccerphoria” event series and campaign specifically for the World Cup, which were heavily promoted across its accounts. As well as the live viewing parties, these events involved mural painting, branded clothes, and limited-edition World Cup cigarette packs designed by local artists.⁷⁹

In 2019, Djarum bought the Italian Serie B club Como 1907, via its subsidiaries SENT Entertainment Ltd and Mola TV. Mola, a television streaming service, has broadcast a reality TV series following 24 young footballers trying to succeed at Como 1907.

• For more on this topic please see the pages on Football Sponsorship and Social Media.

Relevant Links

• Indonesia factsheet, Tobacco Atlas
• Indonesia Tax Scorecard, Tobacconomics
• Dashboard Kawasan Tanpa Rokok [Smoke-Free Area Dashboard], Indonesia Ministry of Health
• Situation reports: Indonesia, Tobacco Enforcement and Reporting Movement, Vital Strategies
• Indonesia, Southeast Asia Tobacco Control Alliance
• Front Groups Indonesia, Southeast Asia Tobacco Control Alliance

Tobacco Tactics Resources

• Flavoured and Menthol Tobacco in LMICs
• Greenwashing
• Gudang Garam and sports endorsement
• Lobby Groups
• Tobacco Industry Tactics

References

The post Indonesia Country Profile appeared first on TobaccoTactics.

Image source: Luis Barrios/CC BY-NC-ND 2.0

Key Points

• Mexico is a country in North America, covered by the World Health Organization’s Regional Office for the Americas.
• It has a population of over 127.5 million with current smoking prevalence of 19% amongst the population aged 20 and over.
• Mexico ratified the World Health Organization Framework Convention on Tobacco Control in 2004. It has not joined the Protocol to Eliminate Illicit Trade in Tobacco Products.
• The Mexican tobacco market is dominated by the big transnational tobacco companies, particularly Philip Morris International and British American Tobacco.
• Recent tobacco industry tactics in Mexico include the use of third parties; the targeting of youth with marketing for newer nicotine and tobacco products, particularly on social media; and corporate social responsibility, including during the COVID-19 pandemic.

Mexico significantly reduced smoking prevalence between 2002-2009, in the years around ratification of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC).⁸⁵⁸⁶⁸⁷ However, between 2009 and 2016 there was no further progress. This may be explained by ongoing industry interference, such as on price and tax; the introduction and rapid growth of flavour capsule cigarettes; as well as challenges involved with implementation of Mexico’s main tobacco control law.⁸⁷⁸⁸ In more recent years, Mexico has redoubled its efforts, passing a major amendment to its tobacco control law in 2021 which significantly increased compliance with the WHO FCTC.⁸⁹ Mexico now has some of the most comprehensive tobacco control regulation in the world.⁸⁹⁹⁰

Tobacco Use in Mexico

In 2022, the population of Mexico was over 127.5 million.⁹¹ According to the 2021 National Health and Nutrition Survey on COVID-19 (ENSANUT), prevalence of current smoking in the Mexican population aged 20 and over was just over 19%. There is significant difference between males and females, with nearly 30% of men reporting current smoking compared to around 9% of women. Prevalence of current smoking amongst Mexican youth aged from 10 to 19 was less than 5%, with 7.5% of males in this age range smoking compared to less than 2% of females.⁹²

There were an estimated 48,400 deaths attributable to smoking in 2019, accounting for 6.6% of all mortality in Mexico that year.⁹³ A study published in 2021 estimated the total cost of tobacco use to the Mexican economy at US$8.2 billion per year. US$5.1 billion is spent on treating diseases associated with tobacco use – equivalent to 9.3% of the annual health budget. The US$1.9 billion that Mexico receives in revenue from the tobacco industry covers just 38% of the burden of tobacco use.⁹⁴

Since 2008, Mexico has prohibited sale, distribution and promotion of any product that resembles a cigarette, which has been applied to e-cigarettes and heated tobacco products (see section “Roadmap to Tobacco Control”).⁹⁵⁹⁶ Even so, in the 2021 ENSANUT survey, current use of e-cigarette by adults aged 20 and over was 1.6% (2.5% for males; 0.7% for females). Amongst youth aged 10 to 19, prevalence was slightly higher, at 1.8% (2.4% for males; 1.1% for females).⁹² A 2022 survey by the National Commission Against Addictions estimated that five million Mexicans between the ages of 12 and 65 had used e-cigarettes at some point, with 975,000 being current users.⁹⁷

Tobacco in Mexico

Market share and leading brands

In 2022, market research company Euromonitor International estimated the Mexican tobacco market to be worth nearly 89 billion Mexican pesos (US$4.5 billion), mostly accounted for by cigarette sales.⁹⁸ The market is dominated by the big transnational tobacco companies (TTCs), particularly Philip Morris International (PMI) and British American Tobacco (BAT), and to a much lesser extent Japan Tobacco International (JTI). Between them, these three companies accounted for virtually all legal cigarette sales in 2022. PMI is the market leader with just over 60%, followed by BAT with just under 36%. JTI’s share was 4%.¹⁸

As of 2022, the top six brands in Mexico were all manufactured by either PMI or BAT. By far the most popular cigarette was PMI’s premium brand Marlboro, with a market share of over 48%. This was followed by BAT’s mid-range cigarette Pall Mall, with under 22%. All other brands had a share of less than 10%.⁹⁹

• For more information on the tobacco industry in Mexico, see the Tobacco Supply Chain Database.

