The boom in fruit flavour cigarettes is driving youth smoking in Latin America—despite the tobacco industry’s promises
BMJ 2024; 387 doi: https://doi.org/10.1136/bmj.q2553 (Published 21 November 2024) Cite this as: BMJ 2024;387:q2553
- María Pérez, senior reporter, The Examination1,
- Jason McLure, correspondent, The Examination2,
- Francisca Skoknic, editor, LaBot3
- Correspondence to: M Pérez maria{at}theexamination.org
While much of the world wrestles with regulations around vapes and their many flavours, Philip Morris International (PMI) and British American Tobacco (BAT) have been pumping flavours into conventional cigarettes and fighting efforts to ban the products throughout Latin America, shows a joint investigation by The Examination and the media outlets Salud Con Lupa (Peru), and LaBot (Chile).
Featuring splashy packaging, breezy names, and flavours that taste like blueberry, apple, or menthol, new varieties of cigarettes—known as click, capsule, or crush ball cigarettes (a capsule is crushed to use them, making a clicking sound)—are soaring in popularity in Latin America (fig 1). Both PMI and BAT have released dozens of new flavour capsule brands in the region in recent years—despite promises to phase out cigarettes in favour of newer nicotine products and vows not to market tobacco in ways that appeal to children.
Flavour capsule cigarettes in Latin America: market share for the child friendly products has surged since 2009
The two companies dominate the cigarette market in Latin America and promote their brands through tactics such as marketing at music festivals and in launch parties at dance clubs. In Chile, brands such as the berry flavour Lucky Strike Fresh Wild account for 42% of the cigarettes sold in the country, up from less than 2% in 2009, says Euromonitor International. In Peru these brands make up more than half of cigarette sales, and in Argentina, Bolivia, Colombia, Costa Rica, Guatemala, and Mexico more than one in five sold are click cigarettes.
The products are banned or restricted by the European Union’s 27 member nations, as well as Canada and at least 20 other countries. In the US, capsule brands such as Camel Crush and Marlboro NXT are allowed only in menthol varieties and account for but a sliver of the market.
The growth in popularity of capsule cigarettes—which are also sold in Russia and parts of Asia and Africa—is drawing the attention of researchers, regulators, and doctors. Tobacco related diseases are estimated to cost health ministries in Latin America close to US$34bn (£26.9bn; €32.9bn) a year.1 They contribute to more than a quarter of a million deaths in the region each year, says the University of Washington’s Institute for Health Metrics and Evaluation, based in Seattle.2
Cigarettes containing flavour capsules are “a huge, global public health threat,” says Crawford Moodie, a researcher with the University of Stirling, UK, who has studied flavour cigarettes for years. Children and young people view them as cool, high tech, and novel, says Moodie: “It makes smoking fun.”
“A better tomorrow”
In 2016 Marlboro’s maker, PMI, announced that it had a new purpose: to deliver a smoke-free future. The company had recently launched its iQOS heated tobacco device, which it promoted as a potentially lower risk alternative to cigarettes. PMI’s new goal was to “ultimately replace combustible products to the benefit of adult smokers, society and our company.”
Yet, over the next eight years, PMI introduced at least 30 new flavour capsule cigarette brands into Latin American markets, including watermelon flavour Marlboro Summer Zest and cherry and menthol flavour Marlboro Blossom Fusion, shows a review of government records, scientific research, and other reporting by The Examination. Just last year, the company executive Werner Barth touted Marlboro’s top position in capsule cigarettes at a meeting with investors, noting that it was one of the few growing areas of the cigarette market and highlighting the company’s success in rolling out new varieties in markets from Mexico to Algeria.
In 2020 PMI’s main rival, BAT, followed suit, announcing that it too would move away from the cigarette business and concentrate on switching smokers to newer products it described as posing a reduced risk, such as its Vuse vaping device. The company trademarked a name for its vision: A Better Tomorrow.
Yet the company continued to roll out new lines of cigarettes featuring fruity flavours. Throughout the Latin American region BAT released at least 27 new flavour capsule brands after A Better Tomorrow was announced, including cigarettes with names such as Kent Neo Tropic and Pall Mall Sunrise Mix. Among the flavours BAT embedded in its cigarettes were berries, melon, and Lucky Strike Charged—a flavour that retailers and others said resembled the energy drink Red Bull.
