Just one of many controls imposed on cigarette
marketing and sales over the past decade in that country, the plain
packaging was linked to a 78-percent spike in calls to territorial
quitlines within a month of its introduction.
"The results suggest the legislation does have a positive early
impact (on smokers) and so other countries could feel more confident
in introducing similar legislation," said Jane Young, a cancer
epidemiologist at the Sydney School of Public Health, who led the
The plain packages, implemented in October 2012, mean that every
brand's cigarettes look nearly identical, with the brand name
relegated to a small, standardized font.
In March 2006, cigarette packaging with graphic health warnings
including photos of cancer-riddled lungs and gangrenous limbs was
introduced in Australia.
"(The labels) inform consumers about what might happen to them when
they use the product," said Joanna Cohen, director of the Institute
for Global Tobacco Control at the Johns Hopkins Bloomberg School of
Public Health in Baltimore, Maryland.
"The plain and standardized packaging is meant to reduce the appeal
of the package and show the warning. Hopefully current smokers will
quit because they are more aware of the health impacts, and fewer
people will start," said Cohen, who was not involved in the new
Young's team wanted to isolate the impact of just the switch to
plain packaging on interest in quitting.
They looked at the number of calls in New South Wales and the
Australian Capital Territory to the national quitline before and
after introduction of the plain packages.
Calls jumped from 363 a week before the packaging change to a peak
of 651 calls a week four weeks after the new packages were
introduced, Young and her colleagues report in the Medical Journal
The study also compared those results to the number of calls
received by the Quitline after Australia's addition of graphic
warning labels. That change was linked with a jump from 910 calls a
week to a peak of 1,653 calls 12 weeks afterwards, representing an
84 percent increase.
The effect of the graphic warnings only lasted an estimated 20
weeks, however, whereas the researchers estimate the effect of plain
packaging to have endured 43 weeks.
[to top of second column]
They also adjusted their results for other potential influences
on interest in quitting smoking, such as cigarette pricing, limits
on smoking in public and on the display of cigarettes at points of
sale, as well as the New Year's resolution effect.
Between 2006 and 2011, Young's team notes, smoking rates in New
South Wales had already dropped from 17.7 percent of residents to
Australia is the only country that has implemented the plain
packaging thus far, but public health experts say others likely will — and should — adopt the policy.
"Anything that we can do to better communicate that the product
is deadly is a good thing," Cohen said.
Britain announced late last year that plain tobacco packaging was
under review, with the option of mandating the packaging change if
evidence showed it would cut down on smoking. The European Union has
also moved to institute graphic health warnings on cigarettes and
measures to ban menthol-flavored cigarettes.
Changing cigarette packaging can take years, often because it means
squaring off in a legal battle with cigarette companies.
"Many countries are in line to follow with the plain and
standardized packaging once the legal issues get resolved," Cohen
The Medical Journal of Australia, online Jan. 13, 2014.
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