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? The Author 2013. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.
doi:10.1093/eurpub/ckt161Advance Access published on 23 October 2013
Adolescent perceptions of cigarette appearance
Allison Ford1,2, Crawford Moodie1, Anne M. MacKintosh1, Gerard Hastings1,2
1 Centre for Tobacco Control Research, Institute for Social Marketing, University of Stirling, Stirlingshire FK9 4LA, UK
2 UK Centre for Tobacco Control Studies, University of Stirling, Stirlingshire FK9 4LA, UK
Correspondence: Allison Ford, Institute for Social Marketing, University of Stirling, Stirlingshire FK9 4LA, UK, Tel: +44 (0)
1786 467390, Fax: +44 (0) 1786 467400, e-mail: firstname.lastname@example.org
Background: To reduce the possibility of cigarette appearance misleading consumers about harm caused by the
product, the European Commission’s draft Tobacco Products Directive proposed banning cigarettes <7.5mm in
diameter. It appears however, following a plenary vote in the European Parliament, that this will not be part of
the final Tobacco Products Directive. To reduce the appeal of cigarettes, the Australian Government banned the
use of branding on cigarettes and stipulated a maximum cigarette length as part of the Tobacco Plain Packaging
Act. We explored the role, if any, of cigarette appearance on perceptions of appeal and harm among adolescents.
Methods: Focus group research with 15-year-olds (N=48) was conducted in Glasgow (Scotland) to explore young
people’s perceptions of eight cigarettes differing in length, diameter, colour and decorative design. Results: Slim
and superslim cigarettes with white filter tips and decorative features were viewed most favourably and rated
most attractive across gender and socio-economic groups. The slimmer diameters of these cigarettes
communicated weaker tasting and less harmful looking cigarettes. This was closely linked to appeal as thinness
implied a more pleasant and palatable smoke for young smokers. A long brown cigarette was viewed as particu-
larly unattractive and communicated a stronger and more harmful product. Conclusion: This exploratory study
provides some support that standardising cigarette appearance could reduce the appeal of cigarettes in adoles-
cents and reduce the opportunity for stick design to mislead young smokers in terms of harm.
Tobacco Control recommend that ‘individual cigarettes or
other tobacco products should carry no advertising or promotion,
including design features that make products attractive’.1To reduce
the appeal of cigarettes, the Australian Government stipulated partial
product standardisation as part of the Tobacco Plain Packaging Act,
which was fully implemented in December 2012. The use of
branding (including colour, brand name and decorative elements)
on cigarettes is now prohibited, a maximum length for cigarettes has
been specified and cigarettes must be white or white with an
imitation cork filter. The legislation does not, however, place any
parameters on cigarette diameter.2
The European Commission proposed a different approach from
Australia with the draft Tobacco Products Directive (TPD)
announced in December 2012. The draft TPD did not propose a
ban on branding on cigarettes but instead a ban on cigarettes less
than 7.5mm in diameter, on the basis that ‘cigarettes with a
diameter of less than 7.5mm shall be deemed misleading’.3This
recommendation would have prohibited the sale of very slim
cigarettes, called ‘superslims’, in the European Union. However,
no research to date has examined the impact of slimmer cigarettes
he guidelines on Article 13 of the Framework Convention on
on product attributes such as the perceived attractiveness or level of
harm among adolescents.
