Smoking, plain packaging, and public health

A recent research report from the Adam Smith Institute reviews the evidence around plain packaging for cigarettes from Australia, the only country to have tried the policy so far. It finds that plain packaging has not had a noticeable impact on smoking rates, but has led to a significant rise in counterfeits, which are more easily available for underage smokers.

A more detailed summary of the paper's findings is.

In 2011, Australia’s government introduced legislation mandating that cigarettes be sold in “plain packages” (i.e., without brand logos and colours). The legislation came into effect in late 2012. (Australia had already banned practically all tobacco advertising and other forms of marketing. In 2006, it had introduced a requirement that cigarette packs display graphic health warnings on a substantial proportion of their surface area.)

Some studies (such as a survey carried out when plain packaging was being introduced, an analysis of calls to a smoking cessation hotline, and a survey of outdoor smoking habits) suggest that plain packaging has indeed, made cigarettes less desirable to smokers and has increased thoughts of quitting.

However, an online survey of smokers carried out in two phases, the first a month before and the second six to eight weeks after the introduction of the plain packaging rules, suggest that the impact of the rules on quitting tendencies is probably small. Moreover, many smokers engaged in defensive behaviors such as covering up health warnings, and did not report changing brands or a significant increased tendency to quit. This finding was corroborated by another survey that found that in the year to July 2013 the proportion of smokers in Australia had not declined since the introduction of plain packaging.

A study looking at discarded packs and other data suggests that consumption of cigarettes in the year to July 2013 remained at the same level as in 2012, but found that the proportion of illicit cigarettes had increased substantially. This is corroborated by the most recent Annual Report of Australia’s Customs and Border Protection Service, which indicates that the number of illicit cigarettes entering Australia has indeed risen dramatically in the past three years.

The discarded pack study concluded that contraband—much of which is in the form of finished cigarettes that are not legally sold anywhere in the world, known as “illicit whites”—now accounts for more than half of illegal sales and about 7.5% of all sales. Part of the blame for the increased availability of illicit whites lies with a 25% increase in excise tax on tobacco introduced in 2010. But, since most of the increase in their market share occurred in the past 18 months, part of the blame almost certainly rests with the plain packaging rules.

The wide availability of illicit whites in Australia means it is highly likely that adolescents now have greater access to cigarettes than previously—and at lower prices. Moreover, these “illicit whites” have no health warnings. Given the contribution of plain packaging in Australia to the rise of the illicit white, it seems reasonable to conclude that it has been counterproductive.

So another case of health advocates harts being in the rights place, but you have to wonder where their brains are?