How did smokers respond to standardised cigarette packaging with new, larger health warnings in the United Kingdom during the transition period? A cross-sectional online survey

Abstract

We assessed whether there was an association between using standardised packs and warning salience, thoughts about the risks of smoking, thoughts about quitting, and awareness and use of stop-smoking websites. Methods: We conducted a cross-sectional online survey with current smokers aged 16 and over (N ¼ 1865) recruited in two regions of England between February-April 2017, when both standardised and fully-branded packs were on the market. Participants were asked about use of standardised packs, warning salience (noticing, reading closely), and whether the packs they were using increased thoughts of the risks of smoking and quitting. They were also asked about awareness of stop-smoking websites, source of awareness (including warnings on packs), and whether they had visited a stop-smoking website. Results: Most participants reported currently using standardised packs (76.4%), 9.3% were not currently using them but had previously used them, and 14.3% had never used them. Compared with never users, current users were more likely to have noticed the warnings on packs often/very often (AOR (95%CI) ¼ 2.76 (2.10, 3.63)), read them closely often/very often (AOR(95%CI) ¼ 2.16 (1.51, 3.10)), thought somewhat/a lot about the health risks of smoking (AOR(95%CI) ¼ 1.92 (1.38, 2.68)), and thought somewhat/a lot about quitting (AOR(95%CI) ¼ 1.90 (1.30, 2.77)). They were also more likely to have noticed a stop-smoking website on packs. Conclusions: Consistent with the broad objectives of standardised packaging, we found that it was associated with increased warning salience and thoughts about risks and quitting. ARTICLE HISTORY

Awareness of product-related information, health messages and warnings on alcohol packaging among adolescents: a cross-sectional survey in the United Kingdom

“…In the UK, health messages and warnings are mandatory on tobacco products, 47 and research shows that such messages are influence smoking attitudes and behaviour. 25 , 26 , 48 The current findings therefore suggest that further steps are required to increase the visibility and comprehension of messages on alcohol packaging, for example further exploration of optimal designs and standardizing across products.…”

The effects of tobacco control policies on global smoking prevalence

“…Large and rotating pictorial graphic warnings are the most effective in attracting smokers’ attention but are lacking in countries with high numbers of smokers, such as China and the USA 20 . Adding best practice health warnings to unbranded packages seems to be an effective way of informing about the negative effects of smoking while also eliminating the tobacco industry’s marketing efforts of using cigarette packages to make these products more appealing, especially for women and young people who are now the prime targets of tobacco companies 24 , 25 .…”

Anticipated responses to a hypothetical minimum price for cigarettes and roll-your-own tobacco: an online cross-sectional survey with cigarette smokers and ex-smokers in the UK

“…Data were collected on age (coded: 19–34, 35–54, 55–64, > 65 years), gender, country (coded: England vs Other) and social grade, with participants classified ABC1 (middle and upper classes, hereafter ‘higher social grade’) or C2DE (working classes, hereafter ‘lower social grade’) using the National Readership Survey system. 31 …”

“…Data were collected on age (coded: 19-34, 35-54, 55-64, >65 years), gender, country (coded: England vs Other) and social grade, with participants classified ABC1 (middle and upper classes, hereafter 'higher social grade') or C2DE (working classes, hereafter 'lower social grade') using the National Readership Survey system. 31 Cigarette smoking status All participants were cigarette smokers at wave one. To assess smoking behaviour at wave three, participants were asked 'Which of the following best describes your CURRENT smoking status?…”