Drab olive cigarette packs bearing a
prominent quit-smoking helpline number, introduced more than a year ago in
Australia, had a sizeable and sustained effect on interest in quitting,
Just one of many controls imposed on
cigarette marketing and sales over the past decade in that country, the plain
packaging was linked to a 78% spike in calls to territorial quit lines within a
month of its introduction.
"The results suggest the legislation
does have a positive early impact (on smokers) and so other countries could
feel more confident in introducing similar legislation," said Jane Young,
a cancer epidemiologist at the Sydney School of Public Health, who led the
The plain packages, implemented in October
2012, mean that every brand's cigarettes look nearly identical, with the brand
name relegated to a small, standardised font.
images were present on the labels in the past
In March 2006, cigarette packaging with
graphic health warnings including photos of cancer-riddled lungs and gangrenous
limbs was introduced in Australia. "(The labels) inform consumers about
what might happen to them when they use the product," said Joanna Cohen,
director of the Institute for Global Tobacco Control at the Johns Hopkins Bloomberg
School of Public Health in Baltimore, Maryland.
"The plain and standardised packaging
is meant to reduce the appeal of the package and show the warning. Hopefully
current smokers will quit because they are more aware of the health impacts,
and fewer people will start," said Cohen, who was not involved in the new
Read: Cigarette warnings help smokers quit
A standard box
Young's team wanted to isolate the impact
of just the switch to plain packaging on interest in quitting.
They looked at the number of calls in New
South Wales and the Australian Capital Territory to the national quitline
before and after introduction of the plain packages.
Calls jumped from 363 a week before the packaging
change to a peak of 651 calls a week four weeks after the new packages were
introduced, Young and her colleagues report in the Medical Journal of
The study also compared those results to
the number of calls received by the quitline after Australia's addition of
graphic warning labels. That change was linked with a jump from 910 calls a
week to a peak of 1 653 calls 12 weeks afterwards, representing an 84%
of the study
The effect of the graphic warnings only
lasted an estimated 20 weeks, however, whereas the researchers estimate the
effect of plain packaging to have endured 43 weeks.
They also adjusted their results for other
potential influences on interest in quitting smoking, such as cigarette
pricing, limits on smoking in public and on the display of cigarettes at points
of sale, as well as the New Year's resolution effect.
Between 2006 and 2011, Young's team notes,
smoking rates in New South Wales had already dropped from 17.7% of residents to
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Others may follow
Australia is the only country that has
implemented the plain packaging thus far, but public health experts say others
likely will – and should – adopt the policy. "Anything that we can do to
better communicate that the product is deadly is a good thing," Cohen
Britain announced late last year that plain
tobacco packaging was under review, with the option of mandating the packaging
change if evidence showed it would cut down on smoking. The European Union has
also moved to institute graphic health warnings on cigarettes and measures to
ban menthol-flavoured cigarettes.
Changing cigarette packaging can take
years, often because it means squaring off in a legal battle with cigarette
companies. "Many countries are in line to follow with the plain and
standardized packaging once the legal issues get resolved," Cohen said.
Graphic warnings on cigarette packs help smokers quit
Plain cigarette packets for Australia
Australia: new cigarette pack rules