A study published by Tobacco Control in December 2015 by a team of New Zealand and Australian researchers explored extending the concept of plain packaging one step further – to the cigarette stick itself. New Zealand is moving towards introducing plain packaging; incorporating dissuasive cigarette sticks would put it at the forefront of innovative tobacco control measures.

The study authors explain more in a blog published by Aspire 2025 and reproduced here with permission:

As New Zealand moves towards legislating for plain packaging of cigarettes, the Government should consider measures that extend and improve upon Australia’s model, ASPIRE2025 researchers believe.

In this study, based on an online survey of 313 New Zealand smokers, our researchers and colleagues in Australia have found that cigarette sticks with printed health warnings or unattractive colours could enhance the effects of plain packaging and further reduce the appeal smoking has to young people.

Professor Janet Hoek says the team tested reactions to images of four cigarette sticks that either featured printed warnings or had unattractive colours, such as yellow-brown and green.

“We found that smokers were significantly less likely to choose the test sticks and found all significantly less appealing than the status quo — a white cigarette with a brown filter tip,” she says.

A “minutes of life lost” graphic that went from one minute near the tip up to 15 near the butt had the strongest aversive effect relative to the other sticks tested.

“Requiring cigarette sticks and rolling paper to feature such a graphic, or to be produced in dissuasive colours, would likely increase the impact plain packaging will have on those who smoke, while also deterring others from taking up smoking,” Professor Hoek says.

View a short video about this research here:

Study abstract:
Background
Standardised (or ‘plain’) packaging has reduced the appeal of smoking by removing imagery that smokers use to affiliate themselves with the brand they smoke. We examined whether changing the appearance of cigarette sticks could further denormalise smoking and enhance the negative impact of standardised packaging.

Methods
We conducted an online study of 313 New Zealand smokers who comprised a Best–Worst Choice experiment and a rating task. The Best–Worst experiment used a 2×3×3×6 orthogonal design to test the following attributes: on-pack warning message, branding level, warning size and stick appearance.

Results
We identified three segments whose members’ choice patterns were strongly influenced by the stick design, warning theme and size, and warning theme, respectively. Each of the dissuasive sticks tested was less preferred and rated as less appealing than the most common stick in use; a ‘minutes of life lost’ stick was the most aversive of the stimuli tested.

Conclusions
Dissuasive sticks could enhance the effect of standardised packaging, particularly among older smokers who are often more heavily addicted and resistant to change. Countries introducing standardised packaging legislation should take the opportunity to denormalise the appearance of cigarette sticks, in addition to removing external tobacco branding from packs and increasing the warning size.

Citation
Hoek, J., Gendall, P., Eckert, C., & Louviere, J. (2015). Dissuasive cigarette sticks: the next step in standardised (‘plain’) packaging?. Tobacco control, tobaccocontrol-2015. doi:10.1136/tobaccocontrol-2015-052533

For more information, contact:
Professor Janet Hoek
University of Otago
Email janet.hoek@otago.ac.nz