Plain packaging for cigarettes
At the end of November 2013 the UK government announced an independent review of the effects of plain cigarette packaging (1-5).
At least among politicians, there seems to be some disagreement over whether or not the existing evidence is sufficient to shape policy. Labour supports a plain packaging policy, insisting that “the evidence is clear for all to see”, while Public Health Minister Jane Ellison said that only now is it time to "examine the emerging evidence".
What is the evidence for the potential impact of plain tobacco packaging? A search of the DARE database identifies a recent wide-ranging systematic review on this topic (6). The review identified a total of 37 relevant studies from the global literature. These studies assessed the impact of plain packaging on a range of outcomes, including the appeal of cigarettes, the effectiveness of health warnings, perceptions about the strength and harm of tobacco products, and a variety of smoking-related attitudes, beliefs, intentions and behaviours.
The authors of the review cautiously concluded that “plain packaging has the potential to contribute to reductions in the harm caused by tobacco smoking”. Confidence in this conclusion was partly undermined by shortcomings in the methods of some included studies, but otherwise strengthened by the relative consistency of effects seen across the different populations and countries in which studies were conducted (7).
Perhaps crucially, the systematic review pre-dates the implementation of any national plain tobacco packaging policy, so no evidence was available to determine the effects of such a policy at a population level. However, while the systematic review was ongoing, plain packaging was introduced in Australia. Evidence from this “real world” Australian experience is likely to inform the newly-announced review, which is due to report in March 2014.References
1. Cigarette packaging: Ministers launch fresh review. BBC News, 28th November 2013.
2. David Cameron 'U-Turn' Over Cigarette Packaging. Sky News, 28th November 2013.
3. David Cameron in U-turn on plain packaging for cigarettes. Financial Times, 28th November 2013.
4. Cigarettes could get plain packaging by 2015 after government U-turn. Guardian, 28th November 2013.