Joanna Cohen, director of the Institute for Global Tobacco Control at the Johns Hopkins Bloomberg School of Public Health in Baltimore, says that what tobacco companies do, rather than what they say in public, is what matters. “You have to focus on their actions,” she says. “You can’t take what they’re saying at face value.”
A brief history of flavour cigarettes
Menthols were the first flavour cigarettes to gain mass appeal in the US in the 1950s. Made by adding the minty flavouring to tobacco or rolling paper, these cigarettes were cherished by users for anaesthetising the throat and masking the harsh taste of burning tobacco.
Over the next few decades tobacco companies researched various new flavourings. In the late 1970s, Lorillard Tobacco Co, later absorbed by British American Tobacco (BAT), researched marshmallow, cherry, creme de menthe, and tutti-frutti flavour cigarettes, concluding that some flavours would appeal to consumers who were “very young,” “teenagers,” or “beginner cigarette smokers,” records show.
After years of development the first flavour capsule cigarette hit the market in 2007 in Japan, made by BAT: a Kool Boost, which released menthol flavouring. Soon after that, Camel Crush menthol capsules debuted in the US, made by Reynolds American—then partly owned by BAT.
By 2010 Philip Morris International was also in the game. A company executive in a presentation to investors later applauded one of its capsule advertisements in Argentina whose copy read, “Balls are meant to be broken.”
Youth appeal
PMI has acknowledged that sweet and fruity flavours are a big reason why teenagers start using a product similar to cigarettes—vapes. In 2023 the company supported flavour restrictions for vapes in the UK, “to limit undue youth appeal.”
The candy-like flavours and flashy packaging are just a continuation of the tobacco industry’s long running practice of targeting teenagers, says Dale Mantey, a professor at UTHealth Houston School of Public Health in Texas. “Fruity flavours really appeal to youth,” he says. “Not just the flavours but the marketing, the bright colours . . . it’s almost their way of sneaking Joe Camel back on the market.”
In Mexico, one recent study estimated that half of smokers aged 10-19 used capsule cigarettes.3 In Argentina, another found that about 75% of teen smokers in Buenos Aires reported using flavour cigarettes.4
Effective marketing to young people explains part of the industry’s success. A 2016 video for BAT’s berry flavour Lucky Strike Double Click Wild in Peru features young people running in bathing suits to the tune “Cool Kids” by Echosmith—a pop band led by an 18 year old singer that garnered nominations for the Teen Choice Awards and Nickelodeon Kids’ Choice Awards in 2015.
That same year, at an outdoor launch party for Lucky Strike Indigo capsule cigarettes at Andres Bello University in Santiago, attendees smoked, drank, and wore virtual reality headsets, in photos of the event posted on social media. In 2017 BAT released a lively inhouse video celebrating Lucky Strike Indigo’s success in Peru and Chile, featuring montages of young people dancing and partying to “Stitches” by Shawn Mendes, a teenage singer at the time.
Music has been a pillar of PMI’s marketing efforts as well. Just this year in Peru, the company promoted one of its capsule brands by raffling tickets to DGTL Lima, an electronic music festival and dance party. And in Colombia the company has sponsored the Estéreo Picnic music festival for the past several years. One of the largest musical events in Latin America, the four day concert features pop stars such as Billie Eilish, Olivia Rodrigo, and Lil Nas X.
At these festivals, Marlboro capsule cigarettes were marketed at neon lit kiosks and by models with backpacks meandering through the crowds of young people near the entrance, said a report from the watchdog group Corporate Accountability. Last year the market share of capsule cigarettes in Colombia rose to 33%—more than tripling since 2017, said Euromonitor International.
PMI and BAT both say that their products are not intended for children. “We comply with all local laws, as well as our own strict marketing code that often goes far beyond what is legally required,” says Corey Henry, a PMI spokesman. The company’s marketing code of conduct reads, “We do not want minors to use any PMI product and we do not market to minors.” It adds that PMI assesses flavours before putting them on the market, to “minimise the risk of adverse consequences, including appealing to youth and other unintended audiences.”5
BAT, whose brands include Lucky Strike, Pall Mall, and Kent, says on a web page labelled “Ethics and integrity” that the company’s “marketing is aimed only at adult consumers and is not designed to engage or appeal to children.”6 A BAT spokesman said in a statement, “We are clear that our tobacco and nicotine products are for adults only and should never be used by those who are underage. We abide by strict marketing principles, in addition to requirements under local law to prevent marketing and sales to underage.”
