Clear The Air News Tobacco Blog Rotating Header Image

October 16th, 2013:

Is Consumer Response to Plain/Standardised Tobacco Packaging Consistent with Framework Convention on Tobacco Control Guidelines?

Is Consumer Response to Plain/Standardised Tobacco Packaging Consistent with Framework Convention on Tobacco Control Guidelines? A Systematic Review of Quantitative Studies


Background and Objectives

Standardised or ‘plain’ tobacco packaging was introduced in Australia in December 2012 and is currently being considered in other countries. The primary objective of this systematic review was to locate, assess and synthesise published and grey literature relating to the potential impacts of standardised tobacco packaging as proposed by the guidelines for the international Framework Convention on Tobacco Control: reduced appeal, increased salience and effectiveness of health warnings, and more accurate perceptions of product strength and harm.


Electronic databases were searched and researchers in the field were contacted to identify studies. Eligible studies were published or unpublished primary research of any design, issued since 1980 and concerning tobacco packaging. Twenty-five quantitative studies reported relevant outcomes and met the inclusion criteria. A narrative synthesis was conducted.


Studies that explored the impact of package design on appeal consistently found that standardised packaging reduced the appeal of cigarettes and smoking, and was associated with perceived lower quality, poorer taste and less desirable smoker identities. Although findings were mixed, standardised packs tended to increase the salience and effectiveness of health warnings in terms of recall, attention, believability and seriousness, with effects being mediated by the warning size, type and position on pack. Pack colour was found to influence perceptions of product harm and strength, with darker coloured standardised packs generally perceived as containing stronger tasting and more harmful cigarettes than fully branded packs; lighter coloured standardised packs suggested weaker and less harmful cigarettes. Findings were largely consistent, irrespective of location and sample.


The evidence strongly suggests that standardised packaging will reduce the appeal of packaging and of smoking in general; that it will go some way to reduce consumer misperceptions regarding product harm based upon package design; and will help make the legally required on-pack health warnings more salient.

Download (PDF, 286KB)

Tobacco industry victorious as EU fails to pass tougher laws against tobacco marketing

In the 12 years since the EU first passed the Tobacco Products Directive (TPD)- a set of regulations limiting tobacco sales and promotions aiming to reduce the number of smokers and thereby improving the health of EU citizens – the tobacco industry has been finding loopholes to get around the regulations. Last Tuesday (8 Oct 2013), Members of the EU Parliament (MEPs) were scheduled to vote on an important revision of the Directive. Health warnings on cigarette packets were to be increased, attractive cigarette marketing were to be banned, and electronic cigarettes (e-cigarettes) were to come under strict regulations.

As it turns out, the tobacco industry already got hold of every detail of the proposed revisions within the 24 hours that they were made behind closed doors. The tobacco companies launched an extraordinarily aggressive lobbying campaign, with Philip Morris International spearheading the effort. Third parties sympathetic to the tobacco cause, such as tobacco retailers and consumers, were roped in to speak against the TPD. More serious, though, is that the tobacco lobby managed to hold large numbers of meetings with some 233-250 MEPs, or about a third of the European Parliament, and used their large economic power to influence them in a period of austerity. Philip Morris’ response in light of the reports is that everything it has done is legitimate, and that if conversely they were to remain silent over the proposal (which was not meant for their ears anyway) it would have been illogical.

The tobacco lobby ropes in third parties and appeals for misplaced sympathy to their economic interests (ITGA)

The result of the vote was a victory for the tobacco lobby, as they succeeded in influencing several crucial areas of contention: increase in warning sizes on cigarette packs will be 65% rather than 75%, ‘slim’ cigarettes targeting young people will not be banned while menthol flavours will only receive a gradual phase-out into 2022, and e-cigarettes will not be regulated as medicines.

Not satisfied with the victory, the tobacco lobby and MEPs with outright support for the industry continues to defend the vote by labelling the initial proposals as ‘crazy’ or unnecessary. Health officials, on the other hand, calls it ‘shameful’ that the European Parliament settled for watered-down rules, placing the health and interests of EU citizens at risk.

More in-depth information can be read from an earlier post, taken from the blog Tobacco Unpacked.

Read more on the event below:

Taken from Reuters UK, 4 Oct 2013:

“There is an unprecedentedly intense lobbying campaign from the industry going on inside the European Parliament with the express intention of trying to frustrate this legislation,” a senior Irish official said on Friday, briefing journalists on condition of anonymity.

“This is completely on a scale way beyond lobbying that normally goes on.”

