English on cigarette packs from six non-Anglophone low- and middle-income countries.

OBJECTIVES: Low- and middle-income countries (LMICs) are vital to the global tobacco market. The pack is key to cigarette branding, and review of cigarette packs revealed English as a common feature. The prevalence of English and its potential branding utility is explored.

METHODS: Every available unique cigarette pack was purchased from diverse retailers in six LMICs where English is not the official language (Bangladesh, Brazil, China, Egypt, Ukraine, Vietnam). Packs' front panels were coded for English on pack fronts. English penetration was quantified by country and a comparison of English use between multinational and national brands was undertaken. A qualitative analysis of symbolic and utilitarian usage of English was conducted.

RESULTS: Of 1303 unique cigarette packs analyzed, 67% (n = 876) included some English. English text conveyed product information and usage instruction. English was more prevalent for multinational brands. Qualitatively, English use frequently connected cigarettes with concepts of quality, style, luxury, and aspirational lifestyle.

CONCLUSIONS: Restricting English use should be incorporated into plain packaging policy to protect populations from deceptive branding practices, specifically presenting cigarettes as an aspirational product.