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March 2nd, 2015:

Evidence supports plain tobacco packaging to improve public health

8 JAN 2015

Crawford Moodie

Tobacco companies rely heavily on packaging to create and drive brand image in order to attract new consumers to their products and create brand loyalty. Standardising pack appearance by introducing laws that enforce plain tobacco packaging may contribute to a reduction in smoking rates and improve public health.

Why packaging is important

Since the late 19th century, product packaging has been a valuable communications tool for tobacco companies[1], and it has become increasingly important in recent years for several reasons. Firstly, bans on tobacco advertising, promotion and sponsorship have left packaging as one of the few remaining ways for a tobacco company to distinguish its brand with consumers and create interest in its products — the ‘last chance marketing saloon’ as it has been referred to by tobacco industry analysts[2]. Secondly, there are now a large variety of tobacco brands on the market, which was not always the case, and a growth in brand families, where a single brand can have more than a dozen variants. This makes packaging crucial for inter- and intra-brand differentiation. Thirdly, technological advancement has allowed greater innovation in pack appearance, especially in terms of pack structure (size, shape, closing mechanism) and non-visual sensory elements intended to create a multisensory appeal (such as textures or coatings to create tactile effects, aroma technology or auditory cues). Packaging innovation can reduce risk perceptions and enhance brand appeal, purchase interest, sales and market share[3],[4].


The public health argument

The issue with fully branded tobacco packaging, from a public health perspective, is that it can increase the appeal of the pack, the product and smoking, mislead consumers about how harmful the product is, and distract from the on-pack government health warnings. It was for these reasons that Australia implemented plain cigarette packaging in 2012 in accordance with the World Health Organization Framework Convention on Tobacco Control[5],[6]. A number of other countries, including New Zealand, France, Finland, India and South Africa, are reported to be considering plain (also referred to as standardised) packaging. While Ireland appears firmly committed to introducing this measure, the UK government has yet to make a similar pledge; the Scottish government maintains that it will proceed independently should the UK government fail to do so.

Despite recent announcements, Australia remains the only country to have implemented plain packaging, which is surprising considering that the idea that all tobacco products come in “plain brown wrappers” was proposed by a group of Canadian doctors in the mid-1980s[7]. This slow progress may be explained, at least in part, by the response of tobacco companies. Since the early 1990s, when the Plain Pack Working Group was established by tobacco companies to develop a global strategy against plain packaging, it has strongly opposed this measure and attempted to shape the debate. Within the UK, for instance, tobacco companies have lobbied the government and manipulated media coverage to claim plain packaging will have an adverse impact on retailers and boost the illicit tobacco trade, and have done so via misrepresentation of findings and use of third-party evidence (without disclosing financial links to this evidence)[8].

A lack of research on the potential impacts of plain packaging, at least until recently, is also a contributory factor. As of March 2014, the vast majority of primary plain packaging studies (53 studies out of a total of 62) have been conducted since 2007[9]. There is now a body of evidence, with new research being published regularly, with findings that are generally consistent, irrespective of study date, location, design and sample. Results suggest that introducing plain packaging would: reduce the attractiveness and appeal of tobacco products; increase the noticeability of health warnings; and, at least for darker coloured plain packs, reduce the ability of packaging to mislead consumers about the harmful effects of smoking[10],[11]. Regarding the potential impact on smoking-related attitudes, beliefs, intentions and behaviour, findings are mixed but tend to support plain packaging having a deterrent effect on smoking, with younger people, non-smokers and less heavy smokers more likely to think that plain packs would discourage smoking initiation, encourage cessation or reduce consumption[10],[11].

Smoking behaviour in Australia

Assessment of the impact of plain packaging on smoking prevalence is reliant upon recent findings from Australia, since it is the only country to have implemented this measure. The latest wave of the triennial National Drug Strategy Household Survey (NDSHS), with a nationally representative sample (N=23,855) of the Australian population aged 12 years and older, shows where there have been changes in smoking behaviours in Australia, including prevalence, between 2010 and 2013. The NDSHS found that for those aged 14 years and older — most analyses are conducted with those aged 14 years and older to allow for comparison with earlier surveys — fewer people reported smoking (18.1% to 15.8%) with fewer smoking daily (15.1% to 12.8%), weekly consumption of cigarettes decreased (111 cigarettes to 96 cigarettes), and there was an increase in average age of initiation (15.4 years to 15.9 years) and never smoking (57.8% to 60.1%)[12]. Overall, the key indicators point to tobacco control in Australia being a resounding success.

