JMIR Publications

ABSTRACT

Background:

In 2021, 82 million people used e-cigarettes globally. E-cigarette regulations around the globe vary widely from the product being banned in some jurisdictions to being completely unregulated in others. The Tobacco Pack Surveillance system (TPackSS) was developed in 2012 to monitor tobacco packs available in the 14 low- and middle- income countries with the greatest number of people who smoke. The aim of TPackSS is to assess compliance with country-specific tobacco packaging and labeling requirements and identify marketing features and appeals used on tobacco packaging.

Objective:

The objective of this study was to adapt and expand the previous TPackSS protocol to also include disposable e-cigarette devices and their accompanying products: e-cigarette liquids and pods/cartridges.

Methods:

E-cigarettes were added to TPackSS data collection in 2022 in Indonesia and were also collected in China in 2023. TPackSS tobacco product protocols established in 2013 were used as the foundation for e-cigarette data collection and coding. Protocols were also adapted to account for the retailer landscape for e-cigarettes, unique country contexts (e.g., regulations, market for e-cigarettes), and the heterogeneity of e-cigarette product packaging observed.

Results:

E-cigarette products were purchased from selected cities in these countries using a systematic walking protocol and/or pre-selected vendors. Every unique product available was collected. Vape stores were visited in addition to the stores where consumers most often purchase tobacco products. The coding protocols were adapted from existing TPackSS protocols, as well as by conducting a literature review and consulting researchers with expertise in content analysis of e-cigarette packaging features and appeals and marketing. Each unique e-cigarette product was coded for key marketing features and appeals and for compliance with country-specific packaging and labeling regulations, where applicable. In line with the original TPackSS protocol, each pack was coded by two independent coders, and discrepancies were resolved by a third coder. Inconsistencies in coding were discussed and resolved.

Conclusions:

Across Indonesia and China, 968 unique e-cigarette products were collected. The protocols presented here, which we used in two countries with quite different e-cigarette markets and regulatory requirements, are intended to be adapted for use in other countries. TPackSS data collection and coding protocols, and study findings are publicly available for use on the TPackSS website.