Package Standardization for Smoking Prevention

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: RAND

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 7 Jurisdictions This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 1

Duration: 1 day

900 Participants Needed

Trial Summary

What is the purpose of this trial?

The overall aim of this research is to experimentally evaluate the extent to which partially standardizing the color of tobacco packaging influences tobacco use intentions among young adults who have varying levels of tobacco use experience.

Do I have to stop taking my current medications to join the trial?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Package standardization, Plain packaging, Standardized packaging for smoking prevention?

Research shows that plain packaging can reduce positive perceptions of smoking and discourage tobacco use, especially among youth. It also increases the effectiveness of health warnings and reduces false health beliefs about cigarettes, making it an effective measure in smoking prevention efforts. ^{1 2 3 4 5}

Is standardized packaging for smoking prevention safe for humans?

The research on standardized packaging for smoking prevention focuses on its effectiveness in reducing smoking rates and changing perceptions, but it does not provide specific safety data for humans. The studies reviewed do not indicate any direct harm to humans from the packaging itself. ^{1 4 6 7 8}

How does standardized packaging differ from other smoking prevention treatments?

Standardized packaging for cigarettes is unique because it removes branding and uses plain designs to make smoking less appealing, especially to young people. This approach is different from other smoking prevention methods as it focuses on reducing the attractiveness of tobacco products rather than directly targeting smoking behavior through medications or counseling. ^{1 3 4 9 10}

Eligibility Criteria

This trial is for young adults aged between 21-29 who have smoked cigarettes in the past month. There are no specific exclusion criteria, so a wide range of smokers within this age group can participate.

Inclusion Criteria

I am between 21 and 29 years old.

Past month cigarette smoker

Exclusion Criteria

Not applicable.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants are exposed to different tobacco packaging designs to evaluate their influence on tobacco use intentions

1 day

1 visit (in-person)

Follow-up

Participants are monitored for changes in smoking motivation immediately after exposure

Immediately after shopping

Treatment Details

Interventions

• Package standardization

Trial Overview The study is looking at how changing cigarette packaging to a standardized color affects the intentions of young adults to use tobacco. It's an experiment focusing on whether less appealing packaging can influence smoking habits.

Participant Groups

Group I: Partial standardization Experimental Treatment 1 Intervention

Cigarette packages appear with half of the package using a standardized color

Group II: Full standardization Experimental Treatment 1 Intervention

Cigarette packages appear with all of the packages fully standardized (by color and font)

Group III: Status Quo Packages Active Control 1 Intervention

Cigarette packages appear as they normally do - no standardization

Who Is Running the Clinical Trial?

RAND

Lead Sponsor

Trials

145

Recruited

617,000+

Findings from Research

A systematic review of 10 studies found no evidence that standardized packaging of tobacco products leads to an increase in illicit tobacco use among smokers or retailers.

Most studies indicated that smokers did not intend to purchase illicit tobacco after the introduction of standardized packaging, suggesting that this policy may not negatively impact illicit trade.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Standardized packaging and illicit tobacco use: A systematic review. Haighton, C., Taylor, C., Rutter, A.[2020]

Subtle changes in cigarette packaging, such as dimensions and color saturation, significantly influenced the choices of adult smokers, indicating that packaging design can affect consumer behavior.

In a separate study, factors like design and color hue were found to be key in how smokers perceived the appeal and harmfulness of cigarette packs, suggesting that regulators should pay attention to these elements in tobacco control policies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Changes to cigarette packaging influence US consumers' choices: Results of two discrete-choice experiments to inform regulation. Lee, JGL., O'Brien, KF., Blanchflower, TM., et al.[2021]

A study involving 712 British youth aged 11-17 found that larger pictorial health warnings on cigarette packages made them appear less attractive and reduced the likelihood of encouraging smoking initiation.

Standardized packaging, particularly brown versus white, also contributed to perceptions of higher health risks and less appeal, suggesting that such policies could effectively deter young people from starting to smoke.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The perceptions of UK youth of branded and standardized, 'plain' cigarette packaging. Hammond, D., White, C., Anderson, W., et al.[2016]

Standardized plain cigarette packaging, implemented in Australia in December 2012, has been shown to reduce positive perceptions of smoking and discourage tobacco use, supporting its role in public health efforts to combat smoking-related morbidity and mortality.

Evidence from various studies indicates that plain packaging can effectively prevent youth smoking initiation and promote cessation among current smokers, providing a strong rationale for governments considering similar measures despite potential legal challenges from tobacco companies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Plain packaging of cigarettes: do we have sufficient evidence? Smith, CN., Kraemer, JD., Johnson, AC., et al.[2020]

Standardizing tobacco packaging to a 'plain' design significantly enhances the effectiveness of health warnings, making them more noticeable and impactful for consumers.

