I’ve never been a smoker but I did live with one for the better part of 20 years. My father smoked for about 30 years up until he had a heart attack over a decade ago and that’s a pretty good thing to set everyone straight on the risks of smoking. However I don’t believe it’s my, or anyone else’s business, if people who are fully aware of the risks involved choose to engage that behaviour anyway so long as they’re not harming anyone else in the process. This is why I supported legislation that banned smoking in clubs and in outdoor areas of restaurants as the risk was real and provable then. What I don’t support however is the idea that plain packaging, I.E. olive green packages with bigger warning labels on them, will do anything to lower smoking rates in Australia.
Now I’m fully aware that some people may write me off as a corporate apologist in this regard, I do have a rather lengthy track record of defending certain company’s actions from time to time, but my concerns aren’t the ones that the tobacco companies have brought forward. Whilst I do believe there needed to be some more discussion surrounding the loss of branding potential and the real risk of product counterfeiting my concerns come from the research backing the legislation which, as far as I can tell, don’t really match up with the line that’s being marketed to Australia.
The research from both articles is quite similar so I’ll focus on the systemic review since that’s a much more sound piece of scientific literature. Below is an excerpt showing the review’s aims:
The primary aim of this review is to assess the impact of plain tobacco packaging on the:
1. appeal of the packaging or product;
2. salience and effectiveness of health warnings; and
3. perceptions of product strength and harm.
I’m not going to judge the validity of these research goals, indeed they are interesting points to note, however I feel it’s something of a leap to translate those particular goals into a reduction in of the current rate of smoking. Indeed the main point that the Australian government hammered home with the plain packaging idea was that it would help stop our younger generation from taking up the habit. Looking deeper into the research there’s really nothing in it to support that idea as there was no investigation into the vectors by which youths (and adults) are introduced to tobacco.
The research is also heavily qualitative in nature, which isn’t technically a bad thing, but for the most part it’s also quite comparative. Take for instance the following paragraph relating to product strength and harm:
Perceptions of harmfulness and strength were assessed in several ways, by asking respondents which packs: would deliver the most tar and/or nicotine or would be ‘lighter’ in tar; were a greater risk to health compared to other brands; would be associated with greater or lesser harm; would trigger discussions on harmfulness; inform the smoker about the health effects; and would be more likely to make you think that the cigarettes inside were dangerous.
Whilst this might have shown that people would believe that plain packaged cigarettes were more dangerous to their health than branded ones the research doesn’t show how this would translate into lower smoker incident rates. Indeed much of the research is done in the same manner, with the results being that people found the branded packages more appealing (is that really a surprise?) and that people were more likely to remember the health warnings if they were displayed on a plain package. I’m not disputing these findings, indeed I’m inclined to agree with them, what I’m not getting is how they make the leap to reducing our smoker population.
The argument can be made that if the packaging is less appealing, the health warnings more remembered and the product is thought to be more damaging to their health that these pressures will lead to smokers dropping the habit. You could also argue that it may have some impact on uptake rates as well however the small amount of research into that very idea doesn’t support it. From the systemic analysis again:
Four studies examined the potential impact of plain packs on participants’ own smoking behaviour.
Again the overall pattern is mixed but tends to be supportive of plain packaging having a deterrent
effect on smoking.
It’s statements like the above that really get to me as you can not conclude from mixed results that something is in support of your hypothesis. The only thing you can draw from that is that more research is required to make a proper conclusion, not that it supports your idea. If the conclusion of the study was in fact “we need more research done into this” I’d be much more supportive but instead we’ve got legislation, which is the real issue here.
We’ve had a lot of successful schemes that have helped reduce the number of new and old smokers. Both the health warnings and the ad campaigns on free to air television have a long history of being effective and had good supporting research behind them. Plain packaging on the other hand doesn’t have the same level of evidence to support the conclusion that’s currently being made and fails to investigate critical things like the origins of people’s habits. I would have fully supported a year long trial in order to judge the effectiveness of it and then should the evidence support our hypothesis then we could legislate. However the current approach of taking tangentially related research and then creating policy around that isn’t something I can support and neither should you.