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Vaping device technology and appearance have transformed from cigarette lookalikes to mod devices, to the discreet and colourful designs of JUUL and its many offshoots. Recent innovations in vaping devices include those that resemble miniature toys, including soda bottles, snow cones and popsicles. These products piggy-back on the popularity of toy miniatures, driven by TikTok and other social media sites.

By manipulating device design in this way, vape manufacturers can increase marketability of their device, appeal to younger demographics and potentially increase the uptake of vaping. Regulating the vaping industry to prevent uptake by youth has largely focused on flavours or e-liquid packaging that appeal to children.

Facing increased regulation, vaping device manufacturers have become more creative with the device design. For example, vapes that appear like mini-boba cups went viral on social media in late 2022. These vaping devices are available for purchase around the world, including in the USA or from manufacturers abroad to be shipped to the USA. Device designs that resemble toys, candy or other consumables have the potential to entice youth. The designs may give the impression that the products are less dangerous, while inhaling through a small bendy straw may encourage youth to experiment. The designs may motivate youth who only vape socially to purchase their own devices and turning the devices into collectable items may lead youth to purchase multiple devices rather than just one at a time. Vaping devices that resemble popular toys may also hide the product’s true purpose and facilitate stealth usage by youth. The likelihood that youth can use these products without discovery is increased with added elements by some manufacturers, such as making the device look like a novelty keychain. The designs could also potentially confuse young children who mistake the true purpose of these devices and increase accidental exposures.

To date, tobacco researchers have explored how devices that can be used discreetly can impact vape device usage, but further research is needed on the impact device characteristics have on youth perceptions, access, and use. Regulatory agencies must consider taking steps to regulate device features such as colour, size and style to prevent designs that would entice children or be marketed based on their aesthetic appeal to youth. In November 2022, the US Food and Drug

Administration (FDA) issued warning letters to five firms for the unauthorised marketing of 15 different vaping products that look like toys, food or cartoon characters and are likely to promote use by youth.

Brian King, PhD, MPH, director of the FDA’s Center for Tobacco Products, noted at the time that the ‘The designs of these products are an utterly flagrant attempt to target kids’. Despite the FDA’s warning of potential injunction, seizure and/or civil money penalties, products identified in this paper remained available for purchase in the USA as of late February 2023, suggesting that control of such products requires stronger surveillance and enforcement of violations and cross-national cooperation.

Contributors: All authors contributed substantially to the paper’s conceptualization and production. ZT carried out the initial research and wrote the first manuscript draft; HLW led the conceptualisation of the paper and assisted with the manuscript drafting; and AL assisted with manuscript revisions.

Funding: Research reported in this publication was supported in part by the National Cancer Institute and the Food and Drug Administration Center for Tobacco Products funded Tobacco Centers of Regulatory Science at the University of Southern California (U54CA180905).

Competing interests: None declared.

Patient consent for publication: Not applicable.

Ethics approval: Not applicable.

Provenance and peer review: Not commissioned; externally peer reviewed.

Open access: This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial.

See: http://creativecommons.org/licenses/by-nc/4.0/.

ORCID iDs

Zacari Tatum http://orcid.org/0000-0002-3313-1192

Adam Leventhal http://orcid.org/0000-0002-1217-525X

Heather Lynn Wipfli http://orcid.org/0000-0001-9020-2033

REFERENCES

• Levin C. The gigantic joy of collecting teeny-tiny things. slate. 2021. Available: https://slate.com/human-interest/2021/05/obsessed-with-tiny-things-mini-brands-collectibles.html [Accessed 21 Feb 2023].
• Dormanesh A, Allem JP. New products that facilitate stealth vaping: the case of SLEAV. Tob Control 2022;31:685–6.
• FDA News Release. FDA warns firms for selling illegal E-cigarettes that look like toys, food, and cartoon characters. companies must stop marketing unauthorized products or risk enforcement. 2022. Available: https://www.fda.gov/news-events/press-announcements/fda-warns-firms-selling-illegal-e-cigarettes-look-toys-food-and-cartoon-characters

Black history has taught us that Big Tobacco is not an ally

By Phillip Gardiner

Phillip Gardiner is co-chair of the African American Tobacco Control Leadership Council.

