Maruša Požar, Bojana Mitrović, Marinka Šimec, Vid Lah, Breda Barbič-Žagar

Key words
throat irritation, dry cough, hoarseness, iceland moss, lozenges, consumer behaviour

Abstract

Objectives: Throat irritation is a frequently reported symptom that can arise from causes other than infection and is characterised by sensations such as dryness, hoarseness, and cough hypersensitivity. These complaints can significantly impair communication and quality of life, particularly among individuals exposed to environmental stressors or those who frequently use their voice. Iceland moss (Cetraria islandica) is a herbal ingredient recognised for its demulcent properties, forming a protective film over the mucosa to alleviate irritation and dryness. The objective of this market research was to gain insights into the prevalence of throat-related symptoms, consumer behaviour in managing these issues, and to evaluate satisfaction and perceived effectiveness of Iceland moss lozenges.

Methods: The research was conducted in Slovenia in February 2025 by an independent market research agency and consisted of two phases. Phase one involved an online survey of 820 respondents aged 25–55 years to identify symptom patterns, seasonality, and commonly used remedies. Based on predefined criteria, 152 individuals were recruited for phase two – a product test of lozenges containing Iceland moss extract (each lozenge contains 3 mg of dry extract (DER 30–40:1) (Cetraria islandica (L.) Acharius s.l., thallus) during a four-week period following the onset of symptoms. A total of 123 participants tested the product and completed a questionnaire assessing usage context, satisfaction, perceived efficacy, and purchase intent.

Results: Irritation to cough and throat irritation were the most frequently reported symptoms, occurring at least once a month in 17–19% of respondents, with a strong seasonal pattern peaking in colder months. Lozenges were the most common remedy for throat discomfort, chosen by 60% of respondents. During the product test, 76% of participants used Iceland moss lozenges primarily for throat irritation, followed by dry cough (49%). Overall satisfaction was high: 90% of respondents were impressed or satisfied, and 98% reported relief (71% rated it as good or great). Taste and perceived effectiveness were key drivers of positive impressions, with 92% rating the flavour favourably and 87% noting improved mucosal hydration. Compared to their usual products, 67% of respondents rated Iceland moss lozenges as better, and 63% expressed willingness to switch. Purchase intent reached 77%, and 81% of respondents said they would recommend the product.

Conclusion: Throat irritation and related symptoms are common and recurrent, creating a clear need for effective throat-care solutions. Iceland moss lozenges demonstrated strong consumer acceptance, combining sensory appeal with functional benefits such as mucosal hydration and irritation relief. High satisfaction and willingness to repurchase indicate that Iceland moss lozenges are a preferred option for managing throat discomfort.

Introduction

Throat irritation is a frequently reported symptom (1) characterised by dehydrated mucosa (2), hoarseness (3) and cough hypersensitivity (4). While irritation of the pharyngeal mucosa can be associated with an infection, its etiology can also be non-infectious and result from environmental and mechanical factors (5). Such stressors irritate the mucosal surface and disrupt its protective layer (6, 7, 8), triggering symptoms like hoarseness, dryness, a scratchy sensation, strained vocal cords, and an irritating cough that frequently triggers the urge to clear the throat (3, 9, 10). These symptoms are common among individuals who speak or sing professionally (11), are exposed to irritant substances at work (12), work in climate-controlled offices (13, 14), or live in urban environments with high particulate matter (15, 16). Persistent irritation can impair communication, reduce vocal endurance, and negatively affect quality of life, highlighting the importance of appropriate self-management strategies (17, 18).

Although not a precisely defined anatomical term, the word ‘throat’ is commonly used to describe the segment of the upper aerodigestive tract located behind the mouth and extending downward toward the oesophagus, corresponding largely to the pharynx. Depending on the clinical or anatomical context, the larynx may also be regarded as part of this region (19). The pharynx is a muscular tube that connects the nasal and oral cavities to the larynx and oesophagus, allowing the passage for air and food (20). The larynx, or voice box, lies in front of the lower part of the pharynx and contains the vocal cords; it functions in facilitating breathing, and producing sound (21). Each of these regions is lined by a mucosal membrane, a moist lining which helps trap and clear particles, and serves as a frontline of immune defence (22).

