Study explores effect of plain cigarette packs

Behind the Headlines

Tuesday July 15 2014

Why do some smokers remain so resistant towards anti-smoking campaigns?

Going blank: most smokers ignore warnings on packs

"Long-term smokers find the taste of plain-packaged cigarettes worse than that of branded cigarettes," The Guardian reports.

The news comes from Australian research into the impact of plain packaging and health risk warnings on packets of cigarettes and anti-smoking TV adverts.

The researchers found highly emotive warnings were more likely to capture the attention of the study's participants. However, these warning messages did not actually prompt the smokers to try to quit.

Interestingly, some smokers reported they felt the quality and taste of cigarettes had worsened or different brands now all tasted the same after plain packs were introduced.

While this may well be a minority view, it does suggest the effects of branding could have a psychological influence on some smokers, changing how they perceive the quality of the product.

This may explain why tobacco companies have been lobbying against similar laws being introduced in the UK.

Further research is needed to determine the best ways of engaging with vulnerable smokers.

 

Plain packaging

Australia introduced plain packaging laws for cigarettes in 2012.

 

The packs themselves are not plain  all branding and logos has been removed from the packs and replaced with graphic anti-smoking images, such as pictures of the devastating effect oral cancer can have on the mouth and teeth.

 

The only brand-specific information is the name of the brand under the image.

Where did the story come from?

The study was carried out by researchers from the University of Newcastle and the Hunter Medical Research Institute in Newcastle, Australia.

It was funded by an Australian Postgraduate Award PhD Scholarship, the Cancer Institute New South Wales, and Newcastle Cancer Control Collaboration.

The study was published in the peer-reviewed journal Health Education Research.

The Guardian's headline, "Long-term smokers find plain-packaged cigarettes taste worse", gives a false impression of the findings of this study. The researchers did not compare the taste of branded and plain-packaged cigarettes.

Following the implementation of plain packaging, perceptions of the quality and taste of cigarettes did change for some participants.

However, it is unclear from the research article whether this was a majority view, and the research itself was not designed to address the question of whether plain-packaged cigarettes taste different.

 

Never too late to quit

Even if you have been a heavy smoker for decades, it is never too late to experience the health benefits of quitting.

 

If you manage to abstain for a year, you will reduce your risk of heart disease by 50%. After five years, your lung cancer risk will also be reduced by half.

 

Read more about the benefits of quitting smoking and the different ways to kick the habit.

What kind of research was this?

This was a qualitative study that aimed to explore how socioeconomically disadvantaged smokers responded to messages about the health risks of smoking and the benefits of quitting via cigarette packaging (plain packaging and health warning labels) and anti-smoking TV adverts.

The researchers were also interested in participants' responses to the information and whether this influenced their decision to stop smoking.

Qualitative research is designed to reveal a target audience's range of behaviour and the perceptions that drive it. It often makes use of a focus group approach, where a series of interviews are carried out in small groups of people.

The results of qualitative research are descriptive rather than predictive. The research can provide a useful insight into current behaviours and attitudes.

 

What did the research involve?

The researchers organised focus groups of 51 current smokers who were also clients of welfare organisations in New South Wales, Australia.

These focus groups discussed health warning labels, plain packaging and anti-smoking TV adverts. The discussions were taped and then analysed to identify themes.

 

What were the basic results?

The researchers found highly emotive warnings delivering messages about the negative health effects of smoking were most likely to capture the attention of the study's participants.

However, these warning messages did not prompt participants to attempt to quit, and participants were sceptical about the effectiveness of cessation programmes such as telephone quit lines.

Active avoidance of health warning messages was common ("I do not even look at the warning") and many participants expressed false and self-exempting beliefs about the harms of tobacco ("The majority of people that smoke all their life don't end up with like their foot rotting off or no teeth in their head").

The Guardian focused on quotes from some focus groups that occurred after plain packaging was introduced in Australia.

For some participants, perceptions of the quality and taste of cigarettes changed once plain packaging was introduced.

People were quoted as saying that, "I've noticed the difference in the grading of the tobacco", and that, "They're all the same now, smokes. Everyone's all the same."

It is unclear whether this was a majority view or just the view of a few participants.

 

How did the researchers interpret the results?

The researchers concluded that, "Careful consideration of message content and medium is required to communicate the antismoking message to disadvantaged smokers who consider themselves desensitised to warnings."

They go on to advise that, "Health communication strategies should continue to address false beliefs about smoking and educate on cessation services that are currently underutilised."

 

Conclusion

This qualitative study has examined how socioeconomically disadvantaged smokers conceptualise and respond to messages about the risks of smoking and the benefits of quitting via cigarette packaging (plain packaging and health warning labels) and anti-smoking TV adverts.

It found highly emotive warnings delivering messages of negative health effects were most likely to capture the attention of the study participants.

However, these warning messages did not prompt quit attempts and participants were sceptical about the effectiveness of cessation programmes, such as telephone quit lines.

Active avoidance of health warning messages was common, and many participants expressed false and self-exempting beliefs about the harms of tobacco.

The effect plain packaging had on the perception of product quality and taste in some smokers is interesting, but we cannot assess how common this shift in attitude is because of the way this study is designed. Hopefully, more systematic research will be carried out into the issue.

Opponents of plain tobacco packaging argue branding has little effect on the behaviour and attitudes of smokers or young people who may become smokers. If that is the case, tobacco companies should be willing to introduce plain packaging.

Issues of branding aside, this research does suggest current anti-smoking campaigns are failing to resonate with certain groups, such as smokers on a low income.

Further research is needed to determine the best ways of engaging with vulnerable smokers.

Analysis by Bazian. Edited by NHS Choices. Follow Behind the Headlines on Twitter. Join the Healthy Evidence forum.

Analysis by Bazian

Edited by NHS Choices

Links to the headlines

Long-term smokers find plain-packaged cigarettes taste worse. The Guardian, July 15 2014

Links to the science

Guillaumier A, Bonevski B, Paul C. Tobacco health warning messages on plain cigarette packs and in television campaigns: a qualitative study with Australian socioeconomically disadvantaged smokers. Health Education Research. Published online June 25 2014

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