This Black History Month, I have a simple message for nonprofit organizations in the United States: If you have accepted money from the tobacco industry, send it back. For hundreds of years, from enslaved people working on tobacco plantations to today’s menthol smokers, Black people have died for the tobacco industry’s profit. Today, the makers of Marlboro, Camel and Newport are using cash donations to polish their images and influence policy while approximately 45,000 Black Americans die of smoking-related illness every year.

It struck a chord when the Kennedy Center was criticized in The Post for accepting donations from cigarette giants Altria and Philip Morris International. I and many others cannot reconcile any organization saying that it works to support Black communities while simultaneously taking substantial donations from an industry that predatorily targets the same people.

Subsequently, I was horrified to learn the National Museum of African American History and Culture takes donations from Marlboro-maker Altria. As co-chair of the African American Tobacco Control Leadership Council, I wrote to the museum’s leadership to reject tobacco money. Vital Strategies, a global public health organization that helped with this essay, had approached the Kennedy Center with a similar message before Rebecca Perl’s piece ran in The Post and received no response. I did hear from the museum, nearly two months after contacting it. Officials said they appreciated my concern, but it doesn’t appear the museum has any intention to change its existing practices. I don’t think that’s good enough.

Standing tall on our capital’s National Mall alongside the Washington Monument, the museum says its purpose is to “tell the American story through the lens of African American history and culture.” Tobacco’s shameful chapter in that story is forever connected to the slave trade and tobacco plantations, where forced labor formed part of the foundations of the United States — and what is now a global tobacco industry.

Vestiges of that exploitation continue to this day, principally through the predatory marketing of menthol cigarettes and flavored little cigars in the Black community. There are more advertisements, more promotions in Black communities, where menthol cigarettes are cheaper.

Menthol is an anesthetic that masks the harsh taste of tobacco and allows for deeper inhalation of greater amounts of nicotine and tar. Studies show that menthol cigarettes are more addictive and, unsurprisingly, users find it harder to quit than non-menthol cigarette users. These products fuel a cycle of addiction to harmful products that hurt the pocketbooks in Black communities and fuels death, health problems and medical costs.

In 1953, 5 percent of African Americans smoked menthol cigarettes. Today, 85 percent of Black adults and 94 percent of Black youths who smoke use menthol products. Between 1980 and 2018, menthol cigarettes were responsible for 1.5 million new smokers, 157,000 smoking-related premature deaths and 1.5 million life-years lost among African Americans, representing a staggering 41 percent of premature deaths and half of the total in life-years lost in America. In other words, menthol takes a much greater toll on African Americans. Black Americans die disproportionately of heart attacks, lung cancer, strokes and other tobacco-related diseases. Menthol cigarettes are a leading vector for death and disease in Black communities, worsening health and economic inequities.

Responsibility lies with the tobacco companies. It’s time they stopped producing menthol cigarettes and treating the health of Black communities as expendable. Congress should also act to pass the proposed ban on menthol tobacco products without further delay. The Food and Drug Administration estimates that a national menthol ban could save up to 6,000 Black lives each year. Prioritizing profit over Black lives, the industry is lobbying against the legislation.

Tobacco donations to institutions such as the National Museum of African American History and Culture are part of the playbook, giving cigarette companies a sheen of respectability that allows them to access the halls of power and helping them maintain the profitable status quo. Altria, a donor to the museum, owns Philip Morris USA, the largest tobacco company in the United States, with nearly half of the cigarette retail market, including 26 percent of the menthol market. In accepting Altria’s money rather than holding its donor and the industry to account, the National Museum of African American History and Culture is complicit in the industry’s ongoing exploitation of Black people.

Maybe cultural institutions will not break from tobacco companies unless they are forced to do so. Some countries ban tobacco sponsorships so cigarette makers can’t promote themselves under the guise of corporate social responsibility.

Lacking such legislation in the United States, we are reliant on the integrity of the institutions involved or the type of public outrage that led to Sackler donations being rejected when the family’s company, Purdue Pharma, was exposed as a key driver of the opioid epidemic. I’m disappointed but not surprised that we haven’t heard the same volume of voices demanding that the National Museum of African American History and Culture reject cigarette company donations, since many African American organizations take the money. The preservation and honoring of African American history

shouldn’t be an economic and cultural opportunity for corporations whose activities perpetuate inequity and harm for Black Americans.

So, if the National Museum of African American History and Culture or any other cultural or charitable institution would like to demonstrate their support for Black Americans this Black History Month, return the money received from the tobacco industry.