There are several relevant points to consider when interpreting the NDSHS findings: smoking prevalence and consumption is in long-term decline in Australia; plain packaging was not introduced until late 2012; and, aside from plain packaging, other relevant tobacco control measures introduced from 2010 included a mass-media campaign, which accompanied the initial implementation of plain packaging[13], and a large (25%) increase in sales tax. Although this tax increase was introduced some months before the previous survey wave, in 2010, it may be a relevant factor.

The balance of evidence

Packaging is clearly an important and multipurpose marketing tool, a fact that has not been disputed by tobacco companies in the plain packaging debate. It is perhaps unsurprising, therefore, that the accumulating evidence suggests that plain tobacco packaging may have, and is having, a number of potential public health benefits, particularly because there is evidence that plain packaging is associated with cessation-related behaviours[14],[15],[16],[17],[18]. Between 2010 and 2013, smoking prevalence in Australia experienced the greatest percentage decline as a proportion of the smoking population since the NDSHS began. This will serve to encourage policy interest in plain packaging elsewhere.

The case for plain packaging is now stronger than it has ever been.


Multinational tobacco companies don’t want to see Ireland introduce plain packaging because they know it works, writes Minister James Reilly

Feb 20 2015

James Reilly

CIGARETTE PACKETS ARE now sold in slim packets that resemble lipstick with glitzy colours, creative designs and stylish writing. That is advertising.

Standardised packaging of cigarettes will end this.

All cigarette boxes will be the same shape and size and will feature a graphic picture warning on the front and back of the box. The brand name will be printed in a standardised font and size.

It will strip away the illusions created by shiny, pink packets and replace them with shocking images showing the real consequences of smoking. Cigarette packets will be transformed into grim warnings about the stark realities for smokers.

Let’s dwell on the reality of smoking:

Smoking is responsible for almost one in five of all deaths in Ireland – 5,200 deaths every year; 14 deaths every day.
Smoking harms nearly every organ in the body.
Half of smokers will eventually die from a smoking-related disease.
To maintain smoking rates at their current levels, the tobacco industry needs to recruit 50 new smokers every day.
78% of smokers start smoking before they are 18 years old – while they are children.

Our smoking rate is falling

The premature death of 5,200 people per year is a major public health concern. But we are tackling it head on. Last year Ireland became one of the few countries in the EU to have a smoking rate under 20%. Our smoking rate has fallen from 33% in 1998 to 19.5% today. Our aim is to have a Tobacco Free Ireland – defined as a smoking rate of less than 5% – by 2025. We are winning this battle thanks to the determination of successive governments.

The smoking ban, the ban on the sale of packets of ten, the ban on the display of cigarettes in shops and consistent tax increases have all contributed to this progress. Our policies are working. We must continue our battle.

Standardised packaging is the next step in driving our smoking rates down further towards achieving a Tobacco Free Ireland.

We know the impact that it will have.

When standardised packaging was introduced in Australia, so many smokers complained that the cigarettes now tasted differently that a tobacco company issued a statement denying that they had changed their ingredients.

Australia’s quitline received a flood of additional calls.

Research from Australia shows that when smoking cigarettes from a plain pack, smokers are:

• 81% more likely to have thought about quitting at least once a day and rate quitting as a higher priority in their lives
• 70% more likely to say they found them less satisfying
• 66% more likely to think their cigarettes are of poorer quality

Smoking rates in Australia are now at the lowest level since records began. They are declining at the fastest pace in 20 years.

The tobacco industry is vigorously opposing this legislation

Most importantly, standardised packaging will reduce the number of children who become addicted to a product that kills one in two of its long-term users.

The tobacco industry is vigorously opposing this legislation because they fear it. They fear it because they know that it works. They are afraid that Irish smoking rates will tumble and that others in Europe will follow Ireland and Australia.

It looks like they are right. When Ireland became the second country in the world to commit to passing standardised packaging legislation in May 2013, many countries were waiting for legal proceedings against Australia in the World Trade Organisation to conclude – a process that still has not finished.

