Socioeconomic Differences in the Effectiveness of the Removal of the “Light” Descriptor on Cigarette Packs: Findings from the International Tobacco Control (ITC) Thailand Survey

Abstract

Many smokers incorrectly believe that “light” cigarettes are less harmful than regular cigarettes. To address this problem, many countries have banned “light” or “mild” brand descriptors on cigarette packs. Our objective was to assess whether beliefs about “light” cigarettes changed following the 2007 removal of these brand descriptors in Thailand and, if a change occurred, the extent to which it differed by socioeconomic status. Data were from waves 2 (2006), 3 (2008), and 4 (2009) of the International Tobacco Control (ITC) Thailand Survey of adult smokers in Thailand. The results showed that, following the introduction of the ban, there was an overall decline in the two beliefs that “light” cigarettes are less harmful and smoother than regular cigarettes. The decline in the “less harmful” belief was considerably steeper in lower income and education groups. However, there was no evidence that the rate of decline in the “smoother” belief varied by income or education. Removing the “light” brand descriptor from cigarette packs should thus be viewed not only as a means to address the problem of smokers’ incorrect beliefs about “light” cigarettes, but also as a factor that can potentially reduce socioeconomic disparities in smoking-related misconceptions.

What do we know about the effects of exposure to ‘Low alcohol’ and equivalent product labelling on the amounts of alcohol, food and tobacco people select and consume? A systematic review

“…Fourteen of 26 included studies were classified as non-randomised studies (NRSs) (quasi-experimental or non-experimental studies) [20–23, 25, 28–31, 33, 35, 37, 39, 44, 45]. Key characteristics and results of these 14 NRSs are summarised in Additional file 5: Table S2, with further details in Additional file 4.…”

Comprehensive tobacco marketing restrictions: promotion, packaging, price and place

“…318 Evidence from high-income and low-income countries describes significant declines in adult smokers' beliefs that ‘light’ cigarettes deliver less tar, are less harmful or easier to quit. 4748 In Thailand, the labelling restriction significantly reduced the proportion of adult smokers who agreed that ‘light cigarettes are less harmful’, and the impact was most pronounced among the lowest socioeconomic group. 48 Smaller reductions were observed in high-income countries, where false beliefs were lower to start, and the effects decayed over time.…”

“…4748 In Thailand, the labelling restriction significantly reduced the proportion of adult smokers who agreed that ‘light cigarettes are less harmful’, and the impact was most pronounced among the lowest socioeconomic group. 48 Smaller reductions were observed in high-income countries, where false beliefs were lower to start, and the effects decayed over time. 47 In spite of the labelling restriction, approximately 20% of adult smokers in high-income countries reported that ‘some cigarettes could be less harmful than others’, 49 and 39% of adult smokers in Thailand reported that ‘light’ cigarettes were less harmful.…”

“…47 In spite of the labelling restriction, approximately 20% of adult smokers in high-income countries reported that ‘some cigarettes could be less harmful than others’, 49 and 39% of adult smokers in Thailand reported that ‘light’ cigarettes were less harmful. 48 In order to circumvent the regulation, tobacco companies replaced the banned terms with similarly deceptive words (eg, ‘smooth’) or numbers, manipulated the thickness of packaging to indicate that soft packs contained lighter/milder cigarettes than hard packs, 48 and used lighter pack colours to signify lower strength. 50 In many countries including the USA, tobacco companies substituted blue packaging for ‘mild’, gold for ‘light’ and silver for ‘ultralight’ brands.…”

Global tobacco prevention and control in relation to a cardiovascular health promotion and disease prevention framework: A narrative review

“…Accordingly, tobacco control policies ban the use of misleading branding practices (e.g., “mild,” “light,” and “low-tar”) around the world (Elton-Marshall et al, 2010; Siahpush et al, 2011). In some countries, there is evidence of harm reduction, as opposed to harm elimination by total tobacco cessation, when smokeless tobacco products (e.g., snus, snuff, dissolvable tobacco) are used in place of cigarettes (Gartner et al, 2007).…”