Tobacco companies increasingly offer brand variants that feature
alternative cigarette diameters, decorative designs and lengths.4,5
Analyses of tobacco industry documents show that modifications
to the appearance of cigarettes can make them more appealing to
specific target groups, notably ‘starter’ and female smokers and can
help to boost sales and market share.6–8Exemplifying the potential
for product design to influence growth, sales of slim cigarettes grew
by 50% from 23855 million sticks in 2000 to 35673 million sticks in
2010 in Europe, despite a general decline in factory manufactured
cigarette sales.9This is consistent with global trends where the
superslims segment is reported to have grown 10 times faster than
the overall market in the past 5 years.10
It has been suggested that younger people are often the target of
novel product design11and most vulnerable to the impact of tobacco
marketing as they are especially susceptible to tobacco brand
Recently, the public health focus on cues which influence brand
imagery and product beliefs has lain with cigarette packaging.14–17
However, marketing literature suggests that cigarette characteristics,
such as length, diameter, colour and decorative elements, are
intrinsic product cues that are not only consumed along with the
European Journal of Public Health
by guest on January 9, 2016
product but also contain the message of the product and infer
product attributes.18,19Indeed, for young adult smokers, cigarette
appearance has been found to be a method of product differenti-
ation with respect to attractiveness, quality and strength of taste.20
Slim and white cigarette designs have also been shown to help
distance young adult female smokers from negative associations
with smoking by portraying a glamorous, slim, elegant and clean
This study aimed to extend recent work20,21by exploring whether
cigarette appearance may act as a promotional and communications
tool. We examined the appeal of cigarette design and whether design
influences harm perceptions among adolescents. To our knowledge
there has been no research outside the tobacco industry, which has
explored adolescents’ perceptions of different cigarette designs.
Focus groups were employed to explore how young people engage
with different cigarette designs. Exploratory research is appropriate
when there has been little prior study of the issue and the objective is
to gain general insights and an understanding of the dynamics of a
particular subject.22,23Focus groups provide a setting where partici-
pants can freely express beliefs and attitudes, which in turn can be
justified with meaning and interpretation.24,25Focus groups also
gave participants an opportunity to handle cigarettes, rather than
viewing images,20,21and therefore allowed a true representation of
tactility, dimension and colour.
Using purposive sampling, participants were recruited by market
research recruiters according to quota controls on gender and
socio-economic grouping. Potential participants were approached
by recruiters via door-to-door methods and in the street. To
reduce socially desirable responses and disguise the health related
aspect of this research, participants were informed that the study
purpose was to explore the marketing of a range of consumer
products to young people, including tobacco.
Informed participant and parental consent was obtained prior to
the focus groups. Both participants and parents were provided with
an information sheet, given the opportunity to ask questions and
told of their right to withdraw from the research at any time.
Participants received a small incentive (£15) for participation.
All study procedures were approved by the Institute for Socio-
Management ethics committee at the University of Stirling.
Because of potential sensitivities involved in exposing young
people to cigarettes, each session ended with a discussion to
ensure the group did not encourage participants to look
favourably on cigarettes or smoking. Participants were given an in-
formation pack, specifically developed for a youth audience, to take
away. This included information on smoking related harms, harms
associated with second hand smoke exposure, support on quitting
(for those who were smokers) and information explaining how
tobacco marketing may promote smoking among young people.
Educating young people on why and how they are a particular
target of the tobacco industry has been found to be an effective
The study took place in Glasgow, Scotland, in April 2011. The
groups were held in a modern community venue which provided an
informal and relaxed environment. Each group lasted approximately
Eight focus groups, each with six participants, were conducted
with 15 year olds (N=48). Groups were split evenly by gender
working class). We focused on 15 year olds given the difficulty
recruiting those below this age and because of their greater in-
volvement with smoking than younger age groups, e.g. 13% of 15
year olds in Scotland are regular smokers (smoke one or more
cigarettes a week) compared with 3% of 13 year olds.27Within
the sample, 19% percent (N=9) were identified as regular
smokers on a recruitment questionnaire and 81% (N=39) as
non-smokers. It was not possible to segment groups by smoking
status, as intended, because of recruitment difficulties; however,
the smoker/non-smoker split was in line with comparative
national figures.27Among the 39 non-smokers, 34 had never
smoked and 5 had tried smoking in the past. All nine smokers
were from the C2DE economic grouping. Five female smokers
comprised the majority of Group 1 and four male smokers the
majority of Group 4 (see table 1).
At the start of each group, participants were informed that there
were no right or wrong answers, and we were only interested in what
they thought. The groups started with a warm-up discussion on
general shopping habits before moving on to consumer goods
awareness. Participants were asked to think about cigarettes they
had seen and to describe where they saw them, what they looked
like and any differences. Eight cigarettes, which differed in length,
diameter, colour and decorative design, were then shown to partici-
pants; all were available on the UK market at the time of the study.
