Effects of legislation

Effects of legislation post-implementation

Department of Health. Tobacco plain packaging post–implementation review. 2016. Available from:  https://obpr.pmc.gov.au/published-impact-analyses-and-reports/tobacco-plain-packaging

For a detailed discussion of Australian and international real-world research on the effects of plain packaging, see: https://www.tobaccoinaustralia.org.au/chapter-11-advertising/indepth-11a-packaging-as-promotion/11a-9-real-world-research-on-the-effects-of-plain-

Effects on young people

White V, Williams T, and Wakefield M. Has the introduction of plain packaging with larger graphic health warnings changed adolescents’ perceptions of cigarette packs and brands? Tobacco Control, 2015; 24:ii42-ii49. Available from:  http://tobaccocontrol.bmj.com/content/24/Suppl_2/ii42.full

White V, Williams T, Faulkner A, and Wakefield M. Do larger graphic health warnings on standardised cigarette packs increase adolescents' cognitive processing of consumer health information and beliefs about smoking-related harms? Tobacco Control, 2015; 24:ii50-ii57. Available from:  http://tobaccocontrol.bmj.com/content/24/Suppl_2/ii50.full

Diethelm PA and Farley TM. Re-analysing tobacco industry funded research on the effect of plain packaging on minors in Australia: Same data but different results. Tob Prev Cessat, 2017; 3(November):130. Available from: https://www.ncbi.nlm.nih.gov/pubmed/32432204

Dunlop S, Perez D, Dessaix A, and Currow D. Australia's plain tobacco packs: anticipated and actual responses among adolescents and young adults 2010–2013. Tobacco Control, 2017; 26(6):617-26. Available from: http://tobaccocontrol.bmj.com/content/tobaccocontrol/26/6/617.full.pdf

El-Khoury Lesueur F, Bolze C, Gomajee R, et al. Plain tobacco packaging, increased graphic health warnings and adolescents’ perceptions and initiation of smoking: DePICT, a French nationwide study. Tobacco Control, 2018. Available from:  https://tobaccocontrol.bmj.com/content/early/2018/11/08/tobaccocontrol-2018-054573

White VM, Guerin N, Williams T, et al. Long-term impact of plain packaging of cigarettes with larger graphic health warnings: findings from cross-sectional surveys of Australian adolescents between 2011 and 2017. Tobacco Control, 2019. Available from:  https://tobaccocontrol.bmj.com/content/early/2019/08/20/tobaccocontrol-2019-054988

El-Khoury Lesueur F, Bolze C, Gomajee R, White V, Melchior M, et al. Plain tobacco packaging, increased graphic health warnings and adolescents' perceptions and initiation of smoking: DePICT, a French nationwide study. Tobacco Control, 2019; 28(e1):e31–e6. Available from: https://www.ncbi.nlm.nih.gov/pubmed/30409812

White VM, Guerin N, Williams T, and Wakefield MA. Long-term impact of plain packaging of cigarettes with larger graphic health warnings: findings from cross-sectional surveys of Australian adolescents between 2011 and 2017. 2019; 28(e1):e77–e84. Available from: https://tobaccocontrol.bmj.com/content/tobaccocontrol/28/e1/e77.full.pdf

Mitchell D, Moodie C, Critchlow N, and Bauld L. Adolescents' perceptions of standardised cigarette packaging design and brand variant name post-implementation: a focus group study in Scotland. BMC Public Health, 2019; 19(1):1227. Available from: https://www.ncbi.nlm.nih.gov/pubmed/31488096

Mitchell D, Critchlow N, Moodie C, and Bauld L. Reactions to Standardized Cigarette Packs With Varying Structural Designs, and the Association With Smoking Susceptibility: A Postimplementation Cross-Sectional Survey With Never-Smoking Adolescents in Scotland. Nicotine & Tobacco Research, 2020; 22(11):2041–50. Available from: https://www.ncbi.nlm.nih.gov/pubmed/32577739

MacGregor A, Delaney H, Amos A, Stead M, Eadie D, et al. 'It's like sludge green': young people's perceptions of standardized tobacco packaging in the UK. Addiction, 2020; 115(9):1736–44. Available from: https://www.ncbi.nlm.nih.gov/pubmed/32032450

Results of National Plain Packaging Tracking Survey – effects on Australian adults

