Content analysis of e-cigarette packaging in Indonesia: youthful, fun and flavorful

Objectives In Indonesia, 3% of adults and 14.4% of youth use e-cigarettes. Exposure to tobacco marketing is associated with future cigarette and e-cigarette use. This study collected e-cigarette products in Indonesia and assessed the packaging for overall features and appeals. Design E-cigarette products were collected from Jakarta, Medan and Surabaya in 2022 using a systematic protocol designed to identify all unique packs for sale. Products were double coded for various features and appeals. Descriptive statistics were calculated using Stata/BE 17.0. Results We purchased 825 unique products: e-cigarette liquids (n=782), disposable e-cigarette devices (n=26) and disposable e-cigarette pods/cartridges (n=17). E-cigarette packaging frequently incorporated features associated with youth appeals. Over half of the packs (57.7%, n=476) displayed at least one design or marketing element potentially attractive to youth, including bright colours, cartoons, playful fonts, slang or packaging resembling other objects. Most packs (96%, n=792) contained flavour descriptors, and 67.5% (n=557) included visual representations of flavours, with fruit and sweet/dessert flavours being the most prevalent. 2.2% of packs (n=18) included references to Indonesian influencers, celebrities or pop culture. Conclusions Indonesian e-cigarette packaging often included marketing elements that can appeal to youth. Policies such as plain and standardised packaging and banning non-tobacco flavours could reduce the appeal of e-cigarette packaging to Indonesian youth.