Inventory of worldwide availability of flavour accessories: do-it-yourself flavour addition to increase tobacco products’ attractiveness

Introduction Flavours increase tobacco product appeal and contribute to initiation of tobacco product use, particularly among youth. Therefore, many jurisdictions have restricted or prohibited the use of flavours in nicotine and/or tobacco products, particularly to prevent youth uptake of these products. However, the effect of flavour regulations seems to have been weakened by recent market innovations, which most likely were developed, as a response to flavour bans. An example are flavour accessories, which allow consumers to introduce flavours to (unflavoured) tobacco products. Although they seem to increase tobacco product appeal, they are often not subject to (tobacco) legislations. Material and Methods A uniform search protocol was developed to acquire information on the availability and marketing of flavour accessories in web shops accessible from 8markets globally, including Brazil, India, Italy, Singapore, South-Africa, Switzerland, the United Kingdom and the United States of America. Data previously collected from the Netherlands were also analysed. Characteristics of the products and web shops were noted, and flavours were categorized in a flavour wheel. Results Flavour accessories were available in all participating countries, with the reported types being flavour capsules, cards, filter tips and tubes for make-your-own cigarettes, drops, sprays, rolling paper, aroma markers, a flavour stone, and a powder. 121 unique flavours were reported, which were mostly fruit, sweet, alcoholic and minty flavours. Promotion of these products was often associated with (menthol) flavour bans and web shops were in many cases evaluated to be attractive to youth. Conclusions The wide availability and variety of flavouring accessories is concerning. They have attractive flavours and seem to be marketed to youth, and thus circumvent the regulatory aim of flavour bans. Therefore, policy makers should consider banning these products to complement existing tobacco control measures.