title: Characteristics of illegal and legal cigarette packs sold in Guatemala.
abstract: Guatemala, as a party to the Framework Convention on Tobacco Control (FCTC), is required to regulate cigarette packaging and labeling and eliminate illicit tobacco trade. Current packaging and labeling characteristics (of legal and illegal cigarettes) and their compliance with the FCTC is unknown.
  
  
  
  We sought to analyze package and label characteristics of illegal and legal cigarettes sold in Guatemala. We visited the 22 largest traditional markets in the country to purchase illegal cigarettes. All brands registered on tobacco industry websites were purchased as legal cigarettes. Analysis compared labeling characteristics of illegal and legal packs.
  
  
  
  Most (95%) markets and street vendors sold illegal cigarettes; 104 packs were purchased (79 illegal and 25 legal). Ten percent of illegal and none of the legal packs had misleading terms. Half of the illegal packs had a warning label covering 26 to 50% of the pack surface. All legal packs had a label covering 25% of the surface. Illegal packs were more likely to have information on constituents and emissions (85% vs. 45%, p < 0.001) and were less expensive than legal ones (USD 0.70 ± 0.7 and 1.9 ± 1.8, p < 0.001).
  
  
  
  In Guatemala, neither illegal nor legal cigarette packs comply with FCTC labeling mandates. Urgent implementation and enforcement of the FCTC is necessary to halt the tobacco epidemic.
authors.affiliation: Research Department, Cardiovascular Surgery Unit of Guatemala, 5a Ave 6-22 zona 11, Guatemala City, Guatemala.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Arevalo
authors.affiliation: Research Department, Cardiovascular Surgery Unit of Guatemala, 5a Ave 6-22 zona 11, Guatemala City, Guatemala.|Department of Medicine, University of Miami Miller School of Medicine and Jackson Memorial Hospital, Miami, FL, USA.
authors.forename: Juan E
authors.initials: JE
authors.lastname: Corral
authors.affiliation: Research Department, Cardiovascular Surgery Unit of Guatemala, 5a Ave 6-22 zona 11, Guatemala City, Guatemala.
authors.forename: Diego
authors.initials: D
authors.lastname: Monzon
authors.affiliation: Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis, School of Medicine, St. Louis, MO, USA.
authors.forename: Mira
authors.initials: M
authors.lastname: Yoon
authors.affiliation: Research Department, Cardiovascular Surgery Unit of Guatemala, 5a Ave 6-22 zona 11, Guatemala City, Guatemala. barnoyaj@wudosis.wustl.edu.|Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis, School of Medicine, St. Louis, MO, USA. barnoyaj@wudosis.wustl.edu.
authors.forename: Joaquin
authors.initials: J
authors.lastname: Barnoya
mesh_terms: D003132:Commerce / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D006166:Guatemala; D006801:Humans; D011356:Product Labeling / Q000331:legislation & jurisprudence*; D019064:Product Packaging / Q000331:legislation & jurisprudence*; D019460:Tobacco Industry; D062789:Tobacco Products / Q000331:legislation & jurisprudence*
keywords: Cigarette packs; Cigarettes; Illegal cigarettes; Tobacco; Tobacco industry