Plain packaging has not driven smokers to buy cheap imports or illicit tobacco, or to favour discount retailers over corner stores, a study published today in the journal BMJ Open has found.
This puts to bed claims by tobacco companies that plain packs would put smokers in danger because of poor imports and hurt small, local retailers because of longer dispensing times.
The Cancer Council Victoria study, led by senior policy adviser Michelle Scollo, set out to test the claims using the annual smoking behaviour study.
The team phoned and interviewed around 4,000 adult smokers in Victoria about their purchasing behaviours in three November surveys: 2011, before plain packaging was implemented; 2012, during the roll out; and 2013, one year after implementation.
“We found no evidence of smokers shifting from purchasing in small retail outlets to purchasing in supermarkets,” said Dr Scollo.
“We found no evidence on an increase in use of very cheap brands of cigarettes – those manufactured by companies based in Asia. And we found no evidence of an increased use in unbranded tobacco,” she said.
Almost two-thirds of respondents said they bought their tobacco from supermarkets in 2011 (65.4%) and in 2013 (65.7).
Use of low-cost Asian brands was low, and scarcely changed between 2011, when it was 1.1% and 2013, when it was 0.9%.
And use of illicit unbranded didn’t increase: this was 2.3% in 2011 and 1.9% in 2013.
“Victoria is 25% of the country and if there were big increases in these things, we should have been able to detect very large increases,” Dr Scollo said.
Dr Scollo said the report sent a clear message to legislators in countries considering plain packaging, such as the New Zealand, the United Kingdom and Ireland, to be wary of industry rhetoric dressed up as evidence.
The tobacco industry claim the plain packs would increase serving time, for instance, was based on a small retainer focus group and used to predict the impact on sales nationally, she said. But the objective, independent data told a very different story.
“We conducted another study which measured (with stop watches) how long it took for retailers to serve customers. It went up a second or so more in the first couple of days after introduction, but it very quickly returned to normal.”
Professor of Public Health at the University of Melbourne Rob Moodie said the research was “impressive” and put to bed the “hugely emotive threats” by the tobacco industry about plain packaging.
“Not only have we seen the positive side come out in the last couple of months, we’re now seeing the fact that there’s no unintended or negative impact either.
Professor Moodie said that despite the Australian newspaper claiming the plain packaging strategy had failed, Treasury data showed tobacco sales had dropped since the introduction of plain packs and the latest prevalence data showed smoking rates were at a world-wide low of 12.8%
“We want to get to below 10% of Australian smokers by 2018, as the national commitment. Plain packaging will be a part of that and will help. Another part of that is [targeting] social marketing, smoke-free regulations and in particular, the increase in tax.”
Senior lecturer of consumer behaviour and advertising at Deakin University Paul Harrison agreed the downward trend was attributable to a number of anti-smoking measures, including social pressure.
But he said that the public health sector needs to be careful not to overstate the effect of plain packaging or any single intervention.
“The evidence is pretty strong that it does have an effect, [but] the effect, while significant, is small,” he said.
“One of the real mistakes public health can make is to over-emphasise the effects of a single factor because if it is small or changes, it then gives the tobacco industry to something come back with, in terms of pedalling their own studies.”
Dr Harrison said it was important to explore other methods of tobacco control, such as positive message framing, which moved away from the epidemiological approach of “tell people stuff, frighten them, educate them and then they’ll change.”
“In reality, few of us want to be educated and we certainly don’t want to be told what to do,” he said.
“Positive message framing gives people the resources to think differently and consider that life could be better if you give it up, rather than you’ll die if you don’t.”