Since then, New Zealand and the United Kingdom have progressed legislation in their Parliaments. France, Norway and Finland have all indicated their intention to follow suit. Standardised packaging will be the future of cigarettes – not just in Ireland and Australia but throughout the world.

The tobacco industry will move to protect its profits. However, the State has a moral duty to protect the health of its citizens and to prevent our children from being lured into a killer addiction by marketing gimmicks. This Government will not put the profit of multinational tobacco companies ahead of the future health of our children. What kind of a society would we be if we prioritised the intellectual property rights of the tobacco industry over the future health of our children?

I look forward to progressing this legislation to Report and Final Stage in the very near future.

Pressure to bring in tobacco plain-packaging

Mar 2, 2015

Martin Johnston

The Government is being lobbied to bring the tobacco plain-packaging bill back to Parliament for a final vote, now the policy has been found to work “almost like a vaccine against tobacco” in Australia.

The health select committee last year supported the bill but the Government has delayed bringing it back to the House pending the outcome of the challenges against the Australian law by the tobacco industry.

But National support partner the Maori Party and lobby group Action on Smoking on Health (Ash) now say the decline in smoking seen in Australia since its “standardised” packaging law came into force in 2013 means New Zealand can dally no longer.

And public health expert Robert Beaglehole, a University of Auckland emeritus professor, says plain packaging in New Zealand “must be passed with urgency”.

“The Australian evidence shows standardised packaging of cigarettes has had an immense impact on smoking and has worked almost like a vaccine against tobacco use in children and young people.”

Standardised packaging involves removing all brand imagery and colours. The Government-mandated packs in Australia all have the same drab olive-green background with large pictorial health warnings that state “SMOKING KILLS”. The aim is to make smoking less attractive, especially among children and teenagers.

Australian survey data shows the prevalence of daily smoking in those aged 14 or older declined from 15.1 per cent in 2010, before the new law came into effect, to 12.8 per cent in 2013.

Canberra is defending its law in two cases: before World Trade Organisation adjudicators in a case brought by tobacco-producing countries including the Dominican Republic, and at a United Nations commission’s Permanent Court of Arbitration in a case linked to Hong Kong and tobacco firm Philip Morris Asia.

Maori Party co-leader Te Ururoa Flavell rejected the Government’s waiting on the legal challenges. “Waiting for the World Trade Organisation decision means more people die or are sick from smoking-related illnesses. We’re tired of standing at the graveside of loved ones who have had their lives cut short from this highly addictive and poisonous drug.”

Last week, Ireland became the second country in the world to pass a plain-pack law. British MPs are expected to vote within weeks on introducing the policy to England.

In New Zealand, a UMR survey for Ash last year found 75 per cent support for plain packs, including 55 per cent among smokers, if there was evidence they were less attractive than branded packs to young people.

Associate Health Minister Peseta Sam Lotu-Iiga said he was determined the plain-packs bill would become law.

“Our stance remains the same, that it is prudent to await the World Trade Organisation decision, but as minister I am always looking for ways to bring down the incidence of smoking.”

Tobacco companies oppose the plain-packs bill. “Plain packaging is failing in Australia,” said British American Tobacco’s Australian spokesman, Scott McIntyre.

The firm claimed plain packs had “seen a 32 per cent jump” in Australian teen smoking, from 3.8 per cent in 2010 to 5 in 2013, but the Age reported a Government statistician saying it was not possible to say there had been an increase as the sample size was too small and the change was not statistically significant.

World Health Organisation says Pacific considering cigarette plain packaging

30 Jun 2014

The World Health Organisation says a number of countries across the Pacific are considering following in Australia’s footsteps and introducing plain packaging of cigarettes.

The WHO is set to join governments across the region in a major drive to make the Pacific tobacco free within 10 years.

The WHO Pacific coordinator of non-communicable diseases, Dr Temo Waqanivalu, says the project will be launched in Honiara in two weeks and plain packaging is among the tactics being considered.

“The actual measure itself is something that’s greatly supported and there are a few countries that are ahead of the game, (they) are actually talking of moving there now,” Dr Waqanivalu told Radio Australia’s Pacific Beat.

“They’ve done the graphic warnings on the packets so the next step after that is to actually move towards plain packaging.”

Dr Waqanivalu says increasing the tax on cigarettes and cracking down on the tobacco black market are the keys to reduce smoking.

“If those two happen, well then especially the young smokers, the youth, they’re the first ones who actually going to begin to quit,” he said.

