By Tahrima Choudhury, Centre for Health Policy Intern
On the 31st of May every year the World Health Organisation (WHO) and partners mark World No Tobacco Day (WNTD), drawing attention to the dangers and health risks associated with tobacco consumption, and advocating for better policies to reduce tobacco use. This year’s WNTD will focus on the standardised (also known as plain) packaging of tobacco products, in the hope that it gains traction worldwide (1).
The standardised packaging of tobacco products refers to limiting or banning of brand images, company logos, colours and promotional information on packaging. This only permits the display of brand and product names on a dark olive green coloured box with a standard font in conjunction with a graphic health warning image (2).
The notion behind this campaign is that tobacco packaging is seen as a mobile billboard. It is the final communication vehicle tobacco companies have left with people, silently promoting the consumption of tobacco, and distracting individuals, particularly children, from health warnings. Stripping away the glossy veneer will expose tobacco products for what they really are: a box of toxic, addictive product that is responsible for the death of around six million people a year (2).
Worryingly in the UK, two-thirds of smokers currently start smoking before they reach 18 years of age (3), beginning an addiction which kills up to two in three long-term smokers from a smoking-related cause (4). Tobacco use in the UK is the single greatest cause of avoidable deaths and preventable illness, with 100,000 people dying from a smoking associated cause each year (4).
A large body of evidence exists which suggests that standardised packaging would reduce the appeal of tobacco products to children. In 2011, the UK Department of Health commissioned a systematic review of 37 studies on the impact of standardised packaging, this was later updated with 17 more studies in 2013 to form ‘the Stirling Review’ (5). The evidence consistently showed that standardised packaging would reduce the appeal of tobacco products. A key theme which emerged from the systematic review’s qualitative studies was that standard packs compared to branded equivalents weaken the attachment to brands and portray a less desirable identity for the smoker (5). The colours used in standard packaging were thought to have negative connotations and exposed the reality of smoking. The quantitative studies of the systematic review showed that standard packs were less attractive than branded equivalents to both adults and children. The review also found that people associated the brand of tobacco to personality traits, such as ‘popular’ or ‘cool’, of the people who smoked them (5).
In 2012 Australia became the first country to introduce standardised packaging. The evidence that has emerged since its inception has promisingly shown a 15 percent decrease in smoking prevalence between 2011 and 2013 – the period of time in which standard packaging was introduced. The data also confirms that fewer young people are taking up smoking (6). Figures reveal that in the first quarter of 2014, Australia saw the lowest ever recorded tobacco consumption (7), and a significant five percent drop in the cigarettes sold per head of the population in the initial year of introducing standard packaging (8).
However, despite the ample evidence supporting the public health benefits of standardised packaging, the tobacco industry has fiercely opposed its implementation through legal avenues. In 2012, for example, tobacco companies in Australia claimed that standardised packaging infringes on their intellectual property rights – a case dismissed by the domestic high courts (2). More recently, the UK faced legal opposition from four major tobacco giants against the new packaging rules that came into force on 20th May 2016, which was also dismissed (9).
The new UK legislation on tobacco packaging is something to celebrate this WNTD. It is a huge victory for public health and a step forward in the fight against the tobacco epidemic. It is set to have a significant impact on the choices that future generations will make on tobacco consumption. These products can now finally be seen for what they truly are: a route to a premature death which is completely avoidable!