1. Perceptions of packaging and plain packaging among children and adults Dr. Crawford Moodie Centre for Tobacco Control Research Institute for Social Marketing University of Stirling Brussels, 12 th January, 2011

2. Study 1: An online survey The Tobacco Packaging Survey ran from June to October 2010 It involved young people aged between 10 and 17 years old completing an online survey Final sample of 658 children

3. Why young people choose cigarettes How important do you think each of these things are to young people who smoke when choosing cigarettes? Price The make or brand What their friends/family smoke Seeing a famous person smoke that brand or make The look of the cigarette pack

4. Why young people choose cigarettes Percentage who thought each of the following factors were important or very important 55% the price 39% what their family/friends smoke 35% what celebrities smoke 32% the brand 30% the look of the pack

5. Why young people choose cigarettes Imperial Tobacco (2010) state that ‘tobacco packaging is not identified as a reason why young people choose to purchase tobacco products’ That almost one in three indicated that the look of the pack is an important factor in choosing cigarettes highlights that packaging does appeal to young people. TotalMaleFemale10-1314-17 Ever Smoker Never Smoker The look of the pack30322928333230

6. Perceptions of pack colour Looking at these 4 differently coloured packs, which pack do you think would have...? The strongest tasting cigarettes The weakest tasting cigarettes The most harmful cigarettes The least harmful cigarettes

7. Perceptions of pack colour 29% considered the red pack to have the strongest tasting cigarettes 22% considered the red pack to have most harmful cigarettes 42% considered the white pack (27%) or the light blue pack (15%) to have the weakest tasting cigarettes 33% considered the white pack (18%) or the light blue pack (15%) to have the least harmful cigarettes

8. Perceptions of pack colour For tobacco products, weaker lighter colours such as white and light blue are often used to signify ‘healthier’ products with lower tar and nicotine levels. This “establishment of [a] colour code” is a deliberate strategy according to tobacco marketing documents from the UK (The Research Business, 1996) That a third of young people associate pack colour with product strength and harm demonstrates that pack colour alone can mislead consumers

9. Perceptions of plain (non-branded) packaging Looking at the pack shown below, do you think the pack is...? 1 2 3 4 5 Attractive Not attractive

10. Perceptions of plain (non-branded) packaging Plain packs were rated as: – cheap (51%) – unattractive (91%) – uncool (87%) – a pack that young people would not like to be seen with (88%)

11. Perceptions of different types of plain packaging This picture shows three packs. Pack 1 is a standard pack, pack 2 is a pack which slides open and pack 3 is a thinner pack. Which pack do you..? 1) Like the most 2) Think people of your age would be most likely to smoke?

12. Perceptions of different types of plain packaging 25% liked the dark brown slide pack the most, 10% the flip top pack and 7% the superslims pack. 23% thought that others their age would be most likely to smoke the flip top pack, 21% the slide pack, and 14% the superslims pack. The findings suggests that even with the removal of branding the pack can still function as a marketing tool

13. Study 2: An ecological study The Ecological Study ran from April to June 2010 The study involved young adult smokers (N=48), who were asked to transfer their cigarettes into plain packs provided and use them every day for two weeks. They used their normal packs for the other two weeks They were asked to complete questionnaires, assessing pack perceptions and feelings, and smoking related behaviours, twice a week A sub-sample (N=18) of those who