The use of flavour capsule cigarettes is particularly high in several Latin American countries, including Mexico, where their share of the market has risen year on year since 2012.¹⁰⁰ Although they were only introduced in 2011, flavour capsule cigarettes accounted for nearly 28% of the cigarette market in 2022 – amongst the highest proportions in the world.⁸⁷¹⁰¹ Research has shown that flavour capsules increase the appeal of cigarettes and stimulate a desire to try them, particularly amongst young people.¹⁰¹¹⁰²

• For more information, see Flavoured and Menthol Tobacco in LMICs.

Tobacco farming and child labour

Tobacco growing in Mexico has fallen considerably since 1980, when it produced nearly 94,000 tonnes of leaf, to under 7,000 tonnes in 2010 (see Figure 1). However, in 2010 production started to increase again, rising to over 15,000 tonnes by 2012, since when the figure has remained roughly stable.¹⁰³

Figure 1: Mexican tobacco production, 1961 to 2020.¹⁰⁴ Source: UN Food and Agriculture Organization/Our World in Data | CC BY

Similarly, in 1980 the harvested area was 42,000 hectares, falling to 4,000 hectares in 2010, but up to 7,000 in 2020.¹⁰³

A series of exposés in the 1990s revealed widespread use of child labour on Mexico tobacco farms, as well as the use of banned agrochemicals and poor living and working conditions for tobacco pickers. While the industry claims much has changed since then, an investigation by The Guardian in 2018 found children working on seven out of the ten farms the report visited in the state of Nayarit, Mexico’s main tobacco growing region. The farms featured in the investigation were supplying PMI, BAT and Universal Leaf Tobacco.¹⁰⁵

• For information on tobacco industry responses to accusations of complicity in child labour, please see the pages on CSR: Child Labour and the Eliminating Child Labour in Tobacco-Growing Foundation (ECLT).

Tobacco and the economy

Mexico is a net exporter both of tobacco leaf and cigarettes. According to UN Comtrade, it exported approximately US$7.1 million in raw tobacco in 2022, compared to around US$2.4 million in imports.¹⁰⁶¹⁰⁷

A 2021 report on the impacts of tobacco tax, published by the Center of Research on Food and Development (CIAD), which bases its calculations on the Secretariat of Economy’s Online Tariff Information System, puts the figure for cigarette exports in 2019 at close to US$180 million, compared to imports of over $10 million.¹⁰⁸ This corresponds to customs data from Descartes Datamyne, which put cigarette exports for 2020 at over $168 million, compared to imports of US$10.7 million.¹⁰⁹ However, the Comtrade figure for cigarette exports in 2020 is much lower.¹¹⁰ No import data is available on Comtrade for that year.

According to the CIAD report, seventy per cent of Mexican cigarette exports served the Canadian market, 15% the Colombian market, and 11% Central American markets.¹⁰⁸ Customs data also indicates these are the main export destinations for cigarettes manufactured in Mexico.¹⁰⁹

The CIAD report also states that the tobacco industry is a relatively small sector of the Mexican economy, employing just 0.1% of the national workforce in 2018.¹⁰⁸

Illicit trade

In a 2021 study which measured the Mexican illicit tobacco trade using two methodologies, illicit cigarettes accounted for 8.8% of total consumption based on an analysis of discarded packs, and 7.6% based on a survey of smokers. Both results are significantly lower than the figure of 16.6% which is widely publicised by the tobacco industry.¹¹¹ While the figures obtained via both methodologies represent an increase from previous estimates of illicit cigarette consumption – 0.5% in 2009 and 2.7% in 2015 – they are lower than the global average and lower than the figure for other countries in Latin America such as Brazil, Chile and Uruguay.¹¹²¹¹³ A previous study also found wide geographical variation across the country: for example, in Hermosillo, Sonora, just 0.3% of total cigarette consumption was illicit, while in León, Guanajato, the figure was as high as 27.5%.¹¹²

There is also an illegal e-cigarette market. Between January 2021 and June 2022, Mexican authorities seized over 60,000 devices, suspending the activities of nearly 180 retail outlets.¹¹⁴

Tobacco and the environment

Mexico produces around 40 billion cigarettes annually. This consumes between 109 and 205 billion litres of water and between 73 and 114 million kilowatts of energy. It also generates CO₂ emissions of between 20,000 and 29,000 tonnes. Around 55 million cigarette butts are discarded every day in Mexico, at an estimated cost of close to US$140 million annually.¹¹⁵

• For more information, please see the page on Tobacco and the Environment and the long read on Plastics, the Environment and the Tobacco Industry.