The eight cigarettes were: a longer length brown cigarette, a
superking size with an imitation cork tip, three narrow slims and
superslims cigarettes with white tips and decorative elements, a
standard king size cigarette with an imitation cork tip, a white-
tipped king size cigarette and a short unfiltered white cigarette
(see figure 1). To explore the messages young people infer from
cigarette design, participants were asked to group the cigarettes
together in whatever way they thought appropriate. Projective
imagery techniques such as free association, where participants
raise whatever thoughts come to mind when viewing products,
were used to assess what is communicated by cigarette design.28
appearance and indicate the brand imagery projected. Participants
then ordered the items for attractiveness, strength and harm.
Photographs were taken to record the positioning of cigarettes.
The lead moderator used a semi-structured topic guide to allow
the same questions to be asked across groups while allowing flexi-
bility in the group discussions. A second moderator observed and
recorded participants’ non-verbal reactions to cigarettes including
body language, facial expressions and verbal exclamations. This
ensured that other, but no less important, responses were not
missed. Observations, recorded in a systematic way, can be useful
to give accurate accounts of responses and behaviours as they
Table 1 Sample composition
GroupGenderSocial gradeSmoking status
a: Group 1 comprised a majority of smokers with five smokers and
b: Group 4 comprised a majority of smokers with four smokers and
Adolescent perceptions of cigarette appearance
by guest on January 9, 2016
happen and do not rely on the eloquence of participants.29These
observations supplemented the data from the group discussions,
which were audio-recorded with participants’ permission and
Transcripts were initially checked against recordings for accuracy.
Data from the transcripts, photographs and focus group observa-
tions were reviewed using thematic analysis to identify key and
emergent themes. The research team met to discuss and review the
themes until consensus was achieved. Transcripts were coded using
NVivo9 software and the analysis followed an inductive approach to
interpret the data.
Awareness of cigarette design
When initially asked about cigarette appearance, the ‘standard’
identified was a white king-size cigarette with imitation cork filter.
As the discussion progressed, participants recalled cigarettes that
differed from the norm, suggesting that details of cigarette
appearance are noticed by adolescents. Most groups were able to
recall cigarettes with white tips, assumed to indicate menthol
flavouring, and a pink-tipped cigarette was also mentioned. One
group commented that cigarettes could be different lengths. There
was also some awareness of cigarettes displaying branding, such as
brand symbols and brand names, and other decorative features such
as gold bands.
Cigarettes as a promotional and communication tool
When shown the eight cigarettes, a small number of participants,
who had previously referred to cigarettes as disgusting, ugly and
smelly, were disinterested in them or visibly recoiled. However, for
most, the cigarettes generated interest and curiosity. Participants
were surprised with the amount of variation in cigarette
appearance and, in general, studied the cigarettes intently, with
particular attention paid to diameter and decorative elements,
including the font style of brand names. Some participants took
the time to smell them and were sometimes reluctant to pass
them on. It was highlighted in one group that a different looking
product is enough to spark their interest and one boy wanted to try
the superslims size.
You’d be interested. You’d be like ‘what’s that? Does it taste the
same?’ (Boy, C2DE).
I’d smoke it (superslims). I’d only have one but (Boy, C2DE).
There was little evidence that the smokers’ responses were any
different to those identifying as non-smokers. Irrespective of
smoking status, there was surprise at being shown cigarettes,
which differed from the ‘standard’, suggesting that the more
unusual slim, brown and filter-less cigarettes were as unfamiliar to
smokers as they were to non-smokers. There were also few group
differences in terms of gender and no apparent differences by socio-
economic grouping. Participants had no difficulty differentiating
and assigning categories and meanings to the cigarettes. The two
cigarettes with imitation cork filters were usually placed together
as ‘standard’ ones and sometimes with cigarettes of similar
diameter. The three slimmer cigarettes were grouped together
because of their size and decorative patterns or brand name font
on the filter, often described as the ‘cool’ ones, which looked ‘fancy’
and ‘expensive’. They were repeatedly called ‘skinny’, ‘cute’ and
‘feminine’ and likened to ‘sweeties’. The slims and superslims had
the most favourable reaction, leading some participants to laugh and
smile. These positive responses overshadowed the general negative
attitude to smoking among most participants—even among the two
groups with participants who identified as smokers, there was a
feeling of stigma and shame attached to smoking. Within one
group of non-smoking girls, there was a particular tension where
they found it difficult to associate the slimmer cigarettes with
something they had previously held firm negative views on. In
contrast, the brown cigarette enhanced the negative associations
most participants held with regard to smoking. It was repeatedly
likened to a ‘cigar’ and ‘twig’ and described as ‘disgusting’ and
The slims and superslims were consistently rated as most attractive.