Lozenges are widely used for symptomatic relief of local irritation (23). Iceland moss (Cetraria islandica) is a herbal ingredient recognised for its demulcent properties (24). It is rich in mucilaginous polysaccharides (the most important ones being lichenin and isolichenin) (25) that form a protective film over the pharyngeal mucosa (24). This action helps shield the mucosa from local irritation, retain surface moisture, and diminish cough reflex sensitivity (24, 25, 26). Additionally, its compounds may contribute to anti-inflammatory and immunomodulating effects (27, 28).

Understanding the prevalence and underlying drivers of symptoms, as well as consumer behaviour related to symptom self-management, is essential for ensuring that patients are appropriately informed and able to select suitable products for their needs (29, 30). To gain deeper insights into the symptoms commonly addressed with Iceland moss and to better understand consumer behaviour and treatment perceptions, we conducted a product test using lozenges containing Iceland moss extract (each lozenge contains 3 mg of dry extract (DER 30–40:1) (Cetraria islandica (L.) Acharius s.l., thallus). Its main objectives were to explore which symptoms people experience, how they typically manage them, and to assess their satisfaction and rating of the product.

Methods

The product test was carried out in two phases. In the first phase, an online survey was conducted among a representative group of 820 individuals aged between 25 and 55 years. The questionnaire included questions about the types of throat-related issues people experience, their frequency and seasonality, the remedies they typically use and the reasons behind these problems. Based on the responses, we selected respondents who were suitable to test the Iceland moss lozenges. The criteria were as follows: the respondents who had experienced at least one of the following issues at least once a month: hoarseness, irritated and dry mucous membranes of the mouth and throat, strained vocal cords, dry and irritating cough, scratchy throat/irritation to cough. In addition, the respondents were required to have previously used products to alleviate such problems.

In the second phase, Iceland moss lozenges were sent to 152 individuals who met the recruitment criteria from phase 1 and agreed to participate. Each participant received one box containing 24 lozenges and had 4 weeks to test the product. The rule was that they could only test the product if they were experiencing one of the aforementioned issues. A total of 123 individuals tested the product and then completed a questionnaire which examined how and why they used the lozenges, their satisfaction, and their likelihood to repurchase or recommend the product.

The product test was conducted in Slovenia in February 2025 by an independent market research agency (Table 1).

Results

Phase 1 – Overview of throat irritation issues

Among irritation-related issues, irritation to cough was the most frequently reported symptom, with 19% of respondents experiencing it at least once a month and 23% every 2–3 months. Similarly, throat irritation occurred monthly in 17% of respondents and every 2–3 months in 25%. Dry, irritating cough showed comparable patterns, affecting 16% monthly and 20% every 2–3 months (Figure 1). Other irritation-related conditions, such as dry mucosa, inflamed throat and hoarseness, were also recurrent but less frequent on a monthly basis. The common cold was most often reported as occurring every few months (Figure 1).

All issues are more likely to occur during the colder months or at seasonal changes (Figure 2). Throat irritation occurs primarily in winter (46%), while irritated and dry mucosa and irritation to cough show similar seasonal patterns (45% each). A smaller proportion of respondents reported these symptoms evenly throughout the year (20–21%), and around one-third associated them with seasonal changes. Other complaints, such as dry, irritating cough and inflamed throat, also occur predominantly in winter, indicating a strong seasonal influence. The exceptions are strained vocal cords and hoarseness, which occur evenly throughout the year (Figure 2) but are relatively less frequent (Figure 1). The common cold is reported every few months (Figure 1), with a higher incidence during colder months (48%) (Figure 2).