He said officials had been surprised to discover that cigarette manufacturers and their lobbyists had knowledge of precise elements of the law barely 24 hours after they were agreed behind closed doors.

Internal Philip Morris documents leaked to the media and seen by Reuters show that lobbyists have held over 250 meetings with members of parliament to discuss the legislation, especially with conservatives.

In a statement last month responding to criticism, Philip Morris said it was merely trying to express its views on the legislative proposals, and pointed out that it employed 12,500 people in the EU and had invested hundreds of millions of euros.

“The argument that we should remain silent in the face of a proposal that directly concerns us, and on which we have facts and improvement ideas to share, is illogical,” said Drago Azinovic, the president of the company for the EU region.

“We have and will continue to express our views proactively and transparently. As the EU itself says, this kind of interaction is ‘constant, legitimate and necessary for the quality of democracy’.”

Taken from a joint open letter of 11 health organisations to the President of the EU, 1 Oct 2013:

There is widespread concern that the decision to delay the plenary vote on the TPD was a result of tobacco companies like Philip Morris International and others using their economic and political power to influence MEPs. The postponement of the vote is widely believed to be part of a tobacco industry strategy to delay, weaken or even derail the TPD. The leaked documents show that no less than 233 MEPs (almost one third of the Parliament) have been met by Philip Morris International lobbyists at least once. Several MEPs were listed as having had four or five such meetings.

This large number of meetings (which have taken place behind closed doors, without any transparency such as the publication of minutes from these meetings), constitutes a serious violation of the World Health Organisation Framework Convention on Tobacco Control (WHO FCTC) Article 5.3 which is geared towards safeguarding public health policy-making from tobacco industry interference. FCTC Article 5.3 recognises the fundamental and irreconcilable conflict of interest between the tobacco industry and public health policy-making. It also recognises that the tobacco industry has, for decades, been working tirelessly to delay, block, and weaken life-saving health measures, like those enshrined in the FCTC.

FCTC Article 5.3 requires all Parties, when deciding on their public health policies with respect to tobacco control to “. . . act to protect these policies from commercial and other vested interests of the tobacco industry in accordance with national law”.

The WHO’s accompanying guidelines stipulate that decision-makers “should interact with the tobacco industry only when and to the extent strictly necessary to enable them to effectively regulate the tobacco industry and tobacco products.”

The guidelines state that “where interactions with the tobacco industry are necessary, Parties should ensure that such interactions are conducted transparently”.

Taken from European Voice, 3 Oct 2013:

Internal documents from American tobacco giant Philip Morris International, seen by European Voice, suggest that this company alone has used 161 lobbyists, who met 233 MEPs – 31% of the Parliament – from the start of 2011 to June 2012. About half of EPP and ECR MEPs met the company’s lobbyists during that time. A slide presentation from 2011 identified delaying the legislation as a possible way to defeat it.

Last month Margaret Chan, director-general of the World Health Organization (WHO), accused the tobacco lobby of using a “massive army” to “sabotage” the EU vote. She suggested that the lobbyists were trying to delay the legislation until the start of the Greek presidency of the EU on 1 January, hoping that Greece would shelve the directive because it was more tobacco-friendly than the preceding presidencies of Ireland and Lithuania. She also noted that Philip Morris is opening a European distribution centre in Greece.

“Here industry is counting on the historical pattern where economic and commercial interests trump public health concerns,” she told the conference.

The aftermath, taken from the Independent, 8 Oct 2013,

MEPs rejected plans to ban so-called “slim” cigarettes that are particularly attractive to young smokers and opted to phase out menthol cigarettes over eight years rather than three.

They also backed away from proposals to increase the size of health warnings on cigarette packs to cover 75 per cent of the box – agreeing instead to the 65 per cent figure suggested by the industry. The current requirement for health warnings is for 30 per cent minimum coverage on one side and 40 per cent on the other.

“This is a shameful day for the European Parliament, as a centre-right majority has done the bidding of the tobacco industry and voted for weaker rules, which are totally at odds with citizens’ interests and public health,” said Carl Schlyter, who co-chairs the public health committee. “The parliament’s public health committee voted for robust legislation, with a view to tackling the 700,000 Europeans who die from smoking every year, but the core proposals have been scaled back. The only real victors from today’s vote are big tobacco firms, whose aggressive and expensive lobbying campaigns have paid off.”

MEPs rejected calls for e-cigarettes to be subject to the same regulation as nicotine replacement therapies such as patches and gum. The lack of tobacco in e-cigarettes means they are “almost certainly” a much safer way of getting a nicotine hit than smoking cigarettes, according to Cancer Research.