Roadmap to Tobacco Control

Mexico was the first country in the Americas to ratify the WHO FCTC in 2004.⁸⁶ However, it has not joined the Protocol to Eliminate Illicit Trade in Tobacco Products.¹¹⁶

In 2008, The General Law on Tobacco Control came into force, containing most of the provisions established in the WHO FCTC.¹¹⁷ However, it left some significant loopholes. While smoking was completely prohibited indoors in primary and secondary schools, and in federal government facilities, workplaces and other buildings with public access were permitted to provide designated smoking areas. Similarly, the law banned most forms of tobacco advertising, promotion and sponsorship, but made an exception in cases where it was aimed exclusively at adults.¹¹⁸ Some stricter regulation was introduced at subnational level. For example, Mexico City passed its own 100% smokefree law in February 2008 and in the following years 14 states followed suit.¹¹⁹¹²⁰

In 2021, the Mexican Senate unanimously approved a key amendment to the 2008 General Law, which banned smoking in all enclosed public spaces and workplaces, as well as banning all forms of tobacco advertising.⁸⁹ A further update, which came into force in January 2023, extended smoke-free legislation even to open-air environments where there may be public gatherings, such as parks, beaches and restaurant terraces. It also bans the display of tobacco products in all retail outlets.^90121122 With these two measures, Mexico made important progress towards full compliance with the WHO FCTC.⁸⁹

Mexico has taken a tough stance on newer nicotine and tobacco products. Since 2008, there has been a ban on any product that resembles a cigarette.^123124125 Regulators have applied this law to e-cigarettes and heated tobacco products (HTPs), but it has been contested by both retailers and tobacco companies.⁹⁵¹²³ In 2020, the government banned imports of e-cigarettes and HTPs, bringing customs law into line with existing health regulations.¹²⁶ Though a decree published by the Secretariat of Economy in July 2021 created an exception for HTPs, this was reversed by a new presidential decree in October of the same year.¹²⁷¹²⁸

Finally, on World No Tobacco Day in May 2022, President Andrés Manuel López Obrador signed a decree imposing a total ban on “circulation and marketing” of e-cigarettes and HTPs. This effectively makes the import and sale of these products illegal in Mexico.¹²³¹²⁹

For more details, please see the following websites:

• Legislation by country – Mexico, Tobacco Control Laws, Campaign for Tobacco Free Kids
• Mexico, WHO FCTC implementation database, WHO FCTC Secretariat
• Country Profile – Mexico, World Health Organization, WHO report on the global tobacco epidemic 2023

Tobacco Industry Interference in Mexico

Tobacco industry tactics in Mexico include the use of third parties; the targeting of youth with marketing for newer nicotine and tobacco products, particularly on social media; and corporate social responsibility, including during the COVID-19 pandemic.

Use of third parties

Tobacco companies often lobby via industry and trade associations, think tanks, front groups and other third parties, including public relations (PR) companies and professional lobbyists.

In Mexico, the Confederación Patronal de la República Mexicana (COPARMEX) is an employers’ union, which brings together businesses of all sizes and from all sectors.¹³⁰ In 2021, Philip Morris International (PMI) listed COPARMEX as one of the business and trade organisations in which it held a leadership role.¹³¹

In May 2022, Mexico held a public consultation on an update to its revised tobacco control law, regarding proposals to completely ban the display of tobacco products at points of sale, and to further restrict designated smoking areas to limited open-air environments.¹²¹ COPARMEX’s submission to the consultation argued that cost of implementing these measures would be high and adversely impact the owners of small businesses; that the proposals violated the right to free trade; and that they would fuel the growth of the illicit trade.¹³²

The National Tobacco Industry Council (CONAINTA) – of which PMI, BAT and JTI are all members – also opposed these measures, arguing that they would have a negative impact on the national economy, including on tobacco growing communities; that they violated consumer rights; and that they would endanger jobs and investment.¹³³ In 2023, the president of CONAINTA warned that there would be a “storm” of legal appeals against the updated tobacco control law.¹³⁴

Controversial marketing: targeting youth

The tobacco industry has long seen young people as a vital target market; tobacco use generally starts in adolescence. According to the 2016-7 National Survey of Drugs, Alcohol and Tobacco Consumption, the average age of initiation for daily tobacco consumption in Mexico was less than 20 years old.¹³⁵

Mexican media have documented tobacco companies targeting young people with marketing for newer nicotine and tobacco products via social media. From around 2018, industry hashtags – such as #FuturoSinHumo (“#SmokeFreeFuture”) and #EligeElCambio (“#ChooseChange” – both PMI) and #vypefriends and #govype (both BAT) began to appear on posts by popular Mexican actors, influencers, comedians and others.¹³⁶¹³⁷ Products such as PMI’s HTP IQOS and BAT’s e-cigarette Vype (since rebranded as Vuse) featured visibly in this content, though often company sponsorship was not made explicit.¹³⁶

Even before the General Law on Tobacco Control was amended in late 2021, it prohibited tobacco advertising, promotion and sponsorship in all but three circumstances: in adult magazines, in adult-only establishments, or in personal correspondence to adults via post. It also specifically prohibited the online marketing of tobacco products.¹¹⁸ According to a lawyer at the Centro de Investigación y Docencia Económicas, “these products must comply with the General Law on Tobacco Control, which clearly establishes a near-total ban on this publicity.”¹³⁶

A 2022 study on exposure to e-cigarette advertising and the social acceptability of e-cigarette use in Mexico identified online advertising as one of the channels of exposure most significantly associated with a higher likelihood of perceiving e-cigarettes as socially acceptable.¹³⁸ According to a researcher at the National Institute of Public Health – one of the authors of the study – the industry’s aim is the “renormalization” of nicotine consumption amongst young people.¹³⁶

• See also the page on PMI’s Futuro Sin Humo campaign.