The exception was one boy group that rated them as unattractive as
they perceived them to be feminine. For some, the novelty of these
cigarettes, that they did not resemble a ‘standard’ cigarette, enhanced
The patterns, they just look nicer (Girl, ABC1).
There were mixed feelings about the two more ‘standard’ looking
cigarettes: the king size and superking size with imitation cork filters.
Half the groups rated the king size attractive, while three rated the
superking size attractive. Others felt they were boring. This mixed
response was because of the perception that this style of cigarette was
common, which for some participants was a positive and for others a
You always see they cigarettes (Girls, C2DE).
These ones are attractive because everyone smokes them (Girl,
The white-tipped king-size cigarette was generally viewed as un-
attractive and described as ‘boring’, ‘cheap’ and ‘plain’. Often,
appeal was based on the perceived smoking experience. In this
regard, the brown and unfiltered cigarettes were perceived as par-
ticularly unattractive, an unpleasant smoke and smelly, while the
slimmer cigarettes were described as ‘nicer’.
There’s no bud (filter) on it. It doesn’t look like it would be
comfortable to smoke (Boy, ABC1).
They (superslims) look nice to smoke (Boy, C2DE).
Like they (superslims) don’t look like they would taste horrible
Figure 1 Cigarettes used as focus group stimuli. (A) Longer
length brown cigarette with gold More brand name and band.
(B) Superking-size cigarette with imitation cork filter and
Superkings brand name and symbol. (C) Slim-size cigarette with
white tip and purple decorative design. (D) Superslim-size cigarette
with white tip and purple floral design. (E) Superslim-size cigarette
with white tip and Vogue brand name in blue decorative font.
(F) King-size cigarette with imitation cork filter and Mayfair brand
name. (G) King-size cigarette with white tip and green Mayfair
brand name. (H) Shorter filterless cigarette with Woodbine brand
European Journal of Public Health
by guest on January 9, 2016
Appeal was also closely linked with strength and harm perceptions.
Young people appeared to be attracted to weaker and less harmful
If someone hands you a stronger one or a weaker one you’d
probably take the weaker one, depending on how long you’d
been smoking for...So they’re not doing themselves the biggest
amount of damage straight away. So they are just jumping into
the shallow end instead of the deep end kind of thing (Boy,
Strength and harm perceptions
From the outset and unprompted, participants associated cigarettes
with different levels of strength and harm. Judgements about
strength and harm appeared to result primarily from diameter and
to a lesser extent, colour, decoration and length. Overall, the three
slimmer cigarettes were rated weakest and least harmful because of
their small diameter. The general view was that because they contain
less tobacco, they must, therefore, be less harmful. The white tips
and longer length also helped to portray a ‘cleaner’ female image
described as ‘glamorous’ and ‘classy’ and reminded some partici-
pants of females smoking in old movies. These images helped to
soften harm perceptions.
Because it’s skinny you feel that you’re not doing so much damage
...they don’t look like cigarettes so you wouldn’t think like
When you think about who smokes them you don’t think of
someone who is really ill (Girls, C2DE).
Conversely, larger diameters and imitation cork filters gave the
impression of a stronger and more harmful product as did the
longer length of the brown and cork-tipped superking-size
cigarette. The fully brown cigarette was seen as particularly strong
It (brown cigarette) looks really, really strong...
Cos it’s very dark.
Overpowering, the colour (Boys C2DE).
