Plain packaging: a time for action Free

It is almost thirty years since a senior vice president of marketing at British American Tobacco forewarned that tobacco products may eventually have to sell themselves through the pack.¹ His prediction has now come true for countries with wide-ranging marketing controls. The tobacco industry has shown remarkable resilience and marketing ingenuity to continue promoting its wares, and the pack has become the focus of its efforts. The paper by Hammond et al.² in this issue underlines this problem and demonstrates why the time has now come to mandate plain packaging.

The article begins by showing that that the pack has undermined Article 7 of the current EU Directive and Article 11.1(a) of the Framework Convention on Tobacco Control, which prohibit misleading descriptors. It has been used by the industry to introduce a new generation of deceptive words such as ‘smooth’ and a range of beguiling colours to replace the now banned terms ‘light’ and ‘mild’ in the EU. This misinformation provides ‘all’ consumers, irrespective of age and smoking status, with false comfort about the health risks posed by cigarettes.

Hammond et al.’s study also confirms that plain packs—whether white or brown—reduce the attractiveness of cigarettes for young people compared with branded packs. It also helps us understand better what a genuinely plain pack should look like. Specifically it suggests that, contrary to the recommendations of the New Zealand Department of Health’s Toxic Substances Board of two decades ago, all-white packs are not the best option. Although the two plain packs were not directly compared, the findings suggest that in comparison to the identical branded packs plain white cigarette packs were perceived as safer (lower health risk, lower tar delivery, make quitting easier) than plain brown packs. The study also shows that just as the plain white boxes containing medicinal products in pharmacists are perceived as safe, so it is with plain white cigarette packs.

This complements research in France, where white plain packs were viewed favourably by some young people who mentioned the opportunity for stylizing the pack (Gallopel-Morvan K, personal communication). In this case white, unlike brown or grey, acts as a canvas, allowing youth to create a personalized and individual pack design that could, in the event of plain packs, function as a surrogate for the branded pack livery and boost attractiveness. Spanish research has also found plain white packs to be perceived by youth as more attractive than brown or grey packs (Rey JM, personal communication), and ongoing Canadian research similarly reveals that colours such as white (and pink) are considered attractive by teenage girls (Hammond D, personal communication).

Furthermore, these findings are reinforced by industry thinking and research, which shows that ‘White is generally held to convey a clean healthy association’.³ This is perhaps unsurprising, however, as white is deliberately positioned by the industry as the lightest (and thereby safest) pack colour; for instance the very low tar, low nicotine, almost completely white packed Mayfair Fine introduced to the UK market—or the long heritage of the Silk Cut brand whose owners, over a decade ago, recognized the ‘Correlation between amount of white, and the tar/nicotine levels of the cigarette’ so that the brand ‘Looks less harmful than other brands’.⁴

Overtly, the industry has vehemently maintained that packaging does not factor in smoking initiation among youth, although industry document analyses contradict these claims.⁵ The industry contend, as it did for years with advertising, that packaging only stimulates adult brand-switching, but the use of words such as ‘Chill’ on limited edition Richmond cigarette packs in the UK in 2008, and stylish gimmicks such as slide packs suggest a younger target group. Moreover such protestations of innocence have, as always, to be set against the industry’s imperative to recruit and retain youth if it is to survive. And even if we chose to ignore the internal documents, overlook the use of language and images on packs that taps into youth culture and naively assume that adult brand-switching is the industry’s sole aim, there is still the immense problem of collateral damage: attractive or innovative packaging aimed at adults will inevitably be seen by youngsters.

Plain cigarette packaging then cannot come too soon. It would involve the use of standardized packs that have an identical shape, method of opening, base colour and are devoid of ‘all’ promotional elements. Brand name would also be standardized in terms of size, font and place,⁶ and all legal markings, specifically health warnings, Duty Paid stamps and constituent levels (tar, nicotine, carbon monoxide), would continue to be displayed as before. Such a move would differentiate tobacco from all other products in the marketplace and perform three key functions: (i) prevent the use of misleading descriptors or colours, (ii) remove the promotional appeal of the pack and (iii) prevent health warnings being undermined and indeed, by its very nature, plain packaging would serve as an important health warning.

A Philip Morris document, concerning issues of importance for the Worldwide Regulatory Affairs Group, emphasized that ‘we don’t want to see plain packaging introduced anywhere regardless of the size or importance of the market’.⁷ As Simon Chapman says, it is the industry’s Armageddon.⁸ Bring it on.

Conflict of interest: None declared.

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