Systematic misperceptions: cigarette variant names signal (reduced) harm amongst young adults

Introduction Cigarette brand variant names remain a key marketing tool despite restrictions under Article 13 of the EU Tobacco Products Directive. This study investigates whether variant names of popular cigarette brands evoke associations that violate the Directive's prohibitions on harm and flavour-related claims in the Netherlands Methods 1,354 participants (younger adult and adult daily smokers, younger adult non-daily smokers, and younger adult non-smokers) offered unprompted and prompted associations with 10 variants from three major brands to explore perceptions of harm and taste. Qualitative responses were coded and analysed, and quantitative comparisons assessed differences across variant types. Results Variant names referring to former ‘mild’ variant names (e.g., “Gold”, “Blue") were perceived as less harmful than full-flavour variants (e.g., “Red"). Variant names referring to former ‘menthol’ variants (e.g., “Green”, “Alpine") elicited strong associations with menthol flavour, particularly among younger participants. Findings indicate systematic misperceptions about harm and flavour, contrary to regulatory intent. Conclusions This study highlights the continued influence of brand variant names on consumer perceptions, particularly among young smokers and non-smokers. Subtle linguistic and colour cues in variant names were found to reinforce these perceptions, undermining efforts to convey the universal harms of smoking. Policymakers could consider stricter regulation, such as mandating neutral numerical naming systems, to mitigate misleading associations and further reduce product appeal. Strengthened oversight can further align tobacco control policies with public health goals, advancing efforts to prevent smoking initiation and achieve a smoke-free generation. Key messages • Colour-cued variant names create predictable harm and flavour associations, particularly amongst young adults and non-smokers. • Young adult smokers more often smoke low tar and menthol variants.