Wakefield M, Coomber K, Zacher M, Durkin S, Brennan E, et al. Australian adult smokers’ responses to plain packaging with larger graphic health warnings 1 year after implementation: results from a national cross-sectional tracking survey. Tobacco Control, 2015; 24:ii17-ii25. Available from:  http://tobaccocontrol.bmj.com/content/24/Suppl_2/ii17.full

Durkin S, Brennan E, Coomber K, Zacher M, Scollo M, et al. Short-term changes in quitting-related cognitions and behaviours after the implementation of plain packaging with larger health warnings: findings from a national cohort study with Australian adult smokers. Tobacco Control, 2015; 24:ii26-ii32. Available from:  http://tobaccocontrol.bmj.com/content/24/Suppl_2/ii26.full

Brennan E, Durkin S, Coomber K, Zacher M, Scollo M, et al. Are quitting-related cognitions and behaviours predicted by proximal responses to plain packaging with larger health warnings? Findings from a national cohort study with Australian adult smokers. Tobacco Control, 2015; 24:ii33-ii41. Available from:  http://tobaccocontrol.bmj.com/content/24/Suppl_2/ii33.full  

Other Australian and international research on effects on smokers' attitudes and behaviours

Wakefield, M. A., Hayes, L., Durkin, S. and Borland, R., Introduction effects of the Australian plain packaging policy on adult smokers: a cross-sectional study, BMJ Open 2013. Available from  http://www.ncbi.nlm.nih.gov/pubmed/23878174  

Dunlop SM, Dobbins T, Young JM, Perez D, and Currow DC. Impact of Australia's introduction of tobacco plain packs on adult smokers’ pack-related perceptions and responses: results from a continuous tracking survey. BMJ Open, 2014; 4(12). Available from:  http://bmjopen.bmj.com/content/4/12/e005836.abstract

Guillaumier A, Bonevski B, Paul C, Durkin S, and D'Este C. Socioeconomically disadvantaged smokers' ratings of plain and branded cigarette packaging: An experimental study. BMJ Open, 2014; 4(2):e004078. Available from:  http://www.ncbi.nlm.nih.gov/pubmed/24503299 

Yong H-H, Borland R, Hammond D, Thrasher JF, Cummings KM, et al. Smokers’ reactions to the new larger health warning labels on plain cigarette packs in Australia: findings from the ITC Australia project. Tobacco Control, 2015. Available from:  http://tobaccocontrol.bmj.com/content/early/2015/02/19/tobaccocontrol-2014-051979.abstract   

Hardcastle SJ, Chan DC, Caudwell KM, Sultan S, Cranwell J, et al. Larger and More Prominent Graphic Health Warnings on Plain-Packaged Tobacco Products and Avoidant Responses in Current Smokers: a Qualitative Study. Int J Behav Med, 2015. Available from:  http://www.ncbi.nlm.nih.gov/pubmed/25920708 

Nagelhout GE, Osman A, Yong HH, Huang LL, Borland R, et al. Was the media campaign that supported Australia's new pictorial cigarette warning labels and plain packaging policy associated with more attention to and talking about warning labels? Addictive Behaviors, 2015; 49:64-7. Available from:  http://www.ncbi.nlm.nih.gov/pubmed/26050643

Maddox R, Durkin S, and Lovett R. Plain packaging implementation: Perceptions of risk and prestige of cigarette brands among Aboriginal and Torres Strait Islander people. Australian and New Zealand Journal of Public Health, 2015. Available from:  http://www.ncbi.nlm.nih.gov/pubmed/26713418

Balmford J, Borland R, and Yong HH. Impact of the introduction of standardised packaging on smokers' brand awareness and identification in Australia. Drug Alcohol Rev, 2015. Available from:  http://www.ncbi.nlm.nih.gov/pubmed/26369651

Diethelm P and Farley T. Refuting tobacco-industry funded research: empirical data shows decline in smoking prevalence following introduction of plain packaging in Australia. Tobacco Prevention & Cessation (European Network of Smoking and Tobacco Prevention), 2015; 1. Available from: http://www.tobaccopreventioncessation.com/Refuting-tobacco-industry-funded-research-empirical-data-shows-decline-in-smoking-prevalence-following-introduction-of-plain-packaging-in-Australia,60650,0,2.html

Dunlop, S, Perez, D, Dessaix, A, and Currow, D.  Australia's plain tobacco packs: anticipated and actual responses among adolescents and young adults 2010–2013.  Tobacco Control, 2016. Available from:  http://tobaccocontrol.bmj.com/content/early/2016/11/15/tobaccocontrol-2016-053166.abstract?papetoc