The tobacco industry has also sponsored motorsports in Mexico. In the 2022 Mexico City Grand Prix, held in October, the McLaren cars displayed BAT’s Vuse branding – in an apparent violation of the comprehensive ban on e-cigarettes brought in just months beforehand.¹³⁹ Motorsport sponsorship is a longstanding and well-documented promotional strategy aimed at young people, particularly boys and young men.¹⁴⁰

Corporate social responsibility

Tobacco companies often use corporate social responsibility (CSR) initiatives to enhance their public image and corporate reputation.

In 2018, PMI’s local subsidiary Philip Morris México (PMM) set up a partnership with a local start-up, Eco Filter, which uses biotechnology to recycle cigarette butts.¹³⁶¹⁴¹ This partnership involves clean-up and collection initiatives which target young people, with events taking place at concerts, parks and universities. Eco Filter also delivers presentations to young people in which it displays PMI logos, and has used the social media hashtag and PMI slogan #FuturoSinHumo.¹³⁶¹⁴² Eco Filter states that it does not promote PMI’s products or encourage nicotine consumption amongst young people.¹³⁶

In 2021, Eco Filter opened a new factory in Guadalajara, Jalisco, with support from PMM.¹⁴¹¹⁴³ It will process waste from PMM’s manufacturing facility near Guadalajara, as well as cigarette butts from the street.¹⁴⁴¹⁴⁵

• See also Cigarette Filters.

Both PMI and BAT carried out extensive corporate social responsibility (CSR) activities in Mexico during the COVID-19 pandemic. In May 2020, PMI donated electric beds, vital signs monitors and ventilators to a hospital in Guadalajara. PMI also donated money for personal protective equipment (PPE) for healthcare professionals, and meals to a public welfare institution.¹⁴⁶ BAT joined a programme called UNIR y DAR (“UNITE and GIVE”) with other local companies in Nuevo León, where BAT México is headquartered. As part of an initiative called #RespiraNL, these companies made donations for PPE.¹⁴⁷ BAT also provided food supplies in Guadalupe, Nuevo León.¹⁴⁸

There are also CSR initiatives on child labour in Mexico. For example, since 2001 BAT has run a programme called “Florece” (meaning “Blossom” or “Flourish” in English), which provides day centres for the children of workers in the tobacco fields of Nayarit.¹⁴⁹¹⁵⁰

• For more on tobacco industry activity during the pandemic, please see the COVID-19 Tobacco Tactics page and the COVID-19 monitoring database.

Relevant Links

• III Índice Regional de Interferencia de la Industria Tabacalera en países de América Latina y el Caribe 2023, Corporate Accountability, Global Center for Good Governance in Tobacco Control
• Mexico – Tobacco Industry Interference Index 2021, Global Center for Good Governance in Tobacco Control
• Interferencia de tabacaleras en México: reporte de índice regional, Salud Justa, 2021
• Mexico: the long road to Tobacco Control, Pan American Health Organization (PAHO)
• Mexico – Cigarette Tax Scorecard, Tobacconomics
• Tobacco Industry Interference in Mexico, STOP
• México, Organización Panamericana de la Salud

Tobacco Tactics Resources

• E-cigarettes: British American Tobacco
• Futuro Sin Humo
• Flavoured and Menthol Tobacco in LMICs
• PMI’s IQOS: Use, “Switching” and “Quitting”

TCRG Research

• Developing more detailed taxonomies of tobacco industry political activity in low-income and middle-income countries: qualitative evidence from eight countries, B.K. Matthes, K. Lauber, M. Zatoński, L. Robertson, A.B. Gilmore, BMJ Global Health 2021;6:e004096.

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

References

The post Mexico Country Profile appeared first on TobaccoTactics.

• 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).¹⁵¹¹⁵²

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,¹⁵³¹⁵⁴ and they are now available in other countries.¹⁵⁵¹⁵⁶

Flavoured tobacco is used in waterpipe, a device which originated in middle-eastern countries and is increasingly popular elsewhere, including among young people.¹⁵⁷

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.¹⁵⁸ 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).¹⁵⁹ 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.⁹⁰

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.¹⁵⁸¹⁶⁰  However, apart from rare exceptions the tobacco industry contributes little overall to the balance of payments.¹⁶¹¹⁶²

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.¹⁶³  The report points to likely opposition from the tobacco industry in countries or regions with an established menthol market.¹⁶³ 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.”¹⁶³

Research and data

As of 2021, when TCRG researchers conducted a review of evidence on menthol/flavour in LMICs,¹⁶⁴ 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.”¹⁶³

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.¹⁶⁵

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.¹⁶⁶

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.¹⁶⁶

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.¹⁶⁴ 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.¹⁶⁷ Most were mint and menthol flavour but with others the flavour was unclear from the product name.¹⁶⁷

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.¹⁶⁸

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.¹⁶⁴

Tobacco companies also use symbols on cigarette sticks to indicate that they contain capsules.¹⁶⁹ 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.¹⁶⁹

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 2017.¹⁶⁴ 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.¹⁶⁴

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.)¹⁶⁴

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”.¹⁷⁰

Zambia

JTI owned brand Sweet Menthol is the third most popular cigarette in Zambia.  It is cheap and is usually sold as single sticks.¹⁷¹  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.¹⁷²

ITC survey data showed a high prevalence of menthol smokers in Zambia, with 43% of smokers choosing the product.¹⁷³ 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.¹⁷³

