Dissuasive measures on tobacco products: a rapid review of global evidence

New and innovative measures are needed to combat tobacco industry marketing strategies and reduce the harm caused by tobacco products. This rapid review aimed to identify and synthesize global evidence relating to dissuasive tobacco product measures, defined as unappealing colours and/or messages directly applied to individual tobacco products to discourage uptake and motivate cessation. Scopus, PubMed, Ovid, and Google were systematically searched from January 2000 to September 2024 to capture all published evidence relating to dissuasive measures, regardless of study design and tobacco product investigated. 'Forward' and 'backward' citation searching was also conducted. Studies were assessed for quality using JBI critical appraisal tools. Forty-seven eligible publications from 6011 titles/abstracts were included, all relating to conventional cigarettes: 37 peer-reviewed journal articles, including 2 reviews, 29 empirical studies (19 quantitative, 9 qualitative, 1 mixed-methods) and 6 commentaries, 8 government publications, 1 market research report and 1 doctoral thesis. Evidence largely related to perceptions of dissuasive products and their likely impacts. No empirical evidence regarding the relation of dissuasive measures to tobacco control outcomes was located. When compared with standard cigarettes, darker coloured cigarettes-often brown and green-were perceived to be less appealing, whilst cigarettes with messages related to the impact of smoking on finances, others, mortality, and life expectancy were viewed as novel and effective, and capable of inciting behavioural change. The available evidence is generally supportive of dissuasive cigarettes as a tobacco control measure, although a lack of empirical evidence on tobacco control outcomes limits the findings.