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Tobacco Plain Packaging: To Brand or Not To Brand

31 May, 16 | by BMJ Clinical Evidence

Felix Hernandez - croppedRahaghi - cropped



By Felix Hernandez and Franck Rahaghi

As we try to convince a patient to quit smoking after 60 years he quickly reminds us that in “his time” macho cowboys and cool camels advertised cigarettes on the television. With the many restrictions placed on tobacco advertising, the package has become the main vehicle for advertising. When choosing a product to purchase, the child in all of us typically leads us to the one that is packaged in a well thought-out and attractive form as opposed to the product that appears to have a more generic bland appearing package.

Proposed plain packaging UKThis latter concept, called plain packaging, was first signed into law in Australia in 2011 and went into effect in December 2012. It requires the removal of all branding including colors, corporate logos, trademarks, and images from product packaging. The only allowed information on the cigarette packaging is the printing of the brand name in a mandated size together with health warnings. With the enactment of this Australian law came the first evidence of the effectiveness of plain packaging. The Quit Victoria, Cancer Council released pooled findings from 24 studies that examined the impact of plain packaging on young smokers. Some of their main findings included the perception that cigarettes sold in plain packs were less appealing, less palatable and of lower quality.

In April 2016, Andrews et al., published their study in which they looked at the effects of plain packaging and graphic health warnings on adolescent smokers in the USA, Spain and France. They found that plain packs could strengthen the direct effects of graphic health warnings in the USA. These results were attenuated in Spain and France.

With the impacts on world health and the financial market that are at stake with plain packaging of tobacco products, the debate as to whether or not it will lead to a decrease in tobacco use is still ongoing and will likely continue for some time. Until this debate is settled we must continue to rely on the current tobacco cessation guidelines to help us in freeing our patients from the grips of tobacco abuse.

Felix Hernandez MD and Franck F. Rahaghi MD, MHS, FCCP, from the Cleveland Clinic Florida are authors of the BMJ Best Practice topic on smoking cessation.

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