1. Impact on the Quitline of Australia's New Graphic Cigarette Pack Warnings Caroline Miller and Jacqueline Hickling

2. Australia’s graphic cigarette packet warnings Overview  Background – Australia’s pack warnings  Study aims & study tools  Pace of the roll out  Impact on the Quitline  Conclusions and implications

3. Australia’s graphic cigarette packet warnings Background – Australia’s graphic pack warnings  Graphic pack warnings introduced in Australia on 1 March 2006  Legislated date mandated start of manufacture rather than sale

4. Australia’s graphic cigarette packet warnings Background – Australia’s graphic pack warnings  30% of front of pack 90% of back of pack  Includes Quitline number  2 sets of 7 warnings rotated annually

5. Australia’s graphic cigarette packet warnings Background – Australia’s graphic pack warnings Set A:  Smoking causes peripheral vascular disease  Smoking causes emphysema  Smoking causes mouth and throat cancer  Smoking clogs your arteries  Don’t let children breathe your smoke  Smoking - a leading cause of death  Quitting will improve your health

6. Australia’s graphic cigarette packet warnings Background – Australia’s graphic pack warnings Set B:  Smoking harms unborn babies  Smoking causes blindness  Smoking causes lung cancer  Smoking causes heart disease  Smoking doubles your risk of stroke  Smoking is addictive  Tobacco smoke is toxic

7. Australia’s graphic cigarette packet warnings Background – Social marketing campaign  Government ‘primer’ campaign  Purpose made ‘quit’ campaigns  Designed to reinforce pack warnings  Designed to extend impact of pack warnings  “amputation” & “gangrene”

8. Australia’s graphic cigarette packet warnings Aims  The study was designed to assess: 1.The pace of the actual roll-out of packets with the new warnings into shops 2.The impact of the new pack warnings plus tailored social marketing campaigns on demand for the Quitline

9. Australia’s graphic cigarette packet warnings Study Design - (1) Roll out of packs at point of sale Sample:  Small but random sample of retail venues  Adelaide (South Australia) and Melbourne (Victoria) metropolitan areas  Petrol Stations; convenience stores; lunch bars; supermarkets  Repeated visits Measures:  Top tobacco brands  # packs with new warnings out of total # packs  % new packs on display

10. Australia’s graphic cigarette packet warnings Results – (1) Roll out of packs at point of sale in SA

11. Australia’s graphic cigarette packet warnings Study Design – (2) Calls to the Quitline Study Tool:  Telstra Analyser data  provided by the telecommunications company  Based on objective billing data Sample:  All calls to the Australian Quitline for 2006  Comparison with the 2 preceding years

12. Australia’s graphic cigarette packet warnings Results – (2) Calls to the Quitline

13. Australia’s graphic cigarette packet warnings Conclusions and Implications Conclusions: New graphic cigarette packet warnings with accompanying mass media, doubled calls to the Australian Quitline. Flow on to cessation is significant. Implications: Even in a ‘mature’ market like Australia, such a tobacco control intervention has a major impact. Countries planning to introduce such warnings should expect similar impact.