Time to refresh tobacco packaging and update warnings, say researchers

New on-pack warning labels are needed on tobacco packaging to motivate and support smoking cessation, a study from University of Otago researchers has found.

The researchers asked 27 people who used roll-your-own tobacco and came from Dunedin and Wellington how they responded to the large graphic warnings on tobacco packs.

Their findings are published in Nicotine & Tobacco Research.

Research co-leader Professor Janet Hoek, who co-directs the ASPIRE Aotearoa Research Center at the University of Otago, Wellington, says the graphic pack warnings have been highly effective in telling people about the health risks of smoking, but a refresh is needed.

"Study participants thought the warnings had lost impact, but also admitted they actively avoided looking at them and many rationalized the harms smoking posed and had developed arguments as to why they were not likely to be personally harmed by smoking."

Lani Teddy, a Research Fellow with the ASPIRE Aotearoa Center said, "We know from other research that avoidance and counter-argument often indicate greater engagement with warnings; however, our findings suggest we could engage people who smoke more effectively. The warnings have not been refreshed since their introduction in 2018 and it is timely to think about new approaches.

"For example, many on-pack warnings feature diseased organs that participants found difficult to recognize. They felt messages that recognized them as whole people would create greater empathy and do more to encourage them to quit.

"Our participants also identified other themes that they found more motivating and relevant to their everyday lives. These included the cost of smoking, the stress of addiction, and the many harms smoking inflicts on their loved ones."

Professor Hoek says rather than persist with messages that created fear but did not offer solutions, it would be more effective to diversify the warning content and complement this information with supportive details.

She noted that some other countries use health promotional inserts to offer advice on quitting and help people who smoke feel more confident about their ability to quit.

"Given on-pack warnings can arouse fear, it's important that we show people the benefits of quitting and provide tips that might help them become smoke free."

Professor Hoek also noted that Aotearoa lagged behind policy innovations being adopted elsewhere, and that could be implemented here.

"Other countries are moving ahead with additional product design policies. Canada has introduced warnings on individual cigarettes, a move that Australia is also considering. Australia has brought in new regulations that allow for filter regulations and is banning the use of flavor capsules, which make smoking more appealing to young people."

Professor Hoek says the findings of the study should be used by the Government as a basis for new policies to reduce smoking.

"The Government has repealed legislation that would have seen Aotearoa reach its Smokefree 2025 goal of smoking prevalence falling to five percent or below among all population groups, but it has not provided a clear alternative plan.

"At the very least, the Government should maximize the impact that existing measures, such as on-pack warnings, could have and complement these with advice that will help people quit.

"The repeal of the Smokefree Environments and Regulated Products (Smoked Tobacco) Amendment Act 2023 has left a policy vacuum. The Government should demonstrate its commitment to the Smokefree 2025 goal by adopting international best practice in both tobacco product and packaging measures."