Table 3

Summary findings

StudySummary of findings
White et al48Branded packs are significantly (p<0.001) more appealing than plain packs, and plain packs with descriptors (mean scores: branded pack=6, plain=4.3, plain-no descriptor=3.4)
Branded packs had a higher taste rating than plain packs (mean scores: branded pack=4.9, plain=3.9, plain no-descriptor=2.3)
Branded packs rated higher for smoothness compared to plain packs (mean scores: branded pack 4.1, plain=3.1, plain no-descriptor=1.6)
Plain packs with descriptors rated higher than plain packs with no descriptors in regard to appeal (mean scores 4.3:3.4), taste (3.9:2.1) and smoothness ratings (3.1:1.6)
Minimal difference in health risk between packs (mean scores: branded pack=1.5, plain=1.1, plain no-descriptor=1.2)
Arora et al41Focus group discussion
  • General agreement that coloured packs ‘lure’ people from all ages and socioeconomic backgrounds, eg, ‘First time when I saw it (the cigarette pack), I thought the pack contained some candies, it looked beautiful and attractive’ and ‘If I am walking with an expensive cigarette packet, it will create certain status around me’

  • Plain packs reduce the appeal of the tobacco products, especially among youth and children

  • Health warnings will be more prominent, eg, ‘in your face’

  • 83.2% reported that the colours, designs, gloss and large fonts of brand distract from the health warnings

  • 81.8% of tobacco users reported that plain packaging reduces appeal, and 83.2% of non-users report that plain packaging would reduce appeal

  • 91.6% participants reported that plain packaging would make pictorial warnings more effective

  • 69% survey participants strongly supported the plain packaging proposal

  • High SES participants reported that plain packaging reduced the attractiveness of tobacco products more than did low SES (tobacco users 83.3%:81% and non-users 92.9%:79.6%)

Guillaumier et al39Plain packaging was significantly less appealing on taste attributes than branded packaging in the Winfield brand (p=0.004), but no differences were detected in taste ratings in the B&H condition.
Plain packaging was associated with significantly reduced smoker ratings of ‘positive pack characteristics’ (p<0.001), ‘positive smoker characteristics’ (p=0.003) and ‘positive taste characteristics’ (p=0.033) in the Winfield brand name condition only.
There was no difference in the negative smoker characteristic ratings across the four pack conditions (p=0.427)
In comparison to plain packaging, branded packaging was associated with higher odds of smokers’ purchase intentions (OR=2.18, (95% CI 1.34 to 3.54); p=0.002).
Guillaumier et al46Health Warning Labels (HWL) that pictured children elicited emotive response, but desensitisation also occurred with HWL, eg, “hate the baby one…that one disturbs me, but I don't care about the rest of them”
HWL were noticeable on the plain packs and increased thoughts about quitting.
Participants reported active avoidance of HWL
Participants (adults) reported that plain packaging was “aimed at young people”, and suggested it would be effective for this population and that for first-time smokers plain packs might have more of an impact.
Since the implementation of plain packaging, participants reported that the quality and taste of cigarettes had decreased.
Health warnings on new plain packaging were noticed initially, but the multiple focus groups reported the idea of being desensitised