Fighting bans
Public health experts say that banning flavours in cigarettes can considerably reduce the number of minors who smoke. In the US, for example, one study estimated that a 2009 ban on non-menthol flavourings reduced teenage cigarette use by 17%. Another put the figure at 43%.78 Guidelines addressed to an international treaty on tobacco control recommend that the more than 180 member countries ban or restrict cigarette flavourings.
Yet efforts to ban flavours have failed in Latin America. In Mexico, the region’s third biggest market, a bill that would outlaw flavour tobacco products didn’t get past the Senate earlier this year. In Peru a tobacco control bill included a proposed ban on flavour tobacco, but the provision was dropped shortly before Congress passed the bill last month.
In Brazil, trade groups whose members include BAT and PMI first challenged a ban in court in 2012—prompting a delay in implementation that continues at the time of writing. Both companies have been releasing new capsule brands in the interim. But it’s Chile that has the highest rate of tobacco use in the western hemisphere: nearly 30% of Chileans used tobacco in 2020, and the average age that middle and high schoolers start is 13.
Chilean officials tried to block flavours before they became widely available in 2011, when capsule brands were less than 4% of the market. The health ministry sought to ban flavourings under a law that gave it the authority to ban ingredients that increased harm to smokers. But the ban was quickly blocked by another administrative office—that of the comptroller general—that can reject regulations on legal and constitutional grounds. The comptroller said that authorities hadn’t proved that the flavour additives harmed smokers.
The health ministry tried a new ban limited to menthol in 2013, after Chile’s Congress gave it the power to also ban additives that make cigarettes more addictive. Again, it was rejected by the comptroller general’s office. When the health ministry asked the comptroller’s office to reconsider its decision, BAT and PMI filed documents opposing the petition. Again, the health ministry lost.
Documents obtained by The Examination and LaBot show that Chile’s comptroller general at the time, Ramiro Mendoza Zúñiga, had represented BAT as a lawyer on regulatory matters until the day before he took office in 2007. Mendoza himself had signed the first decision blocking a flavour ban in 2011, and that early ruling was cited as precedent by a deputy, who ruled against the menthol ban in 2013. Mendoza declined to explain his actions when approached, saying that it was almost a decade since he’d been comptroller general.
Still, Chilean lawmakers continued their attempts to ban flavours as capsules were exploding in popularity—their market share increasing to 30% by 2015. During that time BAT threatened to close operations in tobacco growing regions and to shutter its manufacturing plant in Chile if a bill banning flavours became law. The closures would affect a “significant” number of growers, and workers would be affected, the company argued. Moreover, smuggling would increase and tax authorities would lose as much as $400m a year as a result of the ban and another of the bill’s measures, the company said in a press release.
Tobacco workers also protested against a ban and targeted individual senators who supported the bills, such as the former senator Guido Girardi, an outspoken opponent of BAT who called cigarette flavourings “criminal.” One banner, hung along a main thoroughfare, read, “Girardi doesn’t give a damn about our source of work.” Another read, “Tobacco law = 5000 unemployed.”
When the proposed ban regained momentum in 2021, BAT—by then publicly committed to A Better Tomorrow—once more opposed it. The bill has been stalled since.
Celso Muñiz, manager of the Chilean government’s Office for the Prevention of Tobacco Consumption, says that industry pressure on the issue has been unrelenting: “It’s constant, whenever there’s progress in the legislative processes.”
The industry’s success in staving off bans in Latin America means that it has retained customers such as 20 year old Martin Retamales, who started smoking click cigarettes at 17 to assuage his anxiety. He says that plain cigarettes taste horrible, and he doesn’t smoke them even when they’re the only ones around at parties. Retamales says that a ban on flavoured cigarettes in Chile would surely affect his life. “I’d quit smoking if they did it,” he says, while taking a break in the courtyard of the University of Chile School of Law.
Acknowledgments
Jason Martínez, Matthew Chapman, Ashley Okwuosa, and Fernanda Aguirre contributed reporting.
Footnotes
Competing interests: MP, JM, and FS declare no competing interests. This article is an edit of a longer version published by The Examination, which receives funding from Bloomberg Philanthropies.
Provenance: Commissioned; not externally peer reviewed.