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20 Mar 2015

Tobacco plain packaging is working to encourage smokers to kick their habit and dissuade young people from taking it up, according to the most comprehensive evaluation of the reform yet undertaken.

Just days after Britain and Ireland followed Australia’s lead by passing laws requiring that tobacco products be sold in plain packaging emblazoned with large health warnings, a British Medical Journal analysis of 14 peer-reviewed studies has concluded that the public health measure is “delivering on its hypothetical promise”.

“The evidence suggests that plain packaging is severely restricting the ability of the pack to communicate and create appeal with young people and adults,” paper’s authors, Professor Gerard Hastings and Dr Crawford Moodie, both of the University of Stirling, said.

Not only was plain packaging effective in reducing the appeal of tobacco products, the authors said a cross-sectional tracking survey of smokers showed plain packaging caused them to think more about quitting the deadly habit.

“Plain packaging in Australia has been a casebook example of effective tobacco control – a policy measure driven by evidence, carefully designed and implemented, and now rigorously assessed,” Professor Hastings and Dr Moodie wrote. “Plain packaging is beginning to deliver on its promise.”

Professor Melanie Wakefield, a Principal Research Fellow of the National Health and Medical Research Council, led the evaluation published in the BMJ, and said its findings were the “first comprehensive set of results of real world plain packaging, and they are pointing very strongly to success in achieving the legislation’s aims”.

“These results should give confidence to countries considering plain packaging that plain packs not only reduce [the] appeal of tobacco products and increase the effectiveness of health warnings, but also diminish the tobacco industry’s ability to use packs to mislead consumers about the harms of smoking,” Professor Wakefield said.

The endorsement of the reform has been welcomed by both sides of politics.

Assistant Health Minister Fiona Nash said she was “extremely pleased” by the BMJ findings, which drew in part on research commissioned by the Commonwealth Health Department.

Senator Nash said plain packaging had played a part in driving the daily smoking rate among Australians 14 years and older down to 12.8 per cent.

Plain packaging legislation was introduced by the previous Labor Government with bipartisan support, and Shadow Health Minster Catherine King said only the tobacco industry thought the measure was a bad thing.

The industry, which has been fighting a bitter battle to have the Australian legislation overturned ever since its introduction in 2012, dismissed the BMJ analysis, and reiterated its claims that plain packaging laws have simply forced smokers onto cheaper cigarettes and fuelled trade in illicit tobacco products.

Philip Morris Limited Director Corporate Affairs Chris Argent said the research had measured perceptions of plain packaging rather than its impact on behaviour, and claimed tobacco excise increases were largely responsible for any changing in smoking habits.

“The fact is that smoking rates in Australia have been declining steadily since 1991, well before plain packaging was implemented, and there has been no significant deviation in that trend since plain packaging was implemented,” Mr Argent said.

Professor Hastings and Dr Moodie admitted that, because plain packaging was introduced as part of a wider package of measures including larger health warnings, mass media campaign and tax increases, it was hard to separate out the effects of each measure.

But they said the picture that had emerged from the 14 studies included in the evaluation suggested the policy was working and, just as significantly, that industry warnings of a surge of trade in cheap and illegal cigarettes were unfounded.

“There is no evidence for either effect,” they said. “Average inflation-adjusted recommended retail prices actually increased for cigarettes in all price segments…there was no decline in the percentage of smokers purchasing from convenience stores, no indication of increased purchase from overseas, online or duty-free, [and] no evidence of an increase in the consumption of illicit ‘cheap white’ cigarettes.”

, both experts in marketing, said that in addition to their immediate effects, plain packaging laws were important in the context of imminent major advances in the use of packaging to promote products.

They said multiple technologies were being developed which would turn packets into multi-sensory billboards for products.

Packs are already being produced that play music, pre-recorded messages and other noises, emit scents and are phosphorescent.

Professor Hastings and Dr Moodie said conductive inks were also being used that allow for cheap electronic circuits to be incorporated into cardboard, with the potential for cigarette packs to carry moving images, or to be capable of communicating with consumers through their mobile phones, smart watches and glasses or other devices.

“Whatever direction these innovations take, it is clear that the marketing power of the pack is only going to increase. So governments which do not act on plain packaging today will have a bigger problem to tackle tomorrow,” they said.

The BMJ study “Death of a salesman” can be viewed at: http://tobaccocontrol.bmj.com/content/24/Suppl_2/ii1.full

Adrian Rollins

 


Published: 20 Mar 2015