Kenya

ITC survey data from Kenya also suggests a high prevalence of menthol smokers.¹⁷³¹⁷⁴ 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).¹⁶⁴  More women smoke menthol than men in Kenya, and two thirds of smokers believed that menthol is less harmful than other cigarettes.¹⁷³¹⁷⁴

Ethiopia

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

• For details see Flavoured and Menthol Tobacco

This was a pre-emptive ban as flavour sales were low. However there has been a lack of enforcement at the retail level.¹⁵⁸ Flavoured products are not made in Ethiopia and more collaboration with customs is needed to prevent illicit importation.¹⁵⁸ There is also a lack of awareness that the ban includes waterpipe products.¹⁶³

Since 2017, two years after the ban was enacted, JTI has owned 70%  the state owned tobacco company, NTE.¹⁷⁵

Latin America

Menthol cigarettes are popular in Latin America, and increasingly so in some countries.¹⁶⁴ 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.¹⁶⁴

Use of flavour capsule cigarettes is particularly high in Chile and Mexico.¹⁷⁶  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.¹⁷⁷

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.⁹⁰ (Similar findings were reported in Uruguay, a high income country, immediately before the implementation of plain pack regulations in 2020.)¹⁷⁸

These products were frequently displayed near the point of sale, or confectionary. Some stores also had advertisements and price promotions.⁹⁰ Unconventional flavour descriptors such as “fusion blast” and “ruby ice” were very common.¹⁷⁹

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.¹⁸⁰ 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.¹⁸⁰

ITC survey data from the same period suggested that 8% of smokers with a regular cigarette brand smoked menthol.¹⁸¹ 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.¹⁸¹

An online sample of women aged 16- 26 (smokers and non-smokers) preferred packs with flavour descriptors.¹⁸²

• The tobacco industry has used a range to tactics to undermine and delay Brazil’s menthol ban. For details see Flavoured and Menthol Tobacco

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.¹⁶³

• For details see Flavoured and Menthol Tobacco

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.¹⁸³¹⁸⁴ 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.¹⁸⁵

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.¹⁸⁶

Guatemala

A study of convenience store retailers in Guatemala found that all sold flavoured tobacco products.¹⁸⁷

The majority (88%) of indoor tobacco advertisements in Guatemala were found to be for capsule cigarettes.¹⁸⁷

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.¹⁶⁴  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.¹⁸⁸

Philippines

Menthol has been advertised to appeal to young women in the Philippines since the 1970s with menthol brands common for many decades.¹⁸⁹ PMI, JTI, BAT and Korea Tobacco & Ginseng (KT&G) all sell flavoured capsule cigarettes in the Philippines.¹⁹⁰

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,¹⁹⁰ and packs were rated as more attractive by young adults.¹⁹¹

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.¹⁹¹  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.¹⁹² An internal document from 1993 reveals how the company was developing sweet and fruit flavours for the Malaysian market. ¹⁹²¹⁹³ 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.¹⁹⁴

In 2013, vanilla, mint and fruit flavoured cigarettes were on sale, and strawberry cigarette packs with pink packaging were documented.¹⁹⁵

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.¹⁹⁶

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 2004.¹⁹⁷  In 2009 PMI and BAT acquired two domestic manufacturers which allowed them access to the kretek market.¹⁹⁸ 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.¹⁹⁸

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.¹⁹⁹

Eastern Mediterranean

There is high market share growth in in Pakistan and Egypt .¹⁶⁴

• 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.¹⁶⁴

Other LMICs in the region with high market share growth are Ukraine, Bosnia Herzegovina, Belarus, Azerbaijan, Kazakhstan and Uzbekistan.¹⁶⁴

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

• Flavoured and Menthol Tobacco
• Menthol Cigarettes: Industry Interference in the EU and UK

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.

References

The post Flavoured and Menthol Tobacco in LMICs appeared first on TobaccoTactics.

• PMI sponsors so-called “smoke-free” policies at holiday destinations which appear to encourage tourists and locals to stop smoking cigarettes, while heavily promoting its heated tobacco product IQOS.
• This circumvents regulations on industry involvement in policy development and the advertising of tobacco products

Background

As part of its claimed movement towards a “smoke-free future”, Philip Morris International (PMI) have developed so-called “smoke-free destinations”. PMI say that these destinations must have a Smoke Free Culture certification from the organisation TUV Austria. This company offers “integrated safety, quality, environmental and technical resource management”.²⁰⁰ In order to obtain this certification, locations must provide space for education about, and use of, its “smoke-free products”, such as its heated tobacco product (HTP) IQOS.²⁰¹

These “smoke-free” destinations are typical holiday destinations, such as the Greek, Spanish and Canary Islands.