“Economic ministers should really think seriously about assisting… part of that is facilitating increased taxation on tobacco cigarettes.”

The WHO says Cook Islands has been a leader on reducing smoking, having significantly increased the price of cigarettes with plans for further rises.

“Cook Islands is really exemplary of what we are trying to promote across the Pacific and they’ve done exceptionally well.”

But Dr Waqanivalu says the tobacco industry is fighting back.

“We know the tobacco industry is always at work,” he said. “We see them influencing ministries of health.”

Dr Waqanivalu says the WHO’s plans also involve setting up services to help people quit.

Solomon Islands introduces Australian-style cigarette packet warnings

28 Jan 2015

Solomon Islands has followed Australia’s lead and introduced new graphic health warnings on its cigarette packets.

The new packets feature graphic imagery in combination with warning statements in Solomon Islands pidgin, the local lingua franca.

They warn of issues such as lung cancer, blindness and the impact on unborn babies.

“These graphic health warnings will deter our younger generation to reduce smoking,” said Dr Geoff Kenilorea, from the ministry of health.

“Also [we hope] people who want to start smoking will refrain from smoking.”

According to the World Health Organisation, more than 40 per cent of the Solomon Islands population are current tobacco smokers.

Some 24 per cent of young people, aged between 13-15, are current cigarette users.

The graphic health warnings were first proposed in 2007 but faced several parliamentary hurdles and legislation was not passed until 2010.

Dr Kenilorea told Radio Australia’s Pacific Beat program that the introduction of new packaging was further delayed because of “interference” from the tobacco industry.

“There was quite a battle in the Solomon Islands with tobacco industry interference and we eventually got [regulations associated with the legislation] through at the end of 2013.”

The new measures were introduced on January 1 and apply to all commercially manufactured tobacco products.

But they do not apply to loose tobacco, which is popular in the Solomon Islands and commonly found at markets.

“It’s another issue we’re having some difficulty with,” Dr Kenilorea said.

“We are trying to figure out how we can best address that by looking at some examples from other Pacific Islands like Tonga and elsewhere.

Similar graphic health warnings were introduced in Australia in 2006, New Zealand in 2008 and Canada in 2012.

Kenya: You’re Killing People, Tobacco Firms Told

THE World Health Organisation has put cigarette makers on the spot for flouting anti-tobacco laws like the ban on advertising.

Last week, health officials from Africa met in Nairobi to mark 10 years of the WHO’s framework convention on tobacco control (FCTC).

WHO’s regional director for Africa Dr Matshidiso Moeti, in a speech read on her behalf by WHO’s country director, Dr Custodia Mandlhate, said the industry continues to package and market tobacco products in a very attractive manner despite evidence proving that it has no known health benefits, but it instead causes diseases and premature deaths.

The FCTC is the first international anti-tobacco treaty and Kenya was second to sign it.

Moeti said countries cannot continue to witness passive tobacco users losing lives prematurely.

“Public health should always have priority over any trade and economic interests because it is health that generates wealth,” she said.

Moeti described tobacco epidemic as one of the biggest threats the world has ever faced, killing nearly six million people yearly.

According to WHO, nearly 80 per cent of of the more than a billion smokers worldwide live in low and middle-income countries where tobacco-related illnesses and deaths are heaviest.

The global adult tobacco survey indicates that 19.1 per cent of men and 4.5 per cent of women currently use tobacco in Kenya.

Overall, 41.3 per cent of current smokers started using tobacco aged 20-24 while 32.3 per cent started at age 17-19.

Moeti said tobacco control has been recognised as a priority area for prevention and control of non-communicable diseases.

Health ministry estimates that non-communicable diseases contribute nearly 50 per cent of all admissions in public hospitals in Kenya.

She urged governments to renew political commitment to the convention and allocate adequate resources for implementation to help help tame the “powerful opponent”.

Health CS James Macharia said Africa has become the main target for tobacco industry.

“Our very own Tobacco Control Act was enacted in 2007. Our experience has demonstrated that opportunities for tobacco control continue to be within reach provided that strong political and leadership remain constant,” he said in a speech read by director of medical services Nicholas Muraguri

ITC Project: Plain Packaging of Cigarettes


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Analysis and Feasibility Assessment Regarding EU systems for Tracking and Tracing of Tobacco Products

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