Webb H, Jones BM, McNeill K, Lim L, Frain AJ, et al. Smoke signals: The decline of brand identity predicts reduced smoking behaviour following the introduction of plain packaging. Addictive Behaviors Reports, 2017; 5:49–55. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29450227

British Heart Foundation and The ITC Project. Standardised Packaging for Tobacco Products in England: Evidence of policy impact from the international tobacco control policy evaluation project. 2020. Available from: https://itcproject.s3.amazonaws.com/uploads/documents/ITC_BHF_Report_A4_Feb13v11_Final.pdf

Aleyan S, Driezen P, McNeill A, McDermott M, Kahnert S, et al. Evaluating the impact of introducing standardized packaging with larger health-warning labels in England: findings from adult smokers within the EUREST-PLUS ITC Europe Surveys. European Journal of Public Health, 2020; 30(Suppl_3):iii91–iii7. Available from: https://www.ncbi.nlm.nih.gov/pubmed/32918815

Moodie C, Brose LS, Lee HS, Power E, and Bauld L. How did smokers respond to standardised cigarette packaging with new, larger health warnings in the United Kingdom during the transition period? A cross-sectional online survey. Addict Res Theory, 2020; 28(1):53–61. Available from: https://www.ncbi.nlm.nih.gov/pubmed/31992964

Opazo Breton M, Britton J, and Bogdanovica I. Effect of UK plain tobacco packaging and minimum pack size legislation on tobacco and nicotine product switching behaviour. Addiction, 2020; 115(10):1913–23. Available from: https://www.ncbi.nlm.nih.gov/pubmed/32190939

Moodie C, Angus K, and Stead M. Consumer Response to Standardized Tobacco Packaging in the United Kingdom: A Synthesis of Evidence from Two Systematic Reviews. Risk Manag Healthc Policy, 2021; 14:1465–80. Available from: https://www.ncbi.nlm.nih.gov/pubmed/33883953

Moodie C, Best C, Hitchman SC, Critchlow N, MacKintosh AM, et al. Impact of standardised packaging in the UK on warning salience, appeal, harm perceptions and cessation-related behaviours: a longitudinal online survey. Tobacco Control, 2021. Available from: https://www.ncbi.nlm.nih.gov/pubmed/34272338

Gravely S, Chung-Hall J, Craig LV, Fong GT, Cummings KM, et al. Evaluating the impact of plain packaging among Canadian smokers: findings from the 2018 and 2020 ITC Smoking and Vaping Surveys. Tobacco Control, 2021:tobaccocontrol–2021–056635. Available from: https://www.ncbi.nlm.nih.gov/pubmed/34548384

Moodie C, Best C, Lund I, Scheffels J, Critchlow N, et al. The Response of Smokers to Health Warnings on Packs in the United Kingdom and Norway Following the Introduction of Standardized Packaging. Nicotine & Tobacco Research, 2021; 23(9):1551–8. Available from: https://www.ncbi.nlm.nih.gov/pubmed/33599723

Opazo Breton M, Britton J, Brown J, Beard E, and Bogdanovica I. Was the implementation of standardised tobacco packaging legislation in England associated with changes in smoking prevalence? A segmented regression analysis between 2006 and 2019. Tobacco Control, 2021. Available from: https://www.ncbi.nlm.nih.gov/pubmed/34326193

Pasquereau A, Guignard R, Andler R, Gallopel-Morvan K, and Nguyen-Thanh V. Plain packaging on tobacco products in France: Effectiveness on smokers' attitudes one year after implementation. Tobacco Induced Diseases, 2022; 20:35. Available from: https://www.ncbi.nlm.nih.gov/pubmed/35529322

Vincent H, Laverty AA, Brown J, Beard E, and Bogdanovica I. Association between the implementation of standardised tobacco packaging legislation and illicit tobacco and cross-border purchasing in England: a time-series analysis between 2012 and 2020. Tobacco Control, 2024. Available from: https://tobaccocontrol.bmj.com/content/tobaccocontrol/early/2024/01/05/tc-2023-058253.full.pdfPasquereau A, Guignard R, Andler R, Gallopel-Morvan K, and Nguyen-Thanh V. Plain 

Effects on pack display/social acceptability

Nee-Nee J, Sutherland K, Holland R, et al. Tobacco pack display at hospitality venues after the introduction of standardised tobacco packaging in New Zealand: a field observation study. BMJ Open 2019;9:e027868. Available from:  https://bmjopen.bmj.com/content/9/9/e027868

Zacher M, Bayly M, Brennan E, Dono J, Miller C, et al. Personal pack display and active smoking at outdoor café strips: assessing the impact of plain packaging 1 year postimplementation. Tobacco Control, 2015; 24:ii94-ii97. Available from: http://tobaccocontrol.bmj.com/content/24/Suppl_2/ii94.full 

Zacher, M., Bayly, M., Brennan, E., Dono, J., Miller, C., Durkin, S., Scollo, M. and Wakefield, M., Personal tobacco pack display before and after the introduction of plain packaging with larger pictorial health warnings in Australia: an observational study of outdoor cafe strips, Addiction 2014. p. 653-62. Available from http://www.ncbi.nlm.nih.gov/pubmed/24428427

Brennan E, Bayly M, Scollo M, Zacher M, and Wakefield MA. Observed smoking and tobacco pack display in Australian outdoor cafes 2 years after implementation of plain packaging. European Journal of Public Health, 2018; 28(4):702–7. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29596579

Nee-Nee J, Sutherland K, Holland R, Wilson M, Ackland S, et al. Tobacco pack display at hospitality venues after the introduction of standardised tobacco packaging in New Zealand: a field observation study. BMJ Open, 2019; 9(9):e027868. Available from: https://www.ncbi.nlm.nih.gov/pubmed/31494599

See also:

Wakefield, M. A., Zacher, M., Bayly, M., Brennan, E., Dono, J., Miller, C., Durkin, S. J. and Scollo, M. M., The silent salesman: an observational study of personal tobacco pack display at outdoor café strips in Australia, Tobacco Control 2014. p. 339-344. Available from http://tobaccocontrol.bmj.com/content/23/4/339.abstract

Effects on calls to Quitline

Young, J. M., Stacey, I., Dobbins, T. A., Dunlop, S., Dessaix, A. L. and Currow, D. C., Association between tobacco plain packaging and Quitline calls: a population-based, interrupted time-series analysis, Med J Aust 2014. p. 29-32. Available from http://www.ncbi.nlm.nih.gov/pubmed/24438415

Support for legislation

Swift E, Borland R, Cummings KM, Fong GT, McNeill A, et al. Australian smokers' support for plain or standardised packs before and after implementation: findings from the ITC Four Country Survey. Tob Control, 2014. Available from:  http://www.ncbi.nlm.nih.gov/pubmed/25385449  

Hayes L, Wakefield MA, and Bain E. Change in public support for the introduction of plain packaging and new, enlarged graphic health warnings in the Australian state of Victoria, 2011-2013. Tobacco Control, 2017; 26(6):627–8. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27754923

Kc S, Filippidis FT, and Laverty AA. Legislative provisions for standardised tobacco packaging and changes in public support in 27 European countries. Tobacco Control, 2022. Available from: https://www.ncbi.nlm.nih.gov/pubmed/35017263

Effects on tobacco consumption and sales of tobacco products

Scollo M, Zacher M, Coomber K, Bayly M, and Wakefield M. Changes in use of types of tobacco products by pack sizes and price segments, prices paid and consumption following the introduction of plain packaging in Australia. Tobacco Control, 2015; 24(Suppl 2):ii66–ii75. Available from: https://www.ncbi.nlm.nih.gov/pubmed/28407614

Underwood D, Sun S, and Welters RAMHM. The effectiveness of plain packaging in discouraging tobacco consumption in Australia. Nature Human Behaviour, 2020. Available from:  https://doi.org/10.1038/s41562-020-00940-6

                Critique of the Underwood study

See also, industry claims about lack of effects in Australia

Opazo Breton M, Britton J, and Bogdanovica I. Changes in roll-your-own tobacco and cigarette sales volume and prices before, during and after plain packaging legislation in the UK. Tobacco Control, 2020; 29(3):263–8. Available from: https://www.ncbi.nlm.nih.gov/pubmed/31073097

Hiscock R, Augustin NH, Branston JR, and Gilmore AB. Longitudinal evaluation of the impact of standardised packaging and minimum excise tax on tobacco sales and industry revenue in the UK. Tobacco Control, 2021; 30(5):515–22. Available from: https://www.ncbi.nlm.nih.gov/pubmed/32719111