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Study suggests smokers are still misled by labelling of cigarette packs Roger Dobson

Published 7 September 2009, doi:10.1136/bmj.b3623 Cite this as: BMJ

1 Abergavenny

New research among UK adults and children shows that the use of words such as “smooth” on cigarette packs and lighter coloured packaging misleads people into thinking cigarettes are less harmful than other brands, suggesting that current regulations may be inadequate.

More than half of adults and young people taking part in the study reported that cigarette brands labelled as “smooth” were less harmful to health than “regular” varieties, with, for example, 54% of children considering that the Mayfair Smooth brand of cigarettes was less harmful than Mayfair King Size (European Journal of Public Health, doi:10.1093/eurpub/ckp122).

Regulations requiring the use of plain packaging-including removing colours from cigarette packs-and preventing the use of words such as “smooth,” “gold,” and “silver” would greatly reduce these false beliefs, say the researchers, whose study was funded by a grant from the Department of Health.

“The truth is that all cigarettes are equally hazardous, regardless of what colour the pack is or what words appear on it. These tactics are giving consumers a false sense of reassurance that simply does not exist,” warns the lead author, Professor David Hammond, from the University of Waterloo, Ontario, Canada.

The study, described as the first to examine consumer perceptions of cigarette brands on the UK market, involved 516 adult smokers and 806 children (aged 11-17 years) who completed a survey in which they were asked to compare pairs of cigarette packs on five measures-taste, tar delivery, health risk, attractiveness, and either ease of quitting (adult smokers) or
brands they would choose if trying smoking (children).

Results showed that 75% of adult smokers incorrectly believed that a difference in health risk existed for at least one of the eight brand comparisons shown, and more than 80% incorrectly believed there was a difference in tar delivery.

Brands labelled as “smooth,” “gold,” or “silver” were perceived as being substantially less harmful. Adult smokers were also more likely to believe that each of these brands delivered less tar and was more attractive and to incorrectly believe that these brands would make it easier to quit smoking.

The colour of packs was also associated with false beliefs about tar delivery and health risk. Compared with Marlboro packs with a red logo, Marlboro packs with a gold logo were rated as lower health risk by more than half of adult smokers; and a third believed that it would be easier to quit smoking if they smoked Marlboro brands with a gold logo. Cigarettes in a light grey package were also rated by four out of 10 smokers as less harmful than cigarettes in an otherwise identical red pack.

The authors point out that in 2003 the European Union (EU) banned the words “light,” “mild,” and “low tar” on cigarette packaging on the grounds that they may mislead consumers into the belief that cigarettes are less harmful.

“The current findings provide additional evidence that other descriptors, such as ‘smooth’, are perceived in the same way as these prohibited terms and appear to violate the principle of the EU directive, as well as guidelines of the World Health Organization treaty that prohibits information that creates the false impression that a particular product is less harmful,” they say.

Deborah Arnott, chief executive of Action on Smoking and Health and one of the authors of the study, says: “This research shows that the only sure way of putting an end to this misleading marketing is to require all tobacco products to be sold in plain packaging. That would remove false beliefs about different brands and communicate the message that all cigarettes are

Cite this as: BMJ 2009;339:b3623

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