Background Standardised (or ‘plain’) packaging has reduced the appeal of smoking by removing imagery that smokers use to affiliate themselves with the brand they smoke. We examined whether changing the appearance of cigarette sticks could further denormalise smoking and enhance the negative impact of standardised packaging.
Methods We conducted an online study of 313 New Zealand smokers who comprised a Best–Worst Choice experiment and a rating task. The Best–Worst experiment used a 2×3×3×6 orthogonal design to test the following attributes: on-pack warning message, branding level, warning size and stick appearance.
Results We identified three segments whose members' choice patterns were strongly influenced by the stick design, warning theme and size, and warning theme, respectively. Each of the dissuasive sticks tested was less preferred and rated as less appealing than the most common stick in use; a ‘minutes of life lost’ stick was the most aversive of the stimuli tested.
Conclusions Dissuasive sticks could enhance the effect of standardised packaging, particularly among older smokers who are often more heavily addicted and resistant to change. Countries introducing standardised packaging legislation should take the opportunity to denormalise the appearance of cigarette sticks, in addition to removing external tobacco branding from packs and increasing the warning size.
- Packaging and Labelling
- Public policy
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Contributors JH conceptualised and designed the project, and obtained research funding. With PG, she designed the questionnaire and oversaw the data collection; JH led the manuscript development and, with PG, responded to the reviewers’ suggestions. PG undertook the initial data analyses and developed the results section of the MS. JL designed the choice experiment; CE and JL analysed the choice data; CE prepared figures used in the manuscript. All authors have seen and approved the final version; JH is guarantor.
Funding This research was funded by a grant from the New Zealand Heart Foundation (grant number 1544).
Competing interests None declared.
Ethics approval Delegated authority of the University of Otago’s Human Ethics Committee.
Provenance and peer review Not commissioned; externally peer reviewed.
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