Plain cigarette packaging to cut smoking

Review by research organisation Cochrane suggests impact of UK’s ban on branded packs could echo results seen in Australia

Plain cigarette cartons featuring large, graphic health warnings could persuade 300,000 people in the UK to quit smoking if the measure has the effect it had in Australia, scientists say. Standardised cigarette packaging will be compulsory in the UK from 20 May. A new review from the independent health research organisation Cochrane on the impact of plain packaging around the world has found that it does affect the behaviour of smokers.

In the UK, the tobacco industry has become increasingly innovative in the design of cigarette packets as other controls on sales and advertising have taken hold, according to Ann McNeill, professor of tobacco addiction at King’s College London. “The tobacco industry has been focusing its efforts on the tobacco packs,” she said.

Among those that will be banned are vibrant pink packets, targeted at young women, and gimmicky cartons that slide rather than flip open. The rules that come into force next month require all packs to look alike, with graphic health warnings across 65% of their surface.

The Cochrane reviewers found 51 studies that looked at standardised packaging and its impact on smokers, but only one country had implemented the rule fully at the time. Australia brought in plain packs in 2012.

Analysing the evidence from Australia, the team found a reduction in smoking of 0.5% up to one year after the policy was introduced. According to the Australian government, that translates to 100,000 people no longer smoking. The decline was attributable specifically to plain packaging, after taking into account the continuing drop in the numbers of smokers caused by other tobacco control measures.

Dr Jamie Hartmann-Boyce of the Cochrane tobacco addiction group at Oxford University’s Nuffield Department of Primary Care Health Sciences said: “We are not able to say for sure what the impact would be in the UK, but if the same magnitude of decrease was seen in the UK as was observed in Australia, this would translate to roughly 300,000 fewer smokers following the implementation of standardised packaging.”

The review found signs that more people were trying to quit smoking as a result of plain cartons, rising from 20.2% before to 26.6% after introduction. There was also evidence that standardised packs were less attractive to those who did not smoke, making it less likely that they would start.

However, the researchers say variations in the way countries are introducing standardised packs may affect the outcomes. Some allow different colours, slightly different carton shapes and the use of descriptive words such as “gold” or “smooth”.

Cancer Research UK backs plain packaging. “Smoking kills 100,000 people in the UK every year, so we support any effective measure which can help reduce this devastating impact. The evidence shows that standardised packaging works and helps to reduce smoking rates,” said George Butterworth, the charity’s tobacco policy manager. “It’s too soon to see the impact in the UK, as the new legislation will only be fully implemented in May, but we hope to see similar positive results as the UK strives towards a day when no child smokes tobacco. Cancer Research UK is continuing to evaluate the impact of standardised packaging in the UK and will share the lessons with other countries who are considering introducing them.”

Simon Clark, director of the smokers’ group Forest, said the idea that plain packaging would have an impact on the number of smokers in the UK was based on “hope and anecdotal evidence”.

“Since plain packaging was introduced in Australia, smoking rates have fallen, but only in line with historical trends,” he said. “It’s grasping at straws to credit plain packaging with the continued reduction in smoking rates, because the most significant anti-smoking measure in recent years in Australia has been a massive increase in tobacco taxation. Like graphic health warnings, the novelty of plain packaging quickly wears off.”