Throat lozenges are the primary choice for relieving throat irritation-related symptoms, with 60% of respondents using them for sore, irritated throat, 46% for irritated and dry mucosa, and 44% for hoarseness. Lozenges consistently rank as the most common remedy across nearly all symptoms. Notably, voice- and throat-soothing candies are also widely used, often as a secondary option. For hoarseness, 35% of respondents reported using these candies, and similar patterns were observed for other irritation symptoms, such as strained vocal cords (34%) and irritated mucosa (30%). Warm drinks against the flu and common cold are another popular choice, particularly for the common cold (47%) and sore throat (32%). Throat sprays, flu and cold tablets, and effervescent tablets are comparatively less common across all symptoms (Table 2).

When exploring environmental and occupational factors associated with throat irritation, 43% of respondents agreed or strongly agreed that frequent voice use at work applied to them. Similarly, sensitivity to air conditioning was common, with 38% of participants identifying this as completely or mostly true, and an additional 32% partially agreeing. Other contributing factors included occasional vocal cord strain, persistent throat sensitivity regardless of season, and frequent colds, which were acknowledged by a smaller proportion of respondents (Figure 3).

Phase 2 – Assessment of Iceland moss lozenges

2a – Problems alleviated by Iceland moss lozenges

The majority of respondents reported using Iceland moss lozenges primarily for throat irritation, with 76% citing this as their main reason for use. Other common issues included dry, irritating cough (49%) and irritation to cough (46%). Inflamed throat, hoarseness, and irritated mucosa were mentioned by around 40% of users, while conditions such as common cold (33%) and strained vocal cords (20%) were less frequently associated with Iceland moss lozenge use. Wet cough was rarely cited (8%) (Figure 4).

Most respondents (72%) used only Iceland moss lozenges without additional products. Among those who combined remedies, warm drinks against the flu and common cold were the most common (8%), followed by flu/cold tablets and tea (5% each). Other options such as throat lozenges, candies, and sprays were rarely mentioned (4% or less) (Figure 5).

If Iceland moss lozenges were unavailable, 76% of respondents would use throat lozenges. Other common alternatives included warm beverages (44%) and throat sprays (36%). Candy-based soothing products were also notable, with 35% citing them as their usual choice. Hoarseness lozenges and flu/cold tablets were mentioned less often (30% and 21%), while effervescent tablets and tea were rarely selected (Figure 6).

2b – Satisfaction and rating of Iceland moss lozenges

When asked about their first impressions of Iceland moss lozenges, all respondents provided at least one favourable comment. Pleasant taste was the most mentioned attribute (77%), with mentions of the orange flavour and absence of an unpleasant aftertaste. Effectiveness was noted by 38% of respondents, and 25% highlighted immediate effect. Other positive remarks included “good product” (12%) and “better than other brands” (11%). Common issues addressed were throat irritation (28%), dry cough (8%), and hoarseness (7%). Negative feedback was minimal, mainly mild effect (8%) or minor taste concerns (4%) (Table 3).

Overall satisfaction with Iceland moss lozenges was very high, with 90% of respondents reporting they were impressed or satisfied (41% impressed; 49% satisfied). 7% were neutral, while only 3% expressed dissatisfaction or disappointment (Figure 7).

The main drivers of positive impressions were taste (62%) and effectiveness (30%), followed by fast symptom relief and favourable texture or form. Other factors such as dosing convenience, absence of aftertaste, and natural ingredients were mentioned less frequently (Figure 7).

Almost all participants (98%) reported relief from throat discomfort with Iceland moss lozenges: 28% experienced great relief, 43% good relief, and 20% some relief, while only 7% noted slight relief and 2% no effect (Figure 8).

Compared to other products, 80% perceived Iceland moss lozenges as different – 9% totally different, 26% very different, and 45% somewhat different – while 20% regarded them as similar to existing options (Figure 9).