PMI’s “smoke-free” strategy has been criticised as:

• a marketing strategy to promote newer nicotine and tobacco products, particularly in smoke-free areas; and
• a corporate social responsibility (CSR) strategy to rehabilitate the company’s damaged reputation, to enable it to contribute to policy development.^202203204

Locations

Astypalea, Greece

In September 2019, PMI announced Astypalea, Greece, as “the world’s first smoke-free island”. Smoking cigarettes in some key tourist areas and indoors was banned. PMI said that those who would not stop smoking cigarettes would be informed of alternative options.²⁰⁵ The island received a Smoke-Free Culture certification from TUV Austria for its campaign to encourage either “quitting” cigarettes or switching to alternatives such as PMI’s HTP IQOS.²⁰¹

In a promotional video about Astypalea, PMI said “both locals and visitors alike are encouraged to quit completely or if they don’t, change to smoke-free alternatives”.²⁰⁶ In Astypalea, hotels created spaces for using NGPs, converted from old smoking rooms, and provided trial kits for NGPs such as PMI’s HTP IQOS.²⁰⁷ The deputy mayor of Astypalea said “we encourage people to move away to healthier alternatives”.²⁰⁸

However, the health impacts of HTPs such as IQOS are unclear. Some evidence indicates that most IQOS users continue to smoke cigarettes (see PMI’s IQOS: Use, “Switching” and “Quitting”).

Canary Islands, Spain

In July 2019, the Plaza del Príncipe in Santa Cruz de Tenerife, in the Canary Islands, held an event to introduce an “IQOS terrace”. The event featured live music, a photoshoot and food that apparently reflected the “essence of IQOS”.²⁰⁹

In March 2020, PMI offered support to businesses on the island of El Hierro, Tenerife, to obtain the Smoke-Free Culture certification.²¹⁰ This followed a talk given by a PMI representative at an event for local businesses.²¹¹

In February 2021, the Smoke Free Culture certification from TUV Austria was awarded to the Canary Islands at a meeting between the director general of PMI in the Canary Islands, the president of the Federation of Hospitality and Tourism Entrepreneurs of Las Palmas, the director of operations of the Gloria Thalasso & Hotels group, and the president of the Real Club Náutico de Gran Canaria.²¹²

In June 2021, the Teguise City Council of the island of La Graciosa launched a campaign in collaboration with PMI called ‘La Graciosa sin humo’ [La Graciosa without smoke], which aimed to reduce both the amount of cigarette smoke by promoting alternative products, and to reduce cigarette litter.²¹³ It aimed to obtain the Smoke-Free Culture certification from TUV Austria.²¹⁴ The campaign included “smoke-free space” signs which resembled large cigarettes, in areas including a football field (see Image 1) and a children’s park (see Image 2). The campaign website (lagraciosasinhumo.com) closed in December 2021.²¹⁵²¹⁶

Image 1. A “smoke-free space” sign, resembling a large cigarette, at a football field as part of the ‘La Graciosa sin humo’ campaign (source: lagraciosasinhumo.com).

Image 2: A “smoke-free space” sign, resembling a large cigarette, at a children’s park as part of the ‘La Graciosa sin humo’ campaign (source: lagraciosasinhumo.com).

Reactions

In response to the “La Graciosa Sin Humo” campaign, The Las Palmas Medical Association reported it to the Prosecutor’s Office because it does not comply with the World Health Organization’s (WHO) Framework Convention on Tobacco Control (FCTC) guidelines on tobacco advertising, promotion, and sponsorship.²¹⁷ In June 2021, public health officials in the Canary Islands urged citizens to reject the “La Graciosa Sin Humo” campaign, due to its industry involvement and promotion of IQOS.^218219220 In September 2021, 150 organisations wrote a petition calling for the removal of the agreement between the City Council of Teguise in La Graciosa and PMI.²²¹

In response to the public health community’s concerns, the director of Philip Morris Canarias rejected the characterisation of the campaign as advertising, but claimed instead that it raises awareness of harms from cigarettes.²²² Despite the public health petition, in July 2021, the City Council of Teguise voted against withdrawing the campaign.²²³

In September 2021, the Ministry of Health of La Graciosa requested that TUV Austria stop incorrectly indicating that the Ministry of Health endorses the campaign.²²⁴ TUV Austria has since threatened two organisations which opposed the PMI initiative with legal action. No Fumadores and the National Committee for the Prevention of Smoking were told they carried information which damaged the reputation of TUV Austria.²²⁵²²⁶

Undermining regulation

Policy interference

Article 5.3 of the WHO’s FCTC bans the involvement of tobacco companies in the development and implementation of public health policies. A “smoke-free” policy sponsored by a tobacco company (PMI) represents tobacco industry interference in policy.²²⁷

Advertising

Article 13 of the WHO’s FCTC bans both direct and indirect advertising of tobacco products. This is circumvented by the promotion of IQOS at holiday destinations.

Corporate social responsibility

Article 5.3 of the WHO’s FCTC bans CSR by tobacco companies, as this is a form of marketing to promote their company image and products. PMI is using CSR to promote its “smoke-free” campaign alongside Astypalea’s tourism rebrand towards “well-being, quality and pureness of life”.²²⁸ A new tourism campaign was launched called “Astypalea: Τhe Aegean Energy Spring”, which aims to promote “positive energy” via its tourist destinations, alongside the smoke-free campaign.²²⁹ PMI has also highlighted the environmental benefits gained from reduced cigarette litter²⁰⁵, yet has not acknowledged itself as the cause of the vast environmental harms from cigarette filters. It has also organised beach cleaning events and provided materials with the PMI logo (see Image 3).

Image 3. Philip Morris International-branded litter picking equipment (source: lagraciosasinhumo.com).

Targeting the travel industry

PMI used its promotion of smoke-free destinations to invite a writer of a lifestyle blog covering travel to visit Astypalea. In one of the hotels the writer stayed in, smoking cigarettes indoors was banned, but use of PMI’s IQOS was allowed and promoted. IQOS was promoted across the island, such as at hotels and beaches (see Images 4 and 5)²³⁰ (for more images, see here).

