[Royal College of Physicians of Ireland] RCPI Statement on Outline Heads of the Public Health (Standardised Packaging of Tobacco) Bill. (06 Feb 2014)
Press release.
Dr Pat Doorley, Chair of our newly established RCPI Policy Group on Tobacco, is addressing the Oireachtas Joint Committee on Health and Children on Outline Heads of the Public Health (Standardised Packaging of Tobacco) Bill today, 6 February 2014.
Tobacco is a lethal, addictive drug that kills when it is used as it is supposed to be used. One out of every two people who smoke long term will be killed by tobacco. Tobacco Free Ireland, the first policy document to be published in the context of 'Healthy Ireland', the Government’s overall policy to promote the health and wellbeing of the nation, aims to reduce smoking prevalence in Ireland to 5% of the population, from its current level of 22%.
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Tobacco use is the leading cause of preventable death in Ireland
Data presented by RCPI’s Faculty of Public Health Medicine at its Winter Scientific Meeting in 2011, and referenced in Tobacco Free Ireland highlighted that tobacco use is the leading cause of preventable death in Ireland. Each year at least 5,200 people die from diseases caused by tobacco use, representing approximately 19% of all deaths.
In addition to the health costs - which are experienced by both smokers and by exposure to second hand smoke, the high economic cost of smoking is also an imperative for action. Irish health expenditure on smoking related diseases was estimated at €500 million in 2009, and the cost of premature mortality was estimated at €3.5 million in the same year.
Strong international evidence supports plain packaging
Two of the most recent and relevant pieces of research on plain packaging are systematic reviews carried out by the Centre for Tobacco Control Research at the University of Stirling (Moodie reports). The review published in 2013 is an update to a 2012 systematic review carried out by the same group examining the potential impacts of plain packaging. In both reviews, impacts were analysed under the following categories, based on potential impacts identified by the WHO Framework Convention on Tobacco Control:
- Appeal
- Perceptions of harm
- Salience and effectiveness of health warnings
The 2012 review which examined 37 studies stated the following:
"This review found that there is strong evidence to support the propositions set out in the Framework Convention on Tobacco Control relating to the role of plain packaging in helping to reduce smoking rates; that is, that plain packaging would reduce the attractiveness and appeal of tobacco products, it would increase the noticeability and effectiveness of health warnings and messages, and it would reduce the use of design techniques that may mislead consumers about the harmfulness of tobacco products. In addition, the studies in this review show that plain packaging is perceived by both smokers and non-smokers to reduce initiation among non-smokers and cessation-related behaviours among smokers."
The subsequent systematic review published in 2013 looked at 17 studies from a number of countries including Australia where plain packaging was introduced in December 2012. The studies reviewed related to both adults and children. The authors found that the evidence from these studies suggests that plain packaging would reduce appeal, enhance salience of health warnings on packs and would address the use of packaging elements that mislead smokers about product harm.
Plain packs affect smokers' perceptions
An Australian study conducted as plain packs were being introduced, compared the views of smokers still using branded packs with the views of smokers who had switched to plain packs. Those using plain packs were more likely than those still using branded packs to perceive that their cigarettes were lower quality and less satisfying than they had been a year ago.
This would seem to back up the findings of an online survey of adult smokers in Australia conducted before the implementation of plain packs and larger front of pack pictorial warnings. The survey found that plain packs were consistently associated with lower brand appeal, and that the plainness of the pack had more of a negative impact on brand appeal than did increasing the size of pictorial warnings.
Irish Cancer Society and Irish Heart Foundation findings support plain packs
The Irish Cancer Society and the Irish Heart Foundation conducted a national study on the effects of plain packaging among 15-16 year olds. This study found that:
- Cigarette packaging that is viewed as appealing has the power to generate buzz and motivate purchase whereas packaging that is seen as ‘unattractive’ or ‘old fashioned’ is immediately rejected.
- Teens felt that the positive brand attributes of appealing packs (fun, glamour, masculinity, luxury etc.) can transfer to those who smoke them.
- For teens cigarette packaging is not just about the look and feel of the pack, it is about making the smoker 'look' and feel better about themselves and their status.
- Plain packaging was immediately rejected by teens who expressed concerns about the look and feel of the packaging as well as the perceived users, both of which are completely at odds with the image teens would like to portray of themselves.
- Overall, teen smokers claimed they would quit when plain packs were introduced and non/light smokers said they were unlikely to seek or continue to trial cigarettes.
Health warnings - Labelling Requirements for Retail Packaging of Cigarettes
Finally it is worth mentioning that a study by Geoffrey T Fong, David Hammond and Sara C Hitchman (2009), which is cited by The World Health Organisation, has found evidence that health warning labels on tobacco products constitute the most cost-effective tool for educating smokers and non-smokers alike about the health risks of tobacco use, while they also find that pictorial warnings are more successful at achieving this.
The findings in this report confirm that pictorial warnings are effective and should be introduced on all cigarette packaging. This is relevant in relation to Head 6 - Labelling Requirements for Retail Packaging of Cigarettes.
Items RCPI would like to see included in the final legislation
There are a number of items we would like to see included in the final legislation:
- Size and dimensions of packs should be specified in the Bill (Head 5).
- The term ‘dull and drab colour’ requires more definition and should take into account recent research on colour and harm perceptions (Head 5).
- Ambiguity on the use of variant names on packaging should be addressed (eg whether ‘menthol’, ‘light’ etc may be used in variant names).
- On the colour of the ‘brand text’, ‘business or company name or variant name’, we recommend that the most recent research regarding colour and perception be used to inform these regulations.
The RCPI Policy Group on Tobacco fully supports the approach set out in Tobacco Free Irelandand it is our view that implementation of this Bill, coming as it does, in the context of other strong policy measures in recent years, will bring us one step closer to the day when children in this country can grow up free from tobacco addiction.
Item Type
News
Publication Type
Irish-related
Drug Type
Tobacco / Nicotine
Intervention Type
Prevention, Harm reduction, Policy
Date
6 February 2014
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