Experts believe plain packaging of tobacco products would cut smoking

January 23, 2013, University of Cambridge

Experts believe that plain packaging of tobacco products would cut smoking, a new study has found. Tobacco control experts from around the world estimate that two years after the introduction of generic packaging the number of adult smokers would be reduced by one percentage point (in the UK - from 21 to 20%*), and the percentage of children trying smoking would be reduced by three percentage points (in the UK - from 27 to 24%*). The Cambridge research was published today in the journal BMC Public Health.

Because Australia, the first country to implement plain packaging, only did so in December of last year there is no quantifiable evidence as of yet. Therefore, scientists have used the next best option, the expertise of internationally-renowned tobacco control specialists from around the world.

For the study, 33 tobacco control experts from the UK (14), Australasia (12) and North America (7) were recruited. Professionals in these regions were targeted because these countries are currently considering (or have recently implemented) plain packaging for . They were then interviewed about how plain packaging - packaging without brand or promotional text and using standardised formatting - might impact the rates of smoking in adults and children.

The experts estimated that plain packaging would reduce the number of adult smokers by one percentage point (on average) two years after the introduction of plain packaging.

Professor Theresa Marteau, Director of the University of Cambridge's Behaviour and Health Research Unit, who led the study, said: "Currently, approximately 10 million** adults in Britain smoke. A one percentage point decline - from 21% of the population to 20% - would equate to 500,000 people who will not suffer the of smoking."

More impressively, they believe that generic packaging would reduce the percentage of children trying smoking by three percentage points (on average) two years after plain packaging is introduced.

Dr Rachel Pechey, first author of the study from the University of Cambridge's Behaviour and Health Research Unit, said: "Given that the majority of smokers first try smoking in adolescence, the impact on children is of particular importance. Nicotine dependence develops rapidly after lighting up for the first time, even before the user is smoking once a week."

The experts indicated that plain packaging would reduce the numbers of children trying smoking because they expect younger people to be more affected by less appealing packs, less brand identification, and changes in social norms around smoking. This ties in with previous research that has described three ways in which plain packaging may reduce smoking rates, particularly among youth – by reducing the appeal of packs, by increasing the salience of health warnings and by standardising pack colour.

Pechey added: "Despite the consistency of experts' predictions that plain packaging would reduce smoking rates, many participants felt that the two-year time frame we used was insufficient and did not allow for the full impact of the packaging. This suggests generic packaging could have a greater impact over a longer term period, as the impact on young people starting smoking feeds through into the adult smoking statistics."

Professor David Spiegelhalter from the University of Cambridge Centre for Mathematical Sciences added: "Expert elicitation methods can guide policy makers by quantifying uncertainty where no direct evidence exists."

The UK government recently conducted a public consultation on the possible introduction of a plain packaging policy for tobacco products (from April to August 2012). It is estimated that treating diseases caused by costs the NHS £2.7 billion a year.***

Explore further: Plain packaging reduces the appeal of smoking: study

More information: 'Impact of Plain Packaging of Tobacco Products on Smoking in Adults and Children: An elicitation of international experts' estimates' was published online by BMC Public Health.

* UK smoking prevalence rates used in the study from: Smoking and drinking among adults, 2009: A report on the 2009 General Lifestyle Survey (Adults); Smoking, Drinking and Drug Use among Young People in England in 2010 (Children)

Smoking prevalence rates for North America were: Adults: 17.5%; Children 21.6% (Tobacco Use in Canada: Patterns and Trends, 2011 Edition) and for Australasia: Adults: 18% (Australian Institute of Health and Welfare. 2010 National Drug Strategy Household Survey report); Children: 21.1% (Australian secondary school students' use of tobacco, alcohol, and over-the-counter and illicit substances in 2008)

**2010 General Lifestyle Survey, ONS; see ash.org.uk/files/documents/ASH_106.pdf

*** www.ash.org.uk/files/documents/ASH_121.pdf

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