The evaluation of individual product attributes showed a consistently high level of consumer satisfaction, with all evaluated characteristics of Iceland moss lozenges achieving a minimum satisfaction rate of 70%. Respondents commonly reflected positive aspects such as the lozenges not sticking to the palate or teeth (93%) and their pleasant flavour (92%). Additionally, 87% reported satisfaction with the lozenges’ ability to moisten the oral and throat mucosa. The product also performed well in categories related to efficacy, with 81% stated they experienced instant symptom relief, 77% noted soothing of irritation and inflammation, and 77% recognised the longer dissolution time and sustained soothing effect (Figure 10).

Purchase intent and recommendation rates were high among participants. Overall, 77% of respondents expressed an intention to purchase Iceland moss lozenges, with 41% indicating they would definitely buy them and 36% they would probably buy them. Seventeen percent were undecided, while 6% stated they would probably not or definitely not purchase the product (Figure 11).

The willingness to recommend the product was equally strong, with 81% of respondents indicating that they would endorse Iceland moss lozenges to friends or acquaintances. Only 6% were unlikely to recommend it (Figure 12).

A comparative assessment of Iceland moss lozenges against respondents’ usual throat relief products showed a preference for the tested product. Overall, 67% of participants rated Iceland moss lozenges as better than the product they typically use. One-fifth of respondents considered the product to be as good as their regular brand, while 13% reported that their usual product was better (Figure 13).

A comparison of individual product characteristics between Iceland moss lozenges and respondents’ usual throat relief products conveyed several product characteristics in which Iceland moss lozenges performed better. Pleasant flavour (78%) and non-adhesive texture (77%) were top advantages, followed by moistening effect (68%), longer dissolution (67%), and soothing irritation (60%). Reduction of cough irritation and dry cough relief scored 59%, while fast symptom relief was close behind at 58% (Figure 14).

In total, 63% of participants indicated that they would substitute their current throat relief product with Iceland moss lozenges. Among these, 28% stated they would definitely make the change and 35% would probably do so. Another 24% were undecided, while 13% reported that they would probably or definitely not replace their existing product (Figure 15).

We also explored which product attributes consumers consider most important when selecting a throat relief product. The participants predominantly prioritised characteristics related to product efficacy. The ability to relieve problems quickly was identified as the most important attribute (24% ranked it first; 59% included it among the top five). This was followed by soothing of irritated mucous membranes of the mouth and throat (20%; 56%) and reduction of irritation to cough (17%; 59%) (Table 4).

Although pleasant taste was rated slightly lower as a top priority (14%), it was frequently mentioned among the five most important characteristics (67%). Other relevant properties included hydration of the mucosa (54%) and relief of dry, irritating cough (57%). Aspects such as natural origin, ingredient composition, and suitability for specific dietary needs were generally considered less critical (Table 4).

To assess the relevance of the product concept, participants were asked how often they experience situations associated with hoarseness, strained vocal cords, or throat irritation. In total, 33% reported experiencing such issues often or very often, and an additional 43% reported them occasionally, indicating that the concept is relevant for 76% of respondents (Figure 16).

Among those who do not frequently encounter these situations, the most frequently mentioned alternative causes of throat discomfort were common colds (22%), exposure to cold or dry air (14% and 11%, respectively), and occupational or frequent voice use (11% and 10%). Other less frequent triggers included loud environments, seasonal changes, temperature fluctuations, stress, and consumption of cold beverages (Figure 16).

Discussion

Frequency of different throat symptoms

The survey data indicate that throat and cough-related symptoms are common and recurrent among adults. Such patterns are consistent with previous international findings indicating that more than half of adults experience at least one episode of throat discomfort annually, often with several episodes per year (1, 31). Irritation leading to cough was the most frequently reported issue, followed by throat irritation and a dry, irritating cough. Interestingly, while the common cold was reported on a monthly basis by only 7%, irritation-related complaints occurred considerably more often, suggesting that these symptoms develop independently of acute respiratory infections. Conditions such as hoarseness and strained vocal cords were less frequent monthly (10% and 9%, respectively), yet hoarseness affected around one fifth of participants at least once every six months, indicating an episodic but notable functional impact. Overall, the findings indicate that throat irritation and mucosal dryness are widespread, recurrent phenomena that substantially contribute to perceived throat discomfort in the general population.