Plain packaging also helps to reduce misconceptions about the health risks of smoking and decreases the appeal of tobacco products, especially among younger audiences, suggesting it could be a powerful tool in tobacco control efforts.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

"Plain packaging" regulations for tobacco products: the impact of standardizing the color and design of cigarette packs. Hammond, D.[2023]

In a randomized controlled trial with 128 daily smokers, plain packaging did not significantly change the number of cigarettes smoked or the volume of smoke inhaled, indicating no immediate effect on smoking behavior.

However, smokers reported a more negative experience with plain packs and found health warnings to be more impactful, suggesting that while plain packaging may not alter smoking habits in the short term, it could influence perceptions and attitudes towards smoking.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of first exposure to plain cigarette packaging on smoking behaviour and attitudes: a randomised controlled study. Maynard, OM., Leonards, U., Attwood, AS., et al.[2022]

The New Zealand Government aimed to become a smokefree country by 2025 and planned to implement standardized tobacco packaging (SP) in 2012, but faced legal threats from tobacco companies that delayed the process.

The threat of international litigation created a 'regulatory chill,' postponing the enactment of SP legislation by three years, highlighting how legal challenges can hinder public health initiatives.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Regulatory chills: tobacco industry legal threats and the politics of tobacco standardised packaging in New Zealand. Crosbie, E., Thomson, G.[2020]

In March 2017, 73.5% of adults were aware of the new standardised packaging legislation, with awareness significantly higher among smokers (83.7%) compared to never smokers (20.7%).

The legislation is likely to influence purchasing behavior, as over half of adult smokers (52.4%) were using pack sizes that would become illegal, and 31.4% reported switching to cheaper brands since the legislation began.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Awareness of Standardised Tobacco Packaging among Adults and Young People during the Final Phase of Policy Implementation in Great Britain. Bogdanovica, I., Opazo Breton, M., Langley, T., et al.[2023]

Transnational tobacco companies (TTCs) used misleading tactics to oppose standardized packaging (SP) of tobacco products, including misquoting studies and employing a 'mimicked scientific critique' that rejected valid evidence.

The analysis revealed that TTCs' claims against SP lack a solid foundation, indicating that their strategies are aimed at delaying public health measures rather than presenting genuine scientific concerns.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Representation and misrepresentation of scientific evidence in contemporary tobacco regulation: a review of tobacco industry submissions to the UK Government consultation on standardised packaging. Ulucanlar, S., Fooks, GJ., Hatchard, JL., et al.[2022]

Standardised tobacco packaging significantly reduces the appeal of cigarettes and smoking, leading to perceptions of lower quality and less desirable smoker identities, based on a systematic review of 25 quantitative studies.

The packaging design enhances the effectiveness of health warnings, making them more memorable and impactful, while also influencing consumer perceptions of product harm and strength, with darker packs seen as more harmful.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Is consumer response to plain/standardised tobacco packaging consistent with framework convention on tobacco control guidelines? A systematic review of quantitative studies. Stead, M., Moodie, C., Angus, K., et al.[2022]

References

1. Greece pubmed.ncbi.nlm.nih.gov

Standardized packaging and illicit tobacco use: A systematic review. [2020]

2. Greece pubmed.ncbi.nlm.nih.gov

Changes to cigarette packaging influence US consumers' choices: Results of two discrete-choice experiments to inform regulation. [2021]

3. England pubmed.ncbi.nlm.nih.gov

The perceptions of UK youth of branded and standardized, 'plain' cigarette packaging. [2016]

4. England pubmed.ncbi.nlm.nih.gov

Plain packaging of cigarettes: do we have sufficient evidence? [2020]

5. Mexico pubmed.ncbi.nlm.nih.gov

"Plain packaging" regulations for tobacco products: the impact of standardizing the color and design of cigarette packs. [2023]

6. England pubmed.ncbi.nlm.nih.gov

Effects of first exposure to plain cigarette packaging on smoking behaviour and attitudes: a randomised controlled study. [2022]

7. New Zealand pubmed.ncbi.nlm.nih.gov

Regulatory chills: tobacco industry legal threats and the politics of tobacco standardised packaging in New Zealand. [2020]

8. Switzerland pubmed.ncbi.nlm.nih.gov

Awareness of Standardised Tobacco Packaging among Adults and Young People during the Final Phase of Policy Implementation in Great Britain. [2023]

9. United States pubmed.ncbi.nlm.nih.gov

Representation and misrepresentation of scientific evidence in contemporary tobacco regulation: a review of tobacco industry submissions to the UK Government consultation on standardised packaging. [2022]

10. United States pubmed.ncbi.nlm.nih.gov

Is consumer response to plain/standardised tobacco packaging consistent with framework convention on tobacco control guidelines? A systematic review of quantitative studies. [2022]