Image 4. IQOS promotion at a hotel room in Astypalea. (Source: The Yorkshire Gentleman).

Image 5. IQOS promotion at a beach in Astypalea. (Source: The Yorkshire Gentleman).

PMI’s ‘Smoke-free campaigns’

Since 2014, PMI has claimed to have ‘smoke-free’ objectives as part of its corporate agenda. This has coincided with the development and promotion of newer nicotine and tobacco products (notably its HTP IQOS), and the promotion of itself as a partner in solving the tobacco pandemic (see Philip Morris International’s “Smoke-Free” Campaigns for examples).

Targeting other leisure industries

The tobacco industry has previously targeted other leisure industries, such as hospitality and aviation, to circumvent indoor smoking bans. From the 1970s to the 1990s, tobacco companies promoted indoor smoking via hospitality industry groups that it had funded.²³¹ Several tobacco companies created an organisation to investigate “indoor air quality” (since described by the U.S. Department of Justice as misleading), and sought support from flight attendants against smoking bans on flights.²³² There is no suggestion of any impropriety between PMI and TUV Austria.

TobaccoTactics Resources

Philip Morris International

Heated Tobacco Products

Newer Nicotine and Tobacco Products: Philip Morris International

PMI’s IQOS: Use, “Switching” and “Quitting”

PMI Promotion of IQOS Using FDA MRTP Order

Harm Reduction

CSR Strategy

Cigarette Filters

Tobacco Control Research Group (TCRG) research

• US regulator adds to confusion around heated tobacco products, A.B. Gilmore, S. Braznell, BMJ Editorials, 2020, 2020;370:m3528
• Understanding the emergence of the tobacco industry’s use of the term tobacco harm reduction in order to inform public health policy, S. Peeters, A. Gilmore, Tobacco Control, 2015;24(2):182-189
• PMI New Zealand conflates IQOS heated tobacco products with electronic nicotine delivery systems, L. Robertson, J. Hoek, K. Silver, Tobacco Control, 2021. doi: 10.1136/tobaccocontrol-2021-056964
• The ‘filter fraud’ persists: the tobacco industry is still using filters to suggest lower health risks while destroying the environment, K. Evans-Reeves, K. Lauber, R. Hiscock, Tobacco Control, 2021, doi: 10.1136/tobaccocontrol-2020-056245
• Philip Morris International’s partnerships with local authorities in Europe violate Article 5.3 of the FCTC, N. Taravira, L. Laurence, F.T. Filippidis, Tobacco Control Blog, 29 November 2021.
• Beware big tobacco bearing gifts: tobacco industry corporate social responsibility activities in Greece, N. A. Taravira, L. Laurence, F. T. Filippidis, Tobacco Control, 2022, doi: 10.1136/tobaccocontrol-2021-057143

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

References

The post Smoke-free Destinations appeared first on TobaccoTactics.

• Despite decades of denial, the tobacco industry has long known about the addictiveness of cigarettes.
• Tobacco companies manipulated the addictiveness of cigarettes via changes in content and design to attract and retain smokers. As a consequence, smokers today are at a greater risk of disease than smokers in the 1960’s, despite smoking fewer cigarettes.
• Greater implementation of FCTC guidelines around product innovation is needed to protect smokers from changes to cigarettes that increase addiction and harm.

Industry knowledge

Cigarettes have been called “dangerous by design”²³³. Industry documents reveal that tobacco companies have known for decades about the addictiveness of compounds in cigarettes, including nicotine. They knew how to design cigarettes to affect smokers’ perceptions and behaviours²³⁴, and knowingly altered the content and design of cigarettes to maintain addiction in their customers²³⁵. Yet up until the 1990’s, they continued to claim publicly that cigarettes were not addictive²³⁶ (see Image 1), despite overwhelming evidence at the time showing the opposite to be true²³⁷²³⁸. Tobacco companies’ own internal documents show that they even admitted that they knew all along how addictive their products were²³⁵.

Image 1. Tobacco company executives claimed that nicotine is not addictive in 1994 (Source: AP Photo/John Duricka). See this video (source: University of California San Francisco)

Public knowledge

In contrast to tobacco companies’ knowledge of the addictive compounds in cigarettes, the public is unaware of the majority of chemicals in cigarettes, with little awareness of the existence of additives in cigarettes. Yet, consumers do want more information about the ingredients in cigarettes²³⁹.

Cigarette additives

Tobacco companies increased the addictiveness of cigarettes by manipulating the effects of additives in cigarettes²⁴⁰. They increased the amount of nicotine delivered to smokers; and added other chemicals (eg: flavours, sugars, ammonia) to reduce the harshness and improve the taste of cigarette smoke, and to increase the absorption of nicotine.

Nicotine

Nicotine is the primary addictive component in cigarettes, reaching the brain seven seconds after being inhaled²⁴¹. The amount of nicotine delivered to smokers via tobacco smoke has increased overtime ²⁴²²⁴³. Between 1999 and 2011, it increased by 14.5%; which was due to changes made by manufacturers, rather than natural variation²⁴². This trend has been seen in all major market categories of cigarettes²⁴³ .

