A much-awaited study from Australia, the only country in the world where cigarettes are sold in plain packs, suggests smokers find plain packaged tobacco less appealing. Furthermore, smokers said plain packaging also made them think more about quitting and want to put it higher on their list of priorities.

Australia banned the sale of branded tobacco products in December 2012. Now they can only be sold in plain brown packs, bearing graphic health warnings that take up three quarters of the front of the pack. Prior to this, cigarettes were available in branded packs with smaller health warnings.

Writing in a July 22nd issue of the online journal BMJ Open, researchers at the Centre for Behavioural Research in Cancer located in Carlton, Victoria, conclude that:

“The early indication is that plain packaging is associated with lower smoking appeal, more support for the policy and more urgency to quit among adult smokers.”

Other countries are watching the results of Australia’s bold move to tighten up tobacco control with great interest.

In the UK, the government recently postponed plans to introduce plain cigarette packaging in England, citing lack of evidence, and that they would like to wait and see how the legislation fares in Australia.

Following this new study, health campaigners are now saying the UK government “has no excuse” to delay plain cigarette packaging.

Deborah Arnott, chief executive of health charity Ash (Action on Smoking and Health), says the study “adds to the strong evidence we already have from the UK Government-commissioned review of the evidence which clearly showed that plain, standardised cigarette packs are less attractive to children.”

However, a government spokeswoman told the press that it would wait until the “emerging impact of the decision in Australia can be measured” before deciding whether to do the same in England, reports New Scientist.

The Australian researchers wanted to explore the extent which the new legislation was meeting its intention in the early stages.

In their introduction, they say that the aim of plain tobacco packaging is to reduce attractiveness and appeal of the product, increase awareness and effectiveness of health warnings, and reduce the ability of branded products to mislead the public about the harms of smoking. There is also a hope that children will be less likely to take up smoking.

For their study, they analysed data covering 536 cigarette smokers who smoked a usual brand and who were interviewed over the period starting just before the sale of branded packs became illegal, to just after. Plain packs were already in the shops in the months leading up to the ban.

The interviewees were taking part in a telephone survey that is carried out every year in the state of Victoria to find out about smoking and health.

The survey showed that over 72% of interviewees were smoking cigarettes from plain packs, while the rest were still using branded packs.

The main findings were that compared to smokers using cigarettes from branded packs, those using plain pack cigarettes were significantly more likely to say:

  • The cigarettes they were currently smoking were less satisfying and of lower quality than the ones they smoked a year ago
  • They had thought about quitting cigarettes at least once a day in the past week
  • They rated quitting as a higher priority in their lives, and
  • They supported the plain pack legislation.

When asked if they thought the harms of tobacco products had been exaggerated and how often they thought about the damage that cigarettes could be doing to them, there was little difference in responses between plain pack and branded pack smokers.

As the date of the plain pack legislation drew nearer, more of the interviewees were smoking cigarettes from plain packs, and in terms how appealing the cigarettes were, the more responses of those smoking from branded packs resembled those of plain pack smokers.

The authors suggest this last point could just be a reflection of the reduced likelihood of being able to smoke from a branded pack, or the effect of “social contagion.”

However, they point out that other studies have shown that frequency of thoughts about quitting is a strong predictor of whether smokers actually try to do so.

The researchers conclude that:

“Overall, the introductory effects we observed are consistent with the broad objectives of the plain packaging legislation.”

“We await further research to examine more durable effects on smokers and any effects on youth,” they add.

Written by Catharine Paddock PhD