Study finds plain cigarette pack fears 'unfounded'

Behind the Headlines

Friday August 29 2014

Anti-tobacco groups have lobbied for similar packaging to be introduced in the UK

The Australian packs carry prominent health warnings

"Cigarette plain packaging fear campaign unfounded," reports The Guardian.

After Australia introduced plain packaging laws in 2012, opponents of the legislation argued it would lead to a number of unintended consequences, including:

  • the market would become flooded by cheap Asian brands
  • smokers would be more likely to buy illegal unbranded tobacco (including raw unbranded loose tobacco known locally in Australia as "chop-chop")
  • smokers would be less likely to buy their cigarettes from smaller mixed businesses such as convenience stores and petrol stations, meaning that small businesses would suffer

But a new study conducted in Victoria, Australia, suggests these fears are unfounded.

Researchers compared the responses smokers gave in a telephone survey one year before the introduction of standardised packaging, with responses given one year after its introduction.

The study found no evidence the introduction of standardised packaging had changed the proportion of people purchasing from small mixed-business retailers, purchasing cheap brands imported from Asia, or using illicit tobacco.

But this study did not investigate whether there had been an increase in the use of counterfeit branded tobacco products. The researchers noted that smokers may be unaware they are smoking counterfeit products.

In conclusion, the study suggests there is no evidence for many of the "fears" proposed by opponents of standardised packaging.

 

Plain packaging

Australia introduced plain packaging laws for cigarettes in 2012.

 

The packs themselves are not plain – all branding and logos have 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 Centre for Behavioural Research in Cancer in Melbourne, Australia.

It was supported by Quit Victoria, with funding from VicHealth and the Department of Health for the Victorian Smoking and Health annual survey.

The study was published in the peer-reviewed journal BMJ Open, which is open access, so the study can be read online or downloaded for free.

The results of the study were well reported by the UK media.

 

What kind of research was this?

This was a serial cross-sectional study (a cross-sectional study at different time points) that aimed to determine whether there was any evidence that the introduction of standardised packaging in Australia had changed:

  • the proportion of current smokers who usually purchased their tobacco products from larger discount outlets such as supermarkets, compared with small mixed-business retail outlets
  • the prevalence of the regular use of low-cost brands imported from Asia
  • the use of illicit unbranded tobacco

In Australia, since 2012 all tobacco products have to be sold in standardised dark brown packaging with large graphic health warnings. Brand names are printed in a standardised position with standardised lettering.

The researchers state opponents of plain packaging have suggested its introduction could mean smokers would be less likely to purchase from small mixed-business retailers, more likely to purchase cheap brands imported from Asia, and more likely to use illicit tobacco.

 

What did the research involve?

Smokers aged 18 and over in Victoria, Australia were identified in an annual population telephone survey (the Victorian Smoking and Health Survey).

They were asked about:

  • the place they usually purchase tobacco products from (supermarkets, specialist tobacconists, small mixed businesses, petrol stations or other venues, including informal sellers)
  • their use of low-cost Asian brands (whether their main brand was a low-cost Asian brand)
  • their use of unbranded illicit tobacco (whether they had bought or purchased any unbranded tobacco)

The researchers compared answers from three annual surveys: 

  • 2011 – a year prior to the implementation of standardised packaging
  • 2012 – during roll-out
  • 2013 – a year after implementation

 

What were the basic results?

A total of 754 smokers were surveyed in 2011, 590 in 2012 and 601 in 2013.

The researchers found:

  • the proportion of smokers purchasing from supermarkets did not increase and the percentage purchasing from small mixed-business outlets did not decline between 2011 and 2013
  • the prevalence of low-cost Asian brands was low and did not increase between 2011 and 2013
  • the proportion reporting current use of unbranded illicit tobacco did not change significantly between 2011 and 2013

 

How did the researchers interpret the results?

The researchers concluded that, "One year after implementation, this study found no evidence of the major unintended consequences concerning loss of smoker patrons from small retail outlets, flooding of the market by cheap Asian brands and use of illicit tobacco predicted by opponents of plain packaging in Australia."

 

Conclusion

The study found no evidence the introduction of standardised packaging had changed the proportion of people purchasing from small mixed-business retailers, purchasing cheap brands imported from Asia, or using illicit tobacco in Victoria, Australia.

However, this survey was only conducted in Victoria and only among English-speaking residents, so further studies are required to confirm the generalisability of the findings. As with all surveys, there is the possibility of respondent error and misreporting.

Further studies are required to investigate whether the introduction of standardised packaging has increased the use of counterfeit branded tobacco products, as this was not assessed.

Overall, the results of this study suggest there is no evidence behind many of the "fears" proposed by opponents of standardised packaging.

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

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