Does plain packaging help smokers quit?

Plain cigarette packs “to help smokers quit smoking” is the BBC News headline, while The Daily Telegraph reports there is “no excuse for the delay on plain cigarette packaging”.

!!!They report on the results of a survey comparing the smoking beliefs and thoughts about quitting of people who smoked using a plain cigarette pack of cigarettes compared with those that smoke using the original packets as simple packages were introduced by law in Australia. Since the end of 2012 all tobacco products have been sold in total brown bags, no branding, but with known and graphics designed to encourage people to quit smoking.

The researchers found that, compared with smokers branded cigarette packs, smokers who smoke from ordinary cigarette packets with a large front side of the package health warnings were more likely to:

• perceive their tobacco of lower quality and less satisfying than a year ago

• thinking about and priorities quitting

• maintain the plain packaging law

However, people were surveyed in only one point in time. At the moment it is not clear whether the change in attitude will lead to people to quit smoking. The survey only looked at the beliefs of adults, so we can not say if the young people will have the same reactions.

This is a useful piece of research carried out with a relatively large and representative sample. He added in a discussion about similar legislation package to be introduced in England.

Where the stories come from?

The study was conducted by researchers from the Centre for Behavioural Research in Cancer in the Cancer Council Victoria in Australia and was funded by the anti-smoking lobby organization Quit Victoria.

The study was published in the peer-reviewed open-access medical journal BMJ Open.

From September 2012 all tobacco manufactured for sale in Australia had to be made in a simple dark brown packages with health warnings, which occupied most of the space on the front of the pack. Brand was limited to standardized and font size, and on the front of the pack.

These new simple packages began appearing in stores in October 2012 and before December 1, 2012 all tobacco sold at retail were required by law to be contained in a simple package. Deploying new plain packages accompanied by a national media campaign.

The study’s authors say plain packaging of tobacco is to reduce the attractiveness and appeal of tobacco, increase the visibility and effectiveness of warnings and reduce the ability of branded bags to mislead the general public about smoking harms.

We also hope that the use of plain packaging would encourage the participation of children have taken the habit.

Australia was the first country to implement a simple package, so that all the studies so far do not have a “simulated” plain packaging, not the study of the real situation.

UK media reporting of the study was broadly accurate. As might be expected, many of the papers mentioned the recent decision of the Government not to legislate packaging because there is now “not enough evidence to prove the simple packaging operations.”

What kind of research was this?

This was a cross-sectional study looking at the attitudes and intentions of the two groups of smokers:

• those who smoked tobacco from a simple package with a large front side of the package health warnings, which, compared to

• those who smoked in branded bags with less health warnings

This type of study examines the characteristics of the population at a given time, in this case, attitudes and intentions of the people about smoking tobacco. As this study examines only one point in time, it can not establish a cause-and-effect relationship between factors, or say that packaging is the cause of change in the relationship.

Importantly, it can not tell us whether the change in packaging reaches the desired results or the actual rates increase output preventing people from starting to smoke.

Conclusion

This was a useful piece of research that informs how attitudes and beliefs toward smoking may depend on changes in packaging.

Strong research is that it is based on a relatively large representative sample of people from one Australian state, and that it was timed to occur during the introduction of plain packaging of tobacco in Australia.

However, there are serious limitations to the conclusions that can be drawn from this study, including:

• that people were interviewed at only one point in time, and the relationship may change if surveyed at different time periods

• that the study can not estimate the change in packaging achieves the desired result – increase quit rates

• whether the change in packaging to prevent people from starting to smoke in the first place

While people who smoke cigarettes plain package, significantly more likely to think about quitting and place a higher priority on the output of the intention to quit smoking, remained unchanged.

Because the interviews were conducted in English, the results may not apply to other populations (as it is known that the response to branding may be culture-specific.) Also, just looked at the beliefs of adults, so the results can not be generalized to young people.

The authors also report that the study was not designed to analyze the individual effects as a simple box and a new large graphic health warning because they were introduced at the same time.

It is also worth noting that the number of people smoking was based on their own records, and there is the possibility that participants did not report their level of smoking consumption accurately. This could potentially skew the results, as could the fact that some smokers branded bags can used to smoke from simple packages.

Nevertheless, despite limitations, this study has potential implications for public health and provides preliminary data relationships and intentions of smokers about plain packaging of tobacco.

As Australia is currently the only test bed (although other countries are considering introducing similar laws), further research on the impact of plain packaging of tobacco will be studied with interest.

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