Plain packaging on cigarette packs

“Plain packaging” (also known as generic, standardised or homogenous packaging) means that all logos, graphics, and colours are removed from cigarette packs. Only the brand name of the tobacco company can remain – written in a simple, standard font which would be the same for all brands. The pack itself would be a neutral colour such as white or brown.1

Below is an example of what plain packaging could look like:

Acknowledgement: Action on Smoking and Health (ASH-UK)

By standardising the appearance of cigarette packs, this policy aims to make them less attractive and increase the prominence of health warnings. The Australian government are planning to introduce plain packaging in 2012.2 The UK government recently committed to look at the evidence on plain packaging and consult on policy options by the end of 2011.3

Evidence of the possible benefits

Plain packaging can reduce confusion about the health risks of smoking. Different colours and specific brand names can affect smokers’ perceptions of health risks.4,5 One study found that adults and young people 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 from (adults) or their choice of pack if trying smoking (young people).4

There is also some evidence that young people find plain packaging less appealing4, 5, 6, with similar results in adult smokers.7 This is important as young people are more like to be first-time smokers and the majority of smokers start before the age of 18.

Health warnings on all tobacco packaging are associated with more motivation to quit smoking, but it has been shown that branding decreases this impact.8,9 Plain packaging would allow health warnings to be more prominent and also increased in size. One experiment showed that plain packs with a 75% warning were the most likely to be associated with attempts to quit smoking out of several options.10

Evidence of the possible risks

There are several proposed risks to this policy, but there is little scientific evidence to support them.11

Firstly, tobacco companies assert that banning their logos on packs is an infringement of their intellectual property and trademark rights (although there are some health-related exceptions to trademark law).12 Tobacco companies could appeal to the World Trade Organisation, and the UK would need to defend its policy with a cost to public funds. However, Australia may have already set a legal precedent if it introduces this policy in 2012.

Furthermore, it is claimed by tobacco companies and trade groups associated with the tobacco industry 13 that the removal of logos and special pack features such as holograms would lead to a rise in counterfeit cigarettes on the market.14,15 These may be cheaper or have a higher tar content than genuine cigarettes. However, there is little evidence to support this claim (ref 1). It has also been speculated that tobacco companies may resort to competing on price alone if they are unable to distinguish their products through pack features. However, there is no current evidence for this risk either.11,15

Implications for health/wellbeing

There are still substantial health gains to be made from helping people to stop or never start smoking. 1 in 5 adults in England smoke, but this rises to 1 in 3 for those on the lowest incomes. Two thirds of smokers started before they were 18 years old. Two thirds of those who smoke would like to quit. In 2009, nearly 20% of deaths in those aged over 35 were thought to be due to smoking and there were around 1.5 million hospital admissions from diseases caused by smoking.

There is some evidence that plain packaging would reduce the appeal of smoking to young people and help those trying to quit. Although there are some theoretical arguments against this policy, there is a lack of evidence for these risks.

Author: Kate Mandeville, Specialist Registrar in Public Health and Clinical Research Fellow, London School of Hygiene and Tropical Medicine.

UK area affected: England, proposed across the UK

16 The NHS Information Centre. Statistics on Smoking: England, 2010. 19 August 2010. Available at: http://www.ic.nhs.uk/webfiles/publications/Health%20and%20Lifestyles/Statistics_on_Smoking_2010.pdf.