Cigarette filter ventilation, product appeal and regulatory options: a review of the influence of ventilation on consumers' sensory and risk perceptions.

Objective: Cigarette filter ventilation may enhance product appeal, support initiation and sustained smoking, and increase smoking prevalence. We reviewed recent evidence on how filter ventilation affects consumers' perceptions of product appeal and considered product use preferences to inform regulatory options.

Data sources: PubMed, Embase and PsycINFO databases were searched up to December 2023. Systematic search strategies used terms based on cigarette filter ventilation, and multiple constructs comprising product appeal and user perceptions.

Study selection: Two reviewers screened all 917 retrieved titles and abstracts independently and applied a consensus strategy to identify 16 articles that met eligibility criteria.

Data extraction: Extracted data focused on study design, dependent variables or outcomes, and major conclusions.

Data synthesis: While remaining popular, awareness and risk perception of ventilated cigarettes is generally low. Cigarettes with filter ventilation are perceived as smoother and less irritating than non-ventilated cigarettes. These modified sensory experiences shape perceptions of reduced health risks. Pack text descriptors and colours convey further information to consumers about smoothness, supporting lowered risk perceptions.

Conclusions: Filter ventilation and its associated marketing continue to influence consumers' perceptions of smoothness creating misperceptions about health risks. Standardised ('plain') packaging regulations are recommended to restrict communication of ventilation themes as well as evidence-based health communications to correct consumer misperceptions about smoothness and health risks. Since filter ventilation has no benefits for public health, policy makers could consider banning filter ventilation or even disallowing filters.