Plain Tobacco Packaging Could Reduce Smoking and COPD, Study Reports

Plain tobacco packaging could reduce the appeal of smoking, decreasing the alarming rate of chronic obstructive pulmonary disease (COPD), according to the Cochrane Review.

The article, “Tobacco packaging design for reducing tobacco use,” was published in Cochrane Library. Cochrane is a non-profit that organizes medical research information in a way that helps doctors, patients, policy makers and others make decisions about treatments and other healthcare-related matters. It includes a Cochrane Tobacco Addiction Group that addresses smoking.

COPD is usually caused by smoking. In fact, it accounts for up to eight out of 10 COPD-related deaths, according to the Centers for Disease Control and Prevention (CDC).

To try to reduce smoking, the World Health Organization in 2008 developed standardized packaging that it urged governments to mandate. The packaging was based on recommendations of its Framework Convention on Tobacco Control.

The notion of plain packaging is based on evidence that tobacco promotion, including glitzy packaging, attracts people to smoking. A number of studies have examined the impact of packaging changes on consumers’ behavior.

Standardized packaging removes all branding except a product’s name, including corporate logos, colors, imagery, and trademarks. The name is in a specific size, font and place. The package does include health warnings and legally mandated information, such as the toxins in the product and tax stamps.

To assess standardized packaging’s impact on tobacco use, researchers in the United Kingdom and Canada reviewed 51 studies on plain packaging’s effect on smoking-related attitudes and behavior.

At the time of the review, only one country had mandated plain tobacco packaging: Australia, in 2012. So researchers could use only one large observational study from Australia as evidence that tobacco use decreased after plain packaging went into effect. Evidence from other studies also has suggested that plain packaging reduces the appeal of smoking, however.

“These findings are supported by evidence from a variety of other studies that have shown that standardized packaging reduces the promotional appeal of tobacco packs, in line with the regulatory objectives set,” Professor Ann McNeill of King’s College London, the study’s lead author, said in a news release. “It would appear that the impact of standardized packaging may be affected by the detail of the regulations, such as whether they ban descriptors, such as ‘smooth’ or ‘gold’, and control the shape of the tobacco pack.”

“Our evidence suggests that standardized packaging can change attitudes and beliefs about smoking, and the evidence we have so far suggests that standardized packaging may reduce smoking prevalence and increase quit attempts,” said Jamie Hartmann-Boyce of the Oxford, England-based Cochrane Tobacco Addiction Group, another study author.  “We didn’t find any studies on whether changing tobacco packaging affects the number of young people starting to smoke, and we look forward to further research on this topic.”

No studies in the review assessed whether plain packaging prompted people to reduce or stop smoking or whether it prevents smokers who quit from taking it up again.

The researchers said they will be able to collect more information on the impact of plain packaging as more countries mandate it.

“Evaluating the impact of standardized packaging on smoking behaviour is difficult to do, but the evidence available to us, whilst limited at this time, indicates that standardized packaging may reduce smoking prevalence.” McNeill concluded.