Plain packaging boring enough to make smokers quit?
I analysed how the world first plain packaging legislation effected smokers perceptions of cigarettes in Australia, based on the international tobacco control survey data. I examined the survey for relevant questions i.e. did you select your brand of cigarette based on price?
The frequency of responses over time from the years 2012-2014 indicated a general trend in the way people select their brand of cigarette. I also performed logistic regressions to check for significant associations between variables in the survey.
The results of my study were interesting because selecting a brand based on price had not significantly changed over the years although Australia’s tobacco excise had gone up, also choosing based on price was not significantly associated with making quit attempts. Some of the evidence that suggested the effect of plain packaging was the question did you select your brand based on the look of the packet? Choosing a brand based on look was negatively associated with quit attempts in the year 2012 (before plain packaging), but was positively associated with quit attempts in 2013 and 2014. Now Standardised Packaging (SP) drastically changed the appearance of all cigarettes sold in Australia to be as unappealing as possible, so it makes sense that it caused this change in attitudes towards a smokers’ preferred brand and to smoking in general.
image credit: tobaccofreekids.org
The experts who advised the Australian government in writing the SP legislation argued that increasing dissatisfaction with a smokers’ brand of cigarette and preventing any contradictory advertising or advertising of pleasurable associations, would make people more likely to quit. My research discovered evidence to support this theory after the fact, but there were studies before 2012 that suggested warning labels and reduced satisfaction made someone more likely to quit and positive advertising for cigarettes is well known for attempting to hinder government health warnings.
Another area where SP seems to have an effect is choosing a brand of cigarettes because your friends smoke it. The social pressures to smoke are well evidenced in previous research, but after the SP legislation and in the Australian context where fewer people are smoking the “friends” question was positively associated with quit attempts. This suggests that because it is harder to tell what everyone is smoking it has less of an effect keeping people smoking. There is also a possibility the less recognisable packs offer no incidental advertising in people’s daily life which may also reduce likelihood someone uptakes, or continues, smoking.
My research was a curious mix of epidemiology, market research and psychology. I had to derive meaningful data from self-reported surveys and account for multiple potential confounders and possible effect modifiers in this context. Overall corroborating data from the National Drug Strategy Household Survey and the Australian Bureau of statistics shows fewer Australians smoke compared to a few years ago and this is part of a consistent downward trend. So in future it will be harder to recruit smokers for study and this cohort may be even more resistant to anti-smoking interventions.