Plain cigarette packaging may reduce smoking rates

Plain, standardised packaging for cigarettes may reduce the number of people who smoke, according to a new review of evidence. 

The Cochrane review also found that the plain packaging reduced the appeal of packs. 

The findings come as the UK approaches the last day that branded cigarette packs will be available, May 19. 

Standardised packs require the removal of glitzy branding and promotions. All packs must be an identical colour, shape and design and include larger picture health warnings. They were formally introduced in the UK in May 2016. 

Tobacco use is the single biggest preventable cause of disease and early death worldwide, and smoking can cause at least 14 types of cancer. 

The review looked at 51 studies of standardised packaging, which each analysed different factors such as how packs may affect overall smoking levels, quit attempts, number of cigarettes smoked and appeal of cigarette packs. 

Because only Australia had introduced plain packaging laws at the time of the analysis, the authors say their conclusions could not be completely certain. 

Lead author Professor Ann McNeill, from King’s College London, said that while analysis is difficult and the available evidence limited, it did point towards standardised packaging reducing smoking prevalence. 

One study of 700,000 people in Australia found that the smoking rate fell by 0.5% following the introduction of the new rules. 

“These findings are supported by evidence from a variety of other studies that have shown that standardised packaging reduces the promotional appeal of tobacco packs,” said McNeill.

If smoking rates in the UK saw the same fall, Cancer Research UK estimates there would be 257,000 fewer cigarette smokers.

George Butterworth, Cancer Research UK tobacco policy manager, said: “Smoking kills 100,000 people in the UK every year, so we support any effective measure which can help reduce this devastating impact. The evidence shows that standardised packaging works.”

The researchers didn’t find any evidence suggesting that standardised packaging may increase tobacco use, and a consistent finding was that plain packaging reduced the appeal of the packs.

But the review found mixed results on whether plain packaging was associated with a change in the number of cigarettes smoked by current smokers, but that attempts to quit smoking increased following introduction of the new rules. 

Co-author Jamie Hartmann-Boyce, from the Cochrane Tobacco Addiction Group, Oxford, said that the evidence suggests that standardised packaging can change attitudes and beliefs about smoking. 

“We didn’t find any studies on whether changing tobacco packaging affects the number of young people starting to smoke, and we look forward to further research on this topic,” she added.

Butterworth added that he hoped to see similar positive results in the UK, and that Cancer Research UK will continue to evaluate the impact of standardised packaging after its introduction.