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The simple trick Australia is using to reduce smoking rates

Australian cigarette packages have graphic health warnings. Cameron Spencer/Getty Images

Australian cigarette packages have graphic health warnings. Cameron Spencer/Getty Images

Cigarette packs in Australia look different from anywhere else in the world. There are no brand logos, no bright colors. Every pack is the same shade of dull brown, plastered with graphic images showing the health impacts of smoking. There’s the gangrenous foot, mouth cancer, and everyone’s favorite, the creepy sickly eye.

Tobacco companies don’t do this by choice. In 2011, Australia became the first country in the world to pass plain packaging laws that severely restrict what can appear on cigarette packs.

Naturally, Big Tobacco hates these laws and has done everything it can think of to get rid of them. On Friday, Australia defeated a challenge by cigarette giant Philip Morris after a four-year international trade dispute in Singapore.

Big Tobacco is clearly running scared — and it should be. The latest ruling is likely to open the door for plain packaging laws around the world. Already, 11 other countries — including England, New Zealand, France, Brazil, India, and South Africa — have plans to implement their own plain packaging rules.

Other countries, including the United States, should follow Australia’s lead. Plain packaging laws are a simple, cost-effective way to cut smoking rates. That’s why tobacco companies hate them.

Big Tobacco has been fighting plain packaging on many fronts

Philip Morris exploited an obscure clause in Australia’s free trade agreement with Hong Kong known as investor-state dispute settlement. President Obama’s controversial Trans-Pacific Partnership trade agreement includes an ISDS provision, and it has caused a lot of controversy. Critics worried that big companies — like Philip Morris — could use the ISDS process to overturn countries’ democratically enacted laws.

Australia may have won this round, but its government now faces an estimated $50 million legal bill. And Philip Morris is not the only company to push back against plain packaging laws. In 2012, British American Tobacco (BAT) challenged the laws in Australia’s high court, alleging they infringed the company’s intellectual property. The court ruled in favor of the government.

Eyebrows were raised at the World Trade Organization when Ukraine — a country that doesn’t actually export tobacco to Australia — challenged plain packaging as anti-trade. Later, it was discovered BAT had footed the country’s legal bill.

It’s not clear whether similar challenges from Cuba, the Dominican Republic, and Honduras are also funded by Big Tobacco.

While in public the tobacco giants insist plain packaging laws won’t work, behind closed doors they have spent millions of dollars trying to discredit the laws.

In 2010, a newly formed group called the Alliance of Australian Retailers launched a media blitz criticizing plain packaging. It was a case of “astroturfing” — an attempt to give the impression of a widespread grassroots backlash against the laws that just didn’t exist

Australian investigative journalists unearthed that Philip Morris, BAT, and Imperial funneled more than A$5 million into forming the Alliance of Australian Retailers. The group’s argument against plain packaging was distilled into a simple message: “It won’t work, so why do it.”

Of course, the obvious response is: If it won’t work, why are you spending millions of dollars to fight it? The alliance wasn’t effective. In fact, one study found for some people the ads increased their support for plain packaging.

Early evidence suggests plain packaging is working

The goal of the plain packaging laws is to make cigarettes less attractive and reduce the glamour of smoking. In lab studies, researchers have found they achieve this. More than 20 studies, undertaken over two decades in five countries, strongly suggest that plain packaging increases the impact of health warnings and reduces the appeal of cigarettes.

The laws aren’t a silver bullet to make people stop smoking. Instead, they work alongside higher taxes, public health campaigns, and education to reduce smoking rates over time.

As Australia is the only country to have implemented the laws, real-world evidence on plain packaging is limited. However, there is a growing body of research gathered since the laws were enacted three years ago. While we don’t yet have long-term evidence pointing to changes in smoking rates, short-term shifts seem positive.

A large study in the Australian state of Victoria found that in just 12 months plain packaging both reduced the appeal of smoking and increased desire to quit for adult smokers. Another study found calls to Quitline, an Australian government service to help people quit smoking, rose by 78 percent after the plain packaging laws came into effect. Smoking in outdoor areas, where the graphic packaging is visible to more people, also declined.

British American Tobacco hit back with its own study by Deloitte, which argued health warnings haven’t been effective in reducing consumption of cigarettes. But this study wasn’t independent — it was commissioned and funded by BAT. The study itself admits the researchers were highly selective about what brands they included.

Tobacco taxes alone are not enough

If cigarettes were like any other product, high taxes would be enough to make people stop buying them. But cigarettes are highly addictive, so rising prices don’t have too much impact on a smoker’s decision to buy cigarettes.

It’s estimated that in rich countries, a 10 percent increase in the price of cigarettes will only bring about a 4 percent drop in demand. In poor to middle-income countries, the figures vary quite a bit because of a host of cultural and economic factors. For some though this sizable price bump would reduce demand by just 2 percent.

Of course, smokers could just take their cigarettes out of the packs. They could smoke rollies and put their tobacco in a tin. However, the evidence suggests very few people do. So the plain packs are always there, a graphic reminder of the harms of smoking. It’s a behavioral nudge that smokers carry around with them.

Globally, tobacco kills around 6 million people every year. Smoking costs the US more than $300 billion a year through both direct medical bills and lost productivity. Taxes, education, and public health campaigns are all important in reducing harm. However, Australia has shown that plain packaging needs to be in the mix too. It’s a simple and effective tool in the fight against a deadly habit

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