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. 2014 Dec 18;4(12):e005836.
doi: 10.1136/bmjopen-2014-005836.

Impact of Australia's introduction of tobacco plain packs on adult smokers' pack-related perceptions and responses: results from a continuous tracking survey

Sally M Dunlop  1 , Timothy Dobbins  2 , Jane M Young  3 , Donna Perez  1 , David C Currow  4
Affiliations

Impact of Australia's introduction of tobacco plain packs on adult smokers' pack-related perceptions and responses: results from a continuous tracking survey

Sally M Dunlop et al. BMJ Open. .

Erratum in

  • Correction.
    [No authors listed] [No authors listed] BMJ Open. 2015 Aug 4;5(8):e005836corr1. doi: 10.1136/bmjopen-2014-005836corr1. BMJ Open. 2015. PMID: 26243550 Free PMC article. No abstract available.

Abstract

Objectives: To investigate the impact of Australia's plain tobacco packaging policy on two stated purposes of the legislation--increasing the impact of health warnings and decreasing the promotional appeal of packaging--among adult smokers.

Design: Serial cross-sectional study with weekly telephone surveys (April 2006-May 2013). Interrupted time-series analyses using ARIMA modelling and linear regression models were used to investigate intervention effects.

Participants: 15,745 adult smokers (aged 18 years and above) in New South Wales (NSW), Australia. Random selection of participants involved recruiting households using random digit dialling and selecting the nth oldest smoker for interview.

Intervention: The introduction of the legislation on 1 October 2012.

Outcomes: Salience of tobacco pack health warnings, cognitive and emotional responses to warnings, avoidance of warnings, perceptions regarding one's cigarette pack.

Results: Adjusting for background trends, seasonality, antismoking advertising activity and cigarette costliness, results from ARIMA modelling showed that, 2-3 months after the introduction of the new packs, there was a significant increase in the absolute proportion of smokers having strong cognitive (9.8% increase, p=0.005), emotional (8.6% increase, p=0.01) and avoidant (9.8% increase, p=0.0005) responses to on-pack health warnings. Similarly, there was a significant increase in the proportion of smokers strongly disagreeing that the look of their cigarette pack is attractive (57.5% increase, p<0.0001), says something good about them (54.5% increase, p<0.0001), influences the brand they buy (40.6% increase, p<0.0001), makes their pack stand out (55.6% increase, p<0.0001), is fashionable (44.7% increase, p<0.0001) and matches their style (48.1% increase, p<0.0001). Changes in these outcomes were maintained 6 months postintervention.

Conclusions: The introductory effects of the plain packaging legislation among adult smokers are consistent with the specific objectives of the legislation in regard to reducing promotional appeal and increasing effectiveness of health warnings.

Keywords: PREVENTIVE MEDICINE; PUBLIC HEALTH.

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Figures

Figure 1
Figure 1
Monthly proportions of smokers strongly agreeing that: (A) the graphic warnings encourage me to stop smoking (cognitive response); (B) with the graphic warnings, each time I get a cigarette out I worry that I should not be smoking (emotional response); (C) they make me feel that I should hide or cover my packet from the view of others (avoidant response); (D) the only thing I notice on my cigarette pack is the graphic warnings (warning salience).
Figure 2
Figure 2
Monthly proportions of smokers strongly disagreeing that their cigarette pack is: (A) attractive; (B) says something good about me to other smokers; (C) influences the brand I buy; (D) makes my brand stand out from other brands; (E) is fashionable; (F) matches my style.
Figure 3
Figure 3
Monthly mean score for Graphic Health Warning Impact and Negative Pack Perception.
See this image and copyright information in PMC

References

    1. Tobacco Plain Packaging Act 2011 (No. 148, 2011), Australian Commonwealth Government, 2011.
    1. Wakefield M, Hayes L, Durkin S et al. . Introduction effects of the Australian plain packaging policy on adult smokers: a cross-sectional study. BMJ Open 2013;3:e003175 10.1136/bmjopen-2013-003175 - DOI - PMC - PubMed
    1. Stead M, Moodie C, Angus K et al. . Is consumer response to plain/standardised tobacco packaging consistent with framework convention on tobacco control guidelines? A systematic review of quantitative studies. PLoS One 2013;8:e75919 10.1371/journal.pone.0075919 - DOI - PMC - PubMed
    1. Quit Victoria CCV. Plain packaging of tobacco products: a review of the evidence. Melbourne: Cancer Council Australia; 2011. http://www.cancervic.org.au/plainfacts/browse.asp?ContainerID=plainfacts...
    1. Moodie C, Stead M, Bauld L et al. . Plain Tobacco Packaging: A Systematic Review. http://phrc.lshtm.ac.uk/papers/PHRC_006_Final_Report.pdf (accessed 10 Apr 2014). University of Stirling, 2012. - PubMed

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