Early evidence about the predicted unintended consequences of standardised packaging of tobacco products in Australia: a cross-sectional study of the place of purchase, regular brands and use of illicit tobacco

Abstract

ObjectivesTo test for early evidence whether, following the standardisation of tobacco packaging, smokers in Australia were—as predicted by the tobacco industry—less likely to purchase from small mixed business retailers, more likely to purchase cheap brands imported from Asia and more likely to use illicit tobacco.DesignSerial cross-sectional population telephone surveys in November 2011 (a year prior to implementation), 2012 (during roll-out) and 2013 (a year after implementation).Setting/participantsSmokers aged 18 years and over identified in an annual population survey in the Australian state of Victoria (2011: n=754; 2012: n=590; 2013: n=601).Main outcome measuresChanges between 2011 and 2013 in: proportions of current smokers who purchased their last cigarette from discount outlets such as supermarkets compared with small mixed business retail outlets; prevalence of regular use of low-cost brands imported from Asia and use of unbranded tobacco.ResultsThe proportion of smokers purchasing from supermarkets did not increase between 2011 (65.4%) and 2013 (65.7%; p=0.98), and the percentage purchasing from small mixed business outlets did not decline (2011: 9.2%; 2012: 11.2%; p=0.32). The prevalence of low-cost Asian brands was low and did not increase between 2011 (1.1%) and 2013 (0.9%; p=0.98). The proportion reporting current use of unbranded illicit tobacco was 2.3% in 2011 and 1.9% in 2013 (p=0.46). In 2013, 2.6% of cigarette smokers reported having purchased one or more packets of cigarettes in non-compliant packaging in the past 3 months; 1.7% had purchased one or more packets from an informal seller in the past year.ConclusionsOne year after implementation, this study found no evidence of the major unintended consequences concerning loss of smoker patrons from small retail outlets, flooding of the market by cheap Asian brands and use of illicit tobacco predicted by opponents of plain packaging in Australia.

Standardized packaging and illicit tobacco use: A systematic review

“…The prevalence of any use of illicit tobacco remained at about 3% (adjusted OR=0.79, 95% CI 0.58 to 1.08, p=0.141). The results of this large National study 37 confirmed those of the smaller State-based study 36 . Both found no increase in purchase of unbranded illicit tobacco and low levels of purchase of cigarettes likely to be contraband.…”

“…Searches generated ten relevant empirical studies 21,30,[32][33][34][35][36][37][38][39] : three were qualitative studies (two reporting focus group research with young adult smokers in Scotland 30,32 , and in-depth interviews with retailers in New Zealand 39 ); three were content analyses (of online commentary on tobacco packaging in Australia 33 , UK press coverage of the illicit tobacco trade 34 and the four TTC submissions to the consultation in the UK 35 ); two were cross sectional surveys (of illicit tobacco use following introduction of standardized packaging in Australia) 36,37 ; and two were before and after studies (one of availability of illicit tobacco in small retail outlets 38 and one empty-pack survey before and after the introduction of standardized packaging in Australia) 21 . See Table 2 for a summary of included studies.…”

“…The State-based telephone survey 36 used both mobile and landline phones to survey smokers, which is likely to result in a more representative sample than using landlines alone. However, recent purchase of potentially illicit branded (contraband) tobacco was only assessed in the final year of the survey.…”

“…Three studies examined the actual impact of standardized packaging on illicit tobacco purchasing behaviour following implementation of legislation in Australia 21,36,37 . Two studies used repeated 36 and continuous 37 cross-sectional population telephone surveys, respectively, to examine early evidence of whether Australian smokers were more likely to use illicit tobacco following the standardization of tobacco packaging.…”

“…Two studies used repeated 36 and continuous 37 cross-sectional population telephone surveys, respectively, to examine early evidence of whether Australian smokers were more likely to use illicit tobacco following the standardization of tobacco packaging. Scollo and colleagues 36 or packs purchased from informal sellers (<0.1%; OR=0.24, 95% CI 0.04 to 1.47, p=0.124). The prevalence of any use of illicit tobacco remained at about 3% (adjusted OR=0.79, 95% CI 0.58 to 1.08, p=0.141).…”