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Impact of standardised packaging in the UK on warning salience, appeal, harm perceptions and cessation-related behaviours: a longitudinal online survey
  1. Crawford Moodie1,
  2. Catherine Best1,
  3. Sara C Hitchman2,
  4. Nathan Critchlow1,
  5. Anne-Marie MacKintosh1,
  6. Ann McNeill2,
  7. Martine Stead1
  1. 1Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
  2. 2National Addictions Centre, Institute of Psychiatry, King's College London, London, UK
  1. Correspondence to Dr Crawford Moodie, Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirling FK9 4LA, UK; c.s.moodie{at}stir.ac.uk

Abstract

Introduction In the UK, since 20 May 2017, tobacco companies must sell cigarettes and rolling tobacco in standardised packs.

Methods Three waves of a longitudinal online survey with smokers (≥16) before standardised packaging (wave 1 (W1): April to May 2016) and after standardised packaging (wave 2 (W2): September to November 2017; wave 3 (W3): May to July 2019). Of the 6233 smokers at W1, 4293 responded at W2 and 3175 at W3. We explored smokers’ response to warning salience, appeal (appeal, quality, value, satisfaction and taste compared with a year ago), harm (harmfulness compared with a year ago, harm compared with other brands and whether some brands have more harmful substances), and quit plans, attempts and quitting.

Results Compared with W1, the proportions noticing warnings first on packs, and rating cigarettes/rolling tobacco less appealing and worse value than a year ago, were higher at W2 and W3. Disagreeing that some brands contain more harmful substances was higher at W2. Interactions between social grade and survey wave for warning salience, and each appeal and harm outcome, were non-significant. Smokers switching from not noticing warnings first at W1 to noticing warnings first at W2, or who had a lower composite appeal score at W2, were more likely to plan to quit and to have made a quit attempt at W2. Smokers who switched to disagreeing that some brands contain more harmful substances at W2, after giving a different response at W1, were more likely to quit at W3.

Conclusions Standardised packaging appears to be having the intended impacts.

  • packaging and labelling
  • public policy
  • surveillance and monitoring

Data availability statement

Data are available upon reasonable request. Data will be available on project completion and when planned articles are submitted.

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Data availability statement

Data are available upon reasonable request. Data will be available on project completion and when planned articles are submitted.

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Footnotes

  • Twitter @cathbest, @n_critchlow, @kingsNRG

  • Contributors CM and SCH designed the study. CM and MS obtained funding. CB was responsible for data management and analysis. CM drafted the manuscript. All authors approved the final manuscript.

  • Funding The first two waves were funded by Cancer Research UK and the British Heart Foundation (grant number A18507). The third wave was conducted by the Public Health Policy Research Unit (PH-PRU), commissioned and funded by the National Institute for Health Research Policy Research Programme.

  • Disclaimer The views expressed are those of the authors and not necessarily those of the NHS, the National Institute for Health Research, the Department of Health and Social Care or its arm's-length bodies and other government departments.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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