The European Journal of Public Health Advance Access first published online on September 2, 2009
This version published online on October 5, 2009
The European Journal of Public Health, doi:10.1093/eurpub/ckp122
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Cigarette pack design and perceptions of risk among UK adults and youth
David Hammond1, Martin Dockrell2, Deborah Arnott2, Alex Lee1 and Ann McNeill3
1 Department of Health Studies & Gerontology, University of Waterloo, Waterloo, Ontario, Canada
2 Action on Smoking and Health, London, UK
3 School of Community Health Sciences, Division of Epidemiology & Public Health, University of Nottingham
Correspondence: David Hammond, Department of Health Studies & Gerontology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada, tel: +1 519 888 4567 36462, fax: +1 519 886 6424, e-mail: dhammond{at}uwaterloo.ca
Received May 22, 2009 , accepted July 17, 2009
Background: It is illegal in the EU for tobacco packaging to suggest that some cigarettes are safer than others. This study examined consumer perceptions of cigarette packs in the UK, including perceptions of ‘plain packaging’, in which colour and other design elements are removed, whilst retaining the brand name. Methods: 516 adult smokers and 806 youth aged 11–17 participated in an online survey. Participants 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 brand they would choose if trying smoking (youth). Results: Adults and youth were significantly more likely to rate packs with the terms ‘smooth’, ‘silver’ and ‘gold’ as lower tar, lower health risk and either easier to quit smoking (adults) or their choice of pack if trying smoking (youth). For example, more than half of adults and youth reported that brands labelled as ‘smooth’ were less harmful compared with the ‘regular’ variety. The colour of packs was also associated with perceptions of risk and brand appeal: compared with Marlboro packs with a red logo, Marlboro packs with a gold logo were rated as lower health risk by 53% and easier to quit by 31% of adult smokers. Plain packs significantly reduced false beliefs about health risk and ease of quitting, and were rated as significantly less attractive and appealing to youth for trying smoking. Conclusions: Current regulations have failed to remove potentially misleading information from tobacco packaging. Removing colours from packs (plain packaging), as well as terms such as ‘smooth’ ‘gold’ and ‘silver’ would significantly reduce false beliefs and increase compliance with existing legislation.
Keywords: health policy, plain packaging, tobacco, tobacco marketing.