Tobacco industry claims “plain” packs won’t work based on weak evidence

Most studies lack policy relevance; and relevant research lacks key indicators of quality, including peer review

A critical evaluation of the volume, relevance and quality of evidence submitted by the tobacco industry to oppose standardised packaging of tobacco products doi:10.1136/bmjopen-2013-003757

Tobacco companies lack strong, relevant evidence to support their claims that standardised (plain) packaging of tobacco products in the UK won’t work, finds research published in BMJ Open.

The aim of plain packaging, with no logos, brand imagery, symbols, or promotional text, is to restrict the already limited opportunities that transnational tobacco companies have to market their products, and deter people from starting smoking.

Australia adopted plain packaging for tobacco products in 2012, the same year that the Department of Health in England held a public consultation on similar plans. The Department then said it wanted to wait for more evidence of the likely impact on tobacco consumption before adopting the policy.

It has since commissioned an independent review of evidence relating to unbranded and standardised packaging, which is due to report this spring.

The researchers analysed evidence cited in submissions made to the Department of Health’s consultation on plain packaging by the UK’s four largest transnational tobacco companies: Imperial Tobacco; Japan Tobacco International; Philip Morris Ltd; and British American Tobacco.

The four companies submitted lengthy consultation responses – 1521 pages in total, of which 328 comprised their main responses and 1193 provided supplementary material.

In these submissions, the companies rejected the conclusions of a systematic review, commissioned by the Department of Health, that there was “strong evidence” that plain packaging would reduce the appeal of tobacco products and increase the prominence of health warnings.

Instead, they argued that there is no evidence that plain packaging would reduce smoking prevalence or deter people from starting to smoke.

The researchers looked at the volume, relevance (subject matter) and quality (as measured by independence from industry, and peer review) of the evidence cited by the companies and compared it with the evidence from the systematic review.

Seventy seven out of 143 pieces of evidence were used to promote the companies’ claim that plain packs “won’t work”. Of these, only 17 (22%) addressed standardised packaging, 14 of which were linked to industry. None was published in peer reviewed journals – a key hallmark of quality.

Compared with the evidence in the systematic review, relevant evidence cited by the tobacco industry was of significantly lower quality.

Across all 77 documents, evidence linked to industry was significantly less likely to have been published in a peer reviewed journal than the independent evidence cited by them.

“With few exceptions, evidence cited by [transnational companies] to promote their claim that standardised packaging ‘won’t work’ lacks either policy relevance or key indicators of quality,” conclude the authors.

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