See the page on newer nicotine and tobacco products for information about nicotine in various consumer tobacco and nicotine products, and the page on harm reduction for information on the debate about the role of these products in tobacco control.

Flavours

Flavourings (eg: cocoa, liquorice, menthol) improve the taste and decrease the harshness of cigarette smoke²⁴⁴²⁴⁵. The ingredients in cocoa and liquorice can ease inhalation of tobacco smoke and nicotine²⁴⁶.

Menthol cigarettes (see Image 2) became popular in the 1950s. Menthol masks the harshness of tobacco and alleviates irritation from nicotine, which makes cigarettes easier to smoke²⁴⁷, promotes smoking initiation, and facilitates inhalation of tobacco smoke²⁴⁸. The cool sensation of menthol causes smokers to hold their breath, enabling greater exposure to the harmful substances in tobacco smoke. This results in increased addiction and tobacco-related diseases²⁴⁹.

See the page on Flavoured and Menthol Tobacco for information on how the industry circumvents menthol bans.

Image 2. Newport and Marlboro menthol cigarettes (source: DailyRecord.co.uk).

Other chemicals

Filter design

Tobacco companies deceitfully added filters to cigarettes in the 1950’s in an attempt to imply reduced harm, and entice smokers with health concerns, including women and young smokers. However, this design feature reduces smokers perceptions about the harms of smoking, yet in reality may increase the risk of harm²⁶⁰²⁶¹. The ventilation holes in filters increased the amount of nicotine delivered to smokers²⁶². Smokers of filtered cigarettes (see Image 3) take puffs deeper and more frequently (this is known as compensatory smoking)²⁶³, whilst blocking ventilation holes with their fingers²⁶⁴²⁶⁵, which means that carcinogens that are inhaled more deeply into the lungs²⁶⁶.

See the page on Cigarette Filters for information on marketing and the health and environmental harms.

Image 3. Cigarette filters (source: TheNewYorkTimesMagazine.com).

The U.S. Surgeon General’s report of 2014 concluded that, despite a decline in smoking prevalence, the risk of tobacco-related mortality has increased over the last 50 years due to changes in product composition and design. Specifically, it concluded that adding filters to cigarettes has caused an increase in lung adenocarcinomas (cancers in peripheral areas of the lungs)²⁶⁷.

See the page on Product Innovation for information on concerns around changes to products.

Global regulation

The World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) recognises that “cigarettes and some other products containing tobacco are highly engineered so as to create and maintain dependence”²⁶⁸. Articles 9 and 10 of the WHO FCTC require Parties to regulate the contents of tobacco products and disclose tobacco products ²⁶⁹. The FCTC recommends that attractiveness and its impact on dependence should be taken into consideration for regulation. It recommends that countries:

• Ban misleading and deceptive tobacco advertising, eg: descriptors such as “light” (see Image 4);
• Ban or restrict ingredients used to increase palatability of tobacco products, eg: sugars and sweeteners, and flavourings;
• Ban ingredients associated with energy and vitality in tobacco products;
• Require manufacturers to disclose information on the ingredients in tobacco products to governments, for each product type and each brand²⁶⁸.

See the page on Advertising Strategy for information on the industry’s use of advertising.

Image 4. Packets of Marlboro lights cigarettes (source: NewYorkTimes.com).

Up to date information on tobacco control legislation around the world can be found on the Tobacco Control Laws website (published by the Campaign for Tobacco Free Kids). You can search litigation by country, tobacco control measure, or type of legal action. The website also contains analysis and assessment of FCTC compliance, and policy factsheets. Parties to the WHO FCTC submit regular FCTC COP reports detailing their progress in implementing the treaty, which are presented in the FCTC Implementation database. Further information on countries’ progress in implementing the WHO recommended MPOWER measures can be found in the WHO reports on the global tobacco epidemic, a serious of biennial reports detailing status and compliance.

The tobacco industry has deliberately manipulated the content and design of cigarettes to maintain addiction in its customers. Given the greater harm experienced by smokers as a result²⁶⁷, greater implementation of FCTC guidelines around product innovation is required to protect smokers from changes to cigarettes that increase addiction and harm.

TobaccoTactics Resources

Product Innovation

Flavoured and Menthol Tobacco

Cigarette Filters

TCRG Research

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.

R. Hiscock, K. Silver, M. Zatonski, A. Gilmore, Tobacco industry tactics to circumvent and undermine the menthol cigarette ban in the UK, Tobacco Control, 18 May 2020, doi:10.1136/tobaccocontrol-2020-055769

J. R. Branston, R. Hiscock, K. Silver, D. Arnott, A. Gilmore, Cigarette-like cigarillo introduced to bypass taxation, standardised packaging, minimum pack sizes, and menthol ban in the UK, Tobacco Control, Online First, 26 August 2020, doi: 10.1136/tobaccocontrol-2020-055700

K. Evans-Reeves, K. Lauber, R. Hiscock, The ‘filter fraud’ persists: the tobacco industry is still using filters to suggest lower health risks while destroying the environment, Tobacco Control, 26 April 2021, doi:10.1136/tobaccocontrol-2020-056245

S. Dance, K. Evans-Reeves. Menthol: Tobacco Companies are exploiting loopholes in the UK’s characterising flavours ban. Tobacco Control.

References

The post Addiction Manipulation appeared first on TobaccoTactics.