There were mixed responses to the white-tipped king-size
cigarette. This cigarette’s white tip was associated with menthol
and perceived as weaker and less harmful. However, its diameter
sometimes produced a conundrum as the thicker size was
considered to indicate a stronger product. This suggests that adoles-
cents view cigarette design holistically when forming value
We found that cigarette appearance can generate significant interest
among adolescents. Intrinsic cues, such as colour, length, diameter
and decorative features, easily communicated messages and imagery
related to gender suitability, price, glamour and coolness. Appeal
was based on these characteristics. The slims and superslims with
smaller diameters, white tips and decorative elements were consist-
ently perceived as most attractive. This is in contrast with previous
findings with young adult ever-smokers, who rated an image of a
cigarette with a standard length and diameter and cork tip as most
In our study, smaller diameters, in particular,
communicated weaker and less harmful looking cigarettes. This
was closely linked to the level of appeal as they implied a more
pleasant and palatable smoke for ‘starter’ smokers. These differences
may suggest that adults and adolescents prefer and place importance
on different features of cigarette designs. Alternatively, differences in
study design and the presentation of cigarettes may account for this
incongruence, with previous research showing images of cigarettes
to participants, whereas we allowed participants to handle cigarettes.
The positive imagery conjured up by slimmer cigarettes was at
odds with participants’ negative attitudes towards smoking and
smokers. These cigarettes appeared ‘cleaner’ and did not resemble
a ‘standard’ cigarette, thereby losing some of the negative associ-
ations of smoking. Similarly, the attractiveness of slim cigarettes
has been found to resolve the dissonance between the self-image
and identity young adult females wish to create and the negative
connotations of smoking.21Cigarette characteristics that reduce
negative perceptions and indicate smoothness and mildness have
been identified as important for young smokers in industry
documents.30Slim cigarettes help the tobacco industry create the
image of a safer cigarette by implying ‘ease of draw’ and less
sidestream smoke and tar.8,31
research suggests that while superslims may contain less tobacco
than regular-sized cigarettes, some superslims brands have higher
levels of tobacco specific nitrosamines and aromatic amines than
The study has a number of limitations. Given the small sample
size, the findings cannot be considered representative, although
given the exploratory nature of the study, this was not our aim.
As real cigarettes were used as stimuli, brand names were visible
on some of the cigarettes. Therefore, it is possible that prior brand
knowledge may have played a role in influencing participants’ per-
ceptions, especially for the Mayfair cigarettes, a popular youth
brand. As the nine smokers comprised the majority of two groups,
it is unlikely that non-smoker norms would have influenced their
responses, although it is possible that the stigma the smokers
attached to smoking meant their true responses may have been
suppressed. This may account for the lack of differences between
smokers and non-smokers. In addition, we do not know whether
attractiveness of cigarette design translates into smoking behaviour
or brand choice. However, this exploratory research does suggest
that standardising cigarette appearance may reduce the potential
for cigarettes to be used as a marketing tool, particularly as
tobacco industry journals describe the cigarette as an increasingly
Participants found a longer length brown cigarette least attractive.
This design enhanced participants’ negative associations with
smoking and supports the notion that dissuasive cigarettes could
be used to reduce the appeal of cigarettes and smoking.21
The findings show that differences in cigarette appearance can
generate interest, provide novelty, communicate positive imagery
and mislead adolescents in respect to product harm. While
providing support for the ban on branding, colour and other
decorative elements on cigarettes in Australia, this study suggests
that standardising diameter could further reduce the opportunity
for the tobacco industry to communicate with and influence
young people. In this respect, the fact that the European
Parliament has voted against the proposed ban on cigarettes less
than 7.5mm in diameter would appear a missed opportunity for
improving tobacco control policy in Europe.34
However, importantly, recent
This work was supported by a grant from Cancer Research UK
(C312/A8721). The UK Centre for Tobacco Control Studies
contributed to the funding of Allison Ford and Gerard Hastings.
Conflicts of interest: None declared.
? This is the first study to assess adolescent response to
? Slim and superslim cigarettes were rated most attractive and
indicated weaker and less harmful products, while a long
Adolescent perceptions of cigarette appearance
by guest on January 9, 2016
brown cigarette was viewed as particularly unattractive,
communicated a stronger and more harmful product and
strengthened negative associations with smoking.
? These findings suggest that product standardisation may
help reduce the appeal of cigarettes and smoking in
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