Adapting the Tobacco Pack Surveillance System Protocol to Assess Electronic Cigarette Packaging: Protocol for a...

Area of Science:

• Public Health
• Tobacco Control
• Regulatory Science

Background:

• Global e-cigarette use reached 82 million people in 2021, with wide-ranging international regulations.
• The Tobacco Pack Surveillance System (TPackSS) monitors tobacco packaging in low- and middle-income countries.
• TPackSS assesses compliance and identifies marketing strategies on tobacco packaging.

Purpose of the Study:

• To adapt and expand the TPackSS protocol for disposable e-cigarette devices, liquids, and pods/cartridges.
• To enhance global surveillance of e-cigarette products and their marketing.

Main Methods:

• The TPackSS protocol was adapted for e-cigarettes, incorporating data collection in Indonesia (2022) and China (2023).
• Adaptations included sampling, collection, photography, shipment, translation, and codebook adjustments for country-specific contexts and product diversity.
• The protocol was refined through an iterative process involving expert discussions, literature review, and pilot testing in Indonesia.

Main Results:

• Data collection occurred from September-October 2022 in Indonesia and April-May 2023 in China.
• A total of 968 unique e-cigarette products were collected across both countries.
• TPackSS data, coding procedures, and findings are publicly accessible on the TPackSS website.

Conclusions:

• The adapted TPackSS protocol is suitable for diverse e-cigarette markets and regulatory environments.
• Findings can inform public health policy by revealing e-cigarette design features, marketing tactics, and health warning label compliance.
• This surveillance system provides crucial insights for effective tobacco control strategies.