Seasonal occurrence of different throat symptoms

Seasonal patterns of throat-related complaints revealed that most issues occurred predominantly in colder months or during seasonal changes. This pattern aligns with the known effects of cold air and seasonal infections on mucosal sensitivity (32). The exceptions included strained vocal cords and hoarseness which showed a more even distribution throughout the year, suggesting a non-seasonal

origin linked to continuous vocal strain and occupational voice use. These non-seasonal cases were particularly associated with air-conditioned environments, frequent voice use, and heightened throat sensitivity – factors consistent with literature linking mucosal dryness and mechanical strain to irritation (9, 13-19). The presence of both seasonal and non-seasonal patterns underscores that throat irritation represents a recurrent, year-round issue rather than an exclusively winter phenomenon.

Products used to relieve throat and voice issues

Throat lozenges emerged as the predominant product used for irritation-related problems, confirming their position as the most established form of self-medication for throat discomfort. Their widespread use reflects the advantages of localised delivery, as the slow dissolution of lozenges across the oropharyngeal mucosa ensures prolonged contact with affected tissues and convenient symptom relief (33). However, non-medicated throat candies were also used very frequently, particularly for hoarseness (35%) and strained vocal cords (34%). This overlap reflects consumer behaviour observed in the previous research, where users tend to blur the distinction between therapeutic throat products and those primarily sought for sensory comfort (1). Factors such as pleasant taste and sensory comfort may influence consumer preference (34) alongside perceived soothing effects. However, products that fall under recognised regulatory guidelines such as lozenges made with herbal ingredients that have a long history of well-documented use offer important advantages. They contain a clearly defined quantity of the active plant material (35) and they provide a slow release of active ingredients, ensuring prolonged contact with the affected throat tissue (33). Additionally, they are typically formulated to optimise bioavailability and therapeutic action, and undergo rigorous quality control to ensure safety and absence of contaminants. This standardisation ensures consistent effects and supports reliable symptom relief, in contrast to confectionery-type throat sweets that may soothe through flavour or cooling sensations but do not necessarily deliver a controlled amount of any functional botanical substance. Encouraging consumers towards more rigorously formulated lozenges promotes both efficacy and informed product choice.

Problems alleviated by Iceland moss lozenges

The majority of respondents reported using Iceland moss lozenges primarily for throat irritation, dry cough, and irritation to cough, which indicates good alignment of the product’s perceived role with its intended use. Interestingly, most participants referred to the problems they experienced (“irritation”, “dryness”, “cough”) rather than their underlying causes (“irritated and dry mucous membranes of the mouth and throat”, “common cold”, “strained vocal cords”). This consumer mindset highlights the importance of marketing messages that focus on the felt symptoms rather than etiological explanations, ensuring that the product communication resonates with users’ actual experiences (36). Wet cough was rarely cited (8%), suggesting that lozenges are not typically considered for this symptom.

Satisfaction with and rating of Iceland moss lozenges

The first impression of Iceland moss lozenges was highly positive, with taste emerging as the most frequently spontaneously cited attribute (77%). This finding reinforces the critical role of sensory experience in product acceptance, as pleasant organoleptic properties are consistently associated with improved patient adherence (34). Respondents described Iceland moss’s flavour as balanced and free from unpleasant aftertaste, qualities that enhance compliance (34). In addition to taste, effectiveness (38%) and instant symptom relief (25%) were also highlighted.

Overall satisfaction with lozenges was remarkably high, with 90% of respondents reported being satisfied or impressed with the product. These impressions were strongly supported by efficacy data: 98% of respondents reported relief, with 71% rating it good or great, and 80% considered the lozenges as different from competitors (35% very different). Negative feedback was minimal. Respondents also consistently expressed high satisfaction with the lozenges’ functional properties,

particularly their ability to effectively hydrate oral and throat mucosa (87%), a key benefit for alleviating dryness and irritation. This aligns with the demulcent action of Iceland moss, whose mucilaginous polysaccharides form a soothing, protective film that supports mucosal hydration (24), reinforcing its relevance in throat-care solutions. In line with earlier feedback on taste, 92% of respondents also enjoyed the pleasant flavour, while the non-sticky texture (rated positively by 93%) further contributed to an overall pleasant user experience.

