title: The role of cocoa as a cigarette additive: opportunities for product regulation.
abstract: BACKGROUND
  The 2009 Family Smoking Prevention and Tobacco Control Act prohibited the use of characterizing flavors in cigarettes; however, some of these flavors are still used in cigarettes at varying levels. We reviewed tobacco industry internal documents to investigate the role of one of these flavors, cocoa, with the objective of understanding its relationship to sensory and risk perception, promotion of dependence, and enhancement of attractiveness and acceptability.
  
  
  METHODS
  We used the Legacy Tobacco Documents Library to identify documents relevant to our research questions. Initial search terms were generated following an examination of published literature on cocoa, other cigarette additives, and sensory and risk perception. Further research questions and search terms were generated based on review of documents generated from the initial search terms.
  
  
  RESULTS
  Cocoa is widely applied to cigarettes and has been used by the tobacco industry as an additive since the early 20th century. Cocoa can alter the sensory properties of cigarette smoke, including by providing a more appealing taste and decreasing its harshness. The tobacco industry has experimented with manipulating cocoa levels as a means of achieving sensory properties that appeal to women and youth.
  
  
  CONCLUSIONS
  Although cocoa is identified as a flavor on tobacco industry Web sites, it may serve other sensory purposes in cigarettes as well. Eliminating cocoa as an additive from tobacco products may affect tobacco product abuse liability by altering smokers' perceptions of product risk, and decreasing product appeal, especially among vulnerable populations.
authors.affiliation: Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA; nsokol@hsph.harvard.edu.
authors.forename: Natasha A
authors.initials: NA
authors.lastname: Sokol
authors.affiliation: Propel Centre for Population Health Impact, University of Waterloo, Waterloo, Ontario, Canada; Institute for Global Tobacco Control, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors.forename: Ryan David
authors.initials: RD
authors.lastname: Kennedy
authors.affiliation: Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA;
authors.forename: Gregory N
authors.initials: GN
authors.lastname: Connolly
mesh_terms: D002099:Cacao / Q000737:chemistry*; D005421:Flavoring Agents / Q000737:chemistry*; D012907:Smoking; D013649:Taste; D019460:Tobacco Industry / Q000331:legislation & jurisprudence*; D062789:Tobacco Products / Q000032:analysis*
chemical_list: D005421:Flavoring Agents