Chris Davies, a Liberal Democrat MEP, said: “E-cigs can be a game changer. Hundreds of former smokers have written to tell me that they have helped them give up cigarettes when nothing else worked. They are successful because they are not medicines but products that smokers enjoy using as an alternative to cigarettes.”

Taken from the Guardian, 8 Oct 2013:

The UK e-cigarette industry, which broadly welcomed the parliament’s vote, said it was already in talks with the Advertising Standards Authority but added that it would not be “sensible, proportionate, reasonable or useful” to ban all advertising.

MEPs decided e-cigarettes should only be regulated as medical products if manufacturers claimed they could cure or prevent smoking tobacco – a decision criticised by the government’s main medicines regulator.

They want to put the products, used by an estimated 1.3 million people in Britain by next year, on the same legal basis as gums, patches and mouth sprays aimed at helping smokers to quit but the industry says the expensive process of licensing would help force alternatives to tobacco off the shelves.

Linda McAvan, Labour MEP for Yorkshire and the Humber and spokesman on tobacco issues for the parliament’s Socialist and Democrat group, said: “We know that it is children, not adults, who start smoking. And despite the downward trend in most member states of adult smokers, the World Health Organisation figures show worrying upward trends in a number of our member states of young smokers.

“We need to stop tobacco companies targeting young people with an array of gimmicky products and we need to make sure that cigarette packs carry effective warnings.”

Martin Callanan, the Conservative MEP for North East England, said: “Forcing e-cigs off the shelves would have been totally crazy. These are products that have helped countless people stop smoking more harmful cigarettes and yet some MEPs wanted to make them harder to manufacture than ordinary tobacco.”

Katherine Devlin, president of Ecita, the e-cigarette industry association, said “the really important” decision by MEPs not to support medicines regulation meant that was now off the table.

British American Tobacco claimed the larger health warnings demanded by MEPs went “well beyond” what was needed to inform consumers of health risks from smoking while a ban on mentholated cigarettes would increase demand for black-market goods.

Tobacco Unpacked: Shadowy lobbying against Tobacco Products Directive

from the blog Tobacco Unpacked:

by Andy Rowell, research fellow at the Tobacco Control Research Group, University of Bath, and editor of

European Parliament MEPs will debate the landmark Tobacco Products Directive, seen by public health advocates as a crucial measure in reducing the harm from tobacco across the EU.

For the last two-and-a-half years, we have been monitoring the activities of the tobacco industry under a ground-breaking academic project at the University of Bath, which has been part funded by Cancer Research UK. Instead of just focusing our output on academic journals we have also developed a wiki, called, which has more timely access to our research findings.


Tobacco is unique. No other product kills one in two of its long-term users. If someone invented the cigarette today, it would never make it onto a supermarket shelf. It is now over 60 years since the link between cancer and smoking was first discovered, but millions of us remain addicted.

The reason for this, in part, is one of the most sophisticated and well-funded public relations campaigns ever undertaken by an industry. The tobacco companies set out to deny the scientific evidence of the harmfulness of their product and the addictiveness of nicotine. The object is always to try to sow confusion and doubt and delay action.

Such tactics have again been evident in the multi-million-pound lobbying campaign the industry has inflicted in recent months on Brussels. New leaked documents from Philip Morris International (PMI) reveal the extent of this campaign, which targeted the three pillars of Brussels decision-making: the European Parliament, the European Commission and European Council.


The documents reveal that by mid-2012, the overall strategic objective of PMI’s lobbying campaign was to either “Push” (i.e. amend) or “Delay” the Directive and “block” the proposals coming from the relevant Directorate on health, DG Sanco, which was in charge of the proposals. To this end, PMI employed a two-fold technical and political strategy to ensure it received as many “negative opinions” from other Commission DGs as possible, as well as to try and ensure a political commitment from other business-friendly Commissioners to oppose what PMI was labelling as excessive legislation. PMI identified key messages to push in its lobbying campaign, especially in relation to the Inter-Service Consultation between the directorates, arguing there was a need to “break” into the “silo” of the European Commission. The main lobbying messages used by the company were that the TPD proposals lacked “legal basis”, “evidence”, “logic” and a “market analysis”.


Just as PMI had done fighting proposals on Point of Sale and Plain Packaging in the UK, the tobacco giant was keen to highlight the “illicit trade problem”, despite its historical involvement in smuggling. For more information on this see on smuggling. The company set out to “trigger negative opinions” amongst other Commissioners or their senior advisors, known as their cabinet, and set out to get other “high-level influencers” to directly engage with the Commissioners. The tobacco companies such as PMI have a history of using so-called third party techniques in their lobbying campaign, using other organisations or people to influence the debate on the industry’s behalf.