Comparison of Iceland moss with similar products for throat self-management

Iceland moss lozenges outperformed users’ usual products, with 67% rating it better and 63% willing to switch. While the perception of fast symptom relief and soothing mucosa were key efficacy drivers, taste emerged as the strongest differentiator – 50% rated flavour much better. These findings show that beyond therapeutic performance, sensory experience and ease of use strongly influence choice. Strategically, differentiation through taste and perceived efficacy offers Iceland moss lozenges a competitive edge in the crowded throat care market.

Participants’ ranking of what they appreciate the most when it comes to products confirms that efficacy-related properties remain the primary decision drivers in throat relief product choice (31). Fast symptom relief (24% top-1, 59% top-5) and soothing of irritated mucosa (20% top-1, 56% top-5) were rated as most important. While pleasant taste was slightly lower in priority as a top attribute (14%), it appeared frequently among the five most important features (67%), underscoring that consumers expect effectiveness first, but sensory and usability factors – such as taste – influence adherence and switching behaviour.

The tested concept “Are you feeling under the weather again?” proved highly relevant. It captures situations where voice failure or throat discomfort occurs at critical moments, such as during presentations, cheering at events, singing, or even normal workdays. For those who did not identify with these scenarios, alternative triggers were cited, including colds (22%), winter conditions (14%), dry air (11%), occupational voice use (11%), and loud environments (7%). This confirms that throat irritation and vocal strain are frequent and diverse. Importantly, the connection to both non-seasonal and seasonal factors suggests that Iceland moss lozenges are useful as an everyday solution as well as for seasonal needs.

Market research limitations

While the findings provide valuable insights, several limitations should be noted. The sample size (n=123) may not fully represent demographic or usage-setting variability (e.g. professional voice users, high exposure to environmental irritants, air conditioning) and self-reported data may introduce bias in symptom reporting. Additionally, respondents were drawn from a single country, which may limit the generalisability of the results across different populations or cultural contexts. The short testing period (4 weeks) does not capture long-term usage patterns or repeat purchase behaviour. Future research could incorporate objective measures of throat-surface hydration or voice-strain recovery, and longitudinal studies tracking real-world adherence and repeat purchase behaviour. Additionally, further studies may explore the relative importance of sensory attributes in determining consumer behaviour across competitive lozenge brands.

Conclusion

This market research confirms that throat irritation and related symptoms are common, recurrent, and often non-infectious, creating a strong need for effective throat-care solutions. Iceland moss lozenges demonstrated high consumer acceptance, combining sensory appeal with positive user experience. With 90% overall satisfaction and 98% reporting relief, users highlighted the lozenges for their pleasant taste, non-sticky texture, and most importantly, their ability to effectively hydrate oral and throat mucosa. The concept test confirmed that Iceland moss lozenges are highly suitable for relieving the most common consumer problems associated with throat irritation.

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Authors

Maruša Požar
Krka, d. d., Novo mesto, Dunajska cesta 65, 1000 Ljubljana

Bojana Mitrović
Krka, d. d., Novo mesto, Dunajska cesta 65, 1000 Ljubljana

Marinka Šimec
Krka, d. d., Novo mesto, Dunajska cesta 65, 1000 Ljubljana

Vid Lah
Krka, d. d., Novo mesto, Dunajska cesta 65, 1000 Ljubljana

Breda Barbič-Žagar, dr. med.
Krka, d. d., Novo mesto, Dunajska cesta 65, 1000 Ljubljana

Krka’s medicines are marketed in different countries under different brand names. Some products may not be available in all countries due to still valid patent protection.

For complete information on the products please refer to the Summary of Product Characteristics. You can obtain it from Krka’s medical representatives.

Published: March 2026