Elsevier

Public Health

Volume 126, Issue 7, July 2012, Pages 613-619
Public Health

Original Research
Improper disclosure: Tobacco packaging and emission labelling regulations

https://doi.org/10.1016/j.puhe.2012.03.012Get rights and content

Summary

Objectives

Cigarette packets in many countries display emission numbers such as tar. These numbers may be misleading as they do not represent the amount of toxins delivered to human smokers. This study examined how consumers interpret and understand numerical and descriptive emission information.

Study design

A discrete choice study was conducted among adult smokers (n = 312) and non-smokers (n = 291) in Ontario, Canada.

Methods

Participants viewed groups of cigarette packets with emission labels from the European Union (EU), Canada and Australia. Participants completed ratings on perceived tar delivery, health risks, and usefulness and understandability of the information.

Results

Participants were significantly more likely to believe that Canadian and EU packets with lower emission numbers would have lower tar delivery (92.2% and 89.9%, respectively) and lower health risks (89.5% and 82.9%, respectively) than packets with higher numbers. Approximately 74% of participants rated the numerical Canadian label as providing the most useful information; however, 62% also rated this label as most difficult to understand. Most participants rated the descriptive Australian label as easiest to understand.

Conclusions

Labels featuring quantitative emission values are associated with false beliefs regarding lower tar delivery and health risks. Descriptive statements about emissions are easier to understand and associated with more accurate beliefs.

Introduction

Consumer protection laws help to ensure that the public is informed about health risks from consumer products. Product disclosures on packaging, such as ingredient information on pre-packaged food products, are an important component of consumer protection laws. Product disclosure for tobacco products, however, has presented a unique challenge to regulators. Cigarette smoke contains approximately 4000 chemicals, including over 60 carcinogens and toxins such as hydrogen cyanide, benzene and arsenic.1 Although there is general agreement that cigarette packets should include some information on these chemicals, regulators have struggled with how best to communicate this information in a feasible and meaningful way to consumers.

The traditional regulatory practice in many jurisdictions has been to require manufacturers to print levels for three emissions – tar, nicotine and carbon monoxide – on the side of cigarette packets. Fig. 1 shows an example of emission labelling in the European Union (EU). Communicating emissions numbers to consumers was originally an industry practice.2 Tobacco manufacturers often incorporated tar and nicotine numbers in advertisements and, in some jurisdictions, were required to report emission values directly to government. These early forms of product disclosure appear to have been motivated less by consumer protection than by a marketing strategy intended to capitalize upon widespread misperceptions about the reduced harm of lower tar products.2

In contrast to popular belief, the tar and nicotine emission numbers marketed to consumers and reported to governments do not represent the amounts of tar or nicotine present in the cigarette, or the amounts actually delivered to human smokers.3 Emissions are generated by a machine that ‘smokes’ cigarettes according to a fixed puffing regimen. However, the regimen does not predict the amount of smoke inhaled by individual consumers, or account for design elements such as filter ventilation (tiny holes poked in the filter that yield low emission levels under machine smoking, but much higher levels under human smoking).3 In addition, the testing method traditionally used to generate the emission numbers – the ISO regimen – tests cigarettes under much less intense smoking parameters than is typical for most smokers.4 As a result, there is no association between the machine-generated numbers printed on packets and the health risks of different brands: cigarettes that generate lower tar numbers are no less harmful than higher tar brands.5

Despite early objections by regulatory authorities such as the US Federal Trade Commission regarding how machine-based emission numbers would be interpreted by consumers, the industry practice was adopted by the regulatory communities throughout the world.6 Previous research has shown that many consumers misinterpret tar levels when they are provided by manufacturers.5 Although many smokers are not able to recall the specific tar level of their brand, a substantial proportion nevertheless equate lower numbers with a reduction in exposure and risk, and many use these numbers to guide their choice of brands.7, 8, 9, 10, 11

In response to concerns about how consumers interpret emission numbers, jurisdictions such as Canada supplemented the emission numbers with additional information. In 2000, Canada increased the list of emissions that must be reported (tar, nicotine, carbon monoxide, benzene, hydrogen cyanide and formaldehyde) and added a second set of emission numbers generated under the Health Canada method, a more intensive machine-smoking method (see Fig. 1). This emission testing method is no better at predicting exposure or risks than the lower set of numbers, but was intended to communicate that each product could deliver a range of chemical amounts.12 Other jurisdictions, such as Australia, have removed emission numbers from packets and replaced this information with descriptive statements on emissions and their effects (see Fig. 1). Canada subsequently removed emission numbers from packages as part of new labelling regulations implemented in 2012.13

There is a lack of information regarding consumer perceptions of emission labels mandated by governments, including potential differences across the types of emission information provided in different jurisdictions. The current study sought to examine perceptions of cigarette packets displaying emission labels from Canada, the EU and Australia among Canadian smokers and non-smokers. The primary objectives were to examine the association between labelling information and perceptions of relative risk between cigarette brands in terms of tar delivery and health risks. The study also sought to examine which information was interpreted as most useful and easiest to understand.

Section snippets

Protocol

Respondents were recruited between January and March 2007 from shopping malls in South-western Ontario using convenience sampling methods to participate in a discrete choice study. Eligible participants included smokers and non-smokers aged ≥18 years. After providing consent, participants were seated at a table in a private area and asked to complete a 5-min survey on their smoking status and sociodemographic variables. Participants were then asked to view a series of cigarette packets

Sample characteristics

Table 1 shows sample characteristics for the 603 participants.

Perceptions of packets

Table 2 shows perceptions of tar delivery and health risks for pairs of packets displaying different emission labels. For the packets with EU labels, 92.2% of participants reported that the 4-mg product would deliver less tar than the 10-mg product, whereas 7.8% reported that the 10-mg product would deliver less or an equal amount of tar compared with the 4-mg product (χ2 = 427.7, P < 0.001). Likewise, 89.5% reported that they would

Discussion

The current study provides important evidence on consumer perceptions of emission labelling for cigarettes – the most lethal consumer product available. The findings demonstrate that the vast majority of smokers and non-smokers draw false inferences about the relative risk of cigarette brands based on emission numbers provided in government-mandated labels. For example, more than 90% of participants indicated that they would buy a brand with 4 mg of tar if they were trying to reduce the health

Acknowledgements

The authors wish to thank Carla Parkinson for her assistance in conducting this study.

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