The reason is simple: the use of third parties removes the message from the interested messenger. Moreover, the tobacco industry is such a discredited voice that it has to look for someone else to be its ventriloquist dummy. The public or a politician may be sympathetic about a corner shop going out of business, but they would have less sympathy towards an industry which kills its long-term customers and whose profits stretch into billions.


The documents reveal that PMI’s anti-TPD lobbying campaign, via social and traditional media, would be “led by third parties”. The tobacco giant identified tobacco growers, small and medium-sized businesses, other trade organisations, unions, suppliers, intellectual property organisations, employers’ associations and even consumer associations to front its campaign for it.
And just as the industry used retailers against Point of Sale Display Ban and Plain Packaging in the UK, so they have been central to PMI’s lobbying campaign in Brussels. PMI outlined how the retailers would lobby other parts of the Commission and “promote events to gain visibility” for the campaign. As well as retailers based in Brussels, national retailers associations across the EU were also brought in to help, too.

Another key constituency to front the campaign were tobacco growers and processors. PMI organised meetings between tobacco growers’ unions, such as UNITAB, the European Association of Tobacco Growers and Fetratab, the European Federation of Tobacco Processors, with key officials at the Commission, including a meeting with the Cabinet of the European President Manuel Barroso.


The leaked documents also outline in detail PMI’s strategy in the European Parliament. This time, the tobacco giant undertook direct lobbying as well as indirect. By mid-2012, nearly a third of MEPs had been lobbied by PMI, some 233 MEPs in total. Some MEPs by then had met the tobacco giant four to five times, with meetings happening on a regular basis. Almost half of the European People’s Party and European centre-right groups met with PMI’s lobbyists, the documents show.

At the parliament, the company also focused its lobbying efforts on two influential committees, ENVI and IMCO. The ENVI committee – Environment, Public Health and Food Safety – was tasked with overseeing the TPD through the Parliament. PMI set out to “Break ENVI’s full control on the dossier.” Heads of national delegations were lobbied, as were the “political heavyweights” from each political party. The company sought to “secure political agreement though top level contacts”.


PMI also set out to lobby the Council, in order to create a “blocking majority” against any public health measures it deemed “extreme”. One of these measures is the banning of certain flavours including menthol. PMI’s objective was “exclude” menthol from the TPD. It wanted to get different member states with “significant menthol segments to oppose a menthol ban in TPD at the Council”.

In order to do this it wanted to “neutralise” lead countries in the menthol debate, such as Germany. The use of language such as this is indicative. Here we have a transnational company effectively planning to politically nullify the most powerful EU country. This multi-million-euro lobbying campaign raises all kinds of issues, two of which are deeply important for public health and the political process. The fact that PMI has had such extensive access to the Commission and hundreds of MEPs is clearly a breach of the Framework Convention on Tobacco Control. Article 5.3 of the Convention requires signatories to protect their health policies “from commercial and other vested interests of the tobacco industry”. This clearly has not happened in this case.


Last week, 11 public health and transparency NGOs wrote to President of the European Parliament to argue these meetings constitute “a serious violation” of the Convention.

“We are deeply concerned about the astounding level of access to MEPs by tobacco lobbyists which has been exposed in the leaked Philip Morris International documents,” they wrote.

PMI has also voluntarily signed up to the EU’s Transparency Initiative and is meant to accurately record how many lobbyists and how much money it is spending lobbying in Brussels. The documents reveal that PMI has been using a significant number of lobbyists and consultants. One spread-sheet outlines that 161 employees and consultants were engaged in lobbying concerning the TPD. By mid-2012, the documents also reveal, PMI had spent €1.25 million on consultancy and expenses fighting the proposals.


In contrast, PMI only declares nine lobbyists in its entry to the EU Transparency Register. For the whole of 2012, the company estimated that its lobbying spend had been €1 million–€1.25 million. Behind the scenes we know the lobbying will continue right up to any vote. Via the documents we only have a small snapshot of how widespread and pervasive PMI’s lobbying campaign has been. PMI’s key aims are to reduce the size of health warnings and ensure menthol cigarettes are not banned. If the industry can delay the vote at the Parliament and also at the council again, the whole Directive may be put back years. So, just as it has done many times before, the industry will have delayed action, whilst the profits keep rolling in.

7 Oct 2013