Over multiple years, this study monitored the impact of the introduction of tobacco plain packaging and larger graphic health warnings in Australia in December 2012 on smoking and tobacco pack display behaviours at outdoor cafes and bars in the Australian capital cities of Melbourne and Adelaide. From before to immediately after implementation of plain packaging, we observed a 15% decline in the number of cigarette packs displayed at outdoor cafes, driven by a 23% decline in the number of patrons who were actively smoking. Additional waves of the study showed that rates of pack display and active smoking remained significantly lower at one year post-implementation, and although these lower rates were not completely sustained through to two years post-implementation, they also did not rebound to pre-plain packaging levels. Importantly, we also found that pack display and active smoking were lower in all post-implementation phases at venues where children were present but not at venues without children, such that two years after implementation, children were still being exposed to less smoking and less tobacco packaging than before implementation. There was little evidence that plain packaging had a sustained effect on the way in which smokers displayed their packs. Across all phases, the majority of packs were displayed face-up, and although we observed an early increase in efforts by smokers to conceal their packs, this effect was not sustained through to one or two years post-implementation. On the whole, this novel observational study provided important evidence that the introduction of plain packaging with larger graphic health warnings positively influenced the smoking and pack display behaviours of patrons sitting in the outdoor areas of cafes and restaurants.
Dr Emily Brennan, Megan Bayly, Dr Michelle Scollo, Prof Melanie Wakefield, Assoc Prof Sarah Durkin
Meghan Zacher (Harvard University), Dr Caroline Miller (South Australian Health & Medical Research Institute)
Cancer Council Victoria (and past funding from Cancer Council South Australia)
2011 - 2018