Abstract
ABSTRACTBackground: European Union and national legislation implemented from May 2016 mean that from May 2017 all tobacco products in the United Kingdom must be sold in standardized packs without external branding and with prominent graphic health warnings. This study investigates the level of awareness and acceptability of the legislation in students during the implementation period, and how the legislation may impact on student perceptions of pack attributes, health warning effectiveness, student smokers' willingness to pay for cigarette packs, and intentions to quit.Methods: An online survey link was e-mailed to randomly selected University of Nottingham students in autumn 2016. Descriptive statistics and multivariate logistic regression models were used to investigate awareness, acceptability, and potential quitting behavior.Results: 546 students (175 smokers, 371 nonsmokers) responded. Very few of students had seen a standardized pack. Smokers were more likely to be aware of the new legislation than non-smokers. More smokers noticed the warnings on standardized packs than on branded ones. Fewer smokers were willing to pay current prices for standardized packs than for 20 branded packs. Just under half of smokers anticipated quitting in response to the new legislation, with those who smoke infrequently being more likely to anticipate quitting than daily smokers.Conclusions: Few students had seen a standardized pack, suggesting that the level of implementation of the legislation was low five to six months into the implementation period. However, the findings suggest that the legislation has the potential to increase quitting behavior in smoking students.
Highlights
From May 2016 new tobacco standardised packaging legislation was implemented in the UK with a view to reducing the appeal of tobacco products to consumers, young people.(DH, 2016) The new European Union Tobacco Products Directive introduced changes to tobacco packaging including increased graphic health warnings covering 65% of the front and back of these packs, minimum pack sizes of 20 cigarettes or 30g of loose tobacco, and the prohibition of novel pack shapes.(Directive 2014/40/EU, 2014) National legislation implemented in parallel with the EU legislation saw the UK become the second country in the world to implement standardised tobacco packaging
Evidence from Australia suggests that standardised packaging increased quit attempts in adult smokers and reduced smoking prevalence.(Diethelm & Farley, 2015; Durkin et al, 2015) the timing of any changes in behaviour related to standardised packaging is dependent on the time at which the packs appear in shops and become the norm
The majority of the existing evidence on standardised packaging precedes the implementation of the legislation and focuses on attitudes and potential behaviour change among adults and Impact of standardised tobacco packs on students school-age children.(Doxey & Hammond, 2011; Ford et al, 2013; Ford, MacKintosh, et al, 2013; Germain, Wakefield, & Durkin, 2010; Shankleman et al, 2015; White & Hammond, 2012) These studies suggest that standardised packaging reduces brand appeal and susceptibility to smoking, and increases attention to pack health warnings
Summary
Tobacco packaging has been designed to promote brand names, change perceptions of product risk and quality, distract attention away from health warnings, and, in particular, appeal to young people – the generation of smokers.(Borland, Savvas, Sharkie, & Moore, 2013; Ford, Moodie, MacKintosh, & Hastings, 2013; Ford, MacKintosh, Moodie, Richardson, & Hastings, 2013; Ford, Moodie, Mackintosh, & Hastings, 2013; Gendall et al, 2011; Hammond et al, 2009; Hammond & Parkinson, 2009; Maynard, Munafo, & Leonards, 2013; Moodie et al, 2013; Moodie et al, 2012; Scheffels & Saebo, 2013) Until recently, following bans on tobacco advertising, tobacco direct marketing and tobacco company sponsorship, tobacco packaging remained as one of the few means for tobacco companies to promote smoking in the UK.From May 2016 new tobacco standardised (unbranded) packaging legislation was implemented in the UK with a view to reducing the appeal of tobacco products to consumers, young people.(DH, 2016) The new European Union Tobacco Products Directive introduced changes to tobacco packaging including increased graphic health warnings covering 65% of the front and back of these packs, minimum pack sizes of 20 cigarettes or 30g of loose tobacco, and the prohibition of novel pack shapes.(Directive 2014/40/EU, 2014) National legislation implemented in parallel with the EU legislation saw the UK become the second country in the world (after Australia in 2012) to implement standardised tobacco packaging. Evidence from Australia suggests that standardised packaging increased quit attempts in adult smokers and reduced smoking prevalence.(Diethelm & Farley, 2015; Durkin et al, 2015) the timing of any changes in behaviour related to standardised packaging is dependent on the time at which the packs appear in shops and become the norm. The majority of the existing evidence on standardised packaging precedes the implementation of the legislation and focuses on attitudes and potential behaviour change among adults and Impact of standardised tobacco packs on students school-age children.(Doxey & Hammond, 2011; Ford et al, 2013; Ford, MacKintosh, et al, 2013; Germain, Wakefield, & Durkin, 2010; Shankleman et al, 2015; White & Hammond, 2012) These studies suggest that standardised packaging reduces brand appeal and susceptibility to smoking, and increases attention to pack health warnings. The findings suggest that the legislation has the potential to increase quitting behaviour in smoking students
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