Association between tobacco plain packaging and Quitline calls: a population‐based, interrupted time‐series analysis

Abstract

To investigate whether the introduction of tobacco plain packaging in Australia from 1October 2012was associated with a change in the number of calls to the smoking cessation helpline, Quitline, and to compare this with the impact of the introduction of graphic health warnings from 1March 2006. Whole-of-population interrupted time-series analysis in New South Wales and the Australian Capital Territory between 1March 2005and October 2006for the comparator, graphic health warnings, and October 2011and April 2013for the intervention of interest, tobacco plain packaging. Weekly number of calls to the Quitline, after adjusting for seasonal trends, anti-tobacco advertising, cigarette costliness and the number of smokers in the community. There was a 78% increase in the number of calls to the Quitline associated with the introduction of plain packaging (baseline, 363/week; peak, 651/week [95% CI, 523-780/week; P <0.001]). This peak occurred 4weeks after the initial appearance of plain packaging and has been prolonged. The 2006introduction of graphic health warnings had the same relative increase in calls (84%; baseline, 910/week; peak, 1673/week [95% CI, 1383-1963/week; P <0.001]) but the impact of plain packaging has continued for longer. There has been a sustained increase in calls to the Quitline after the introduction of tobacco plain packaging. This increase is not attributable to anti-tobacco advertising activity, cigarette price increases nor other identifiable causes. This is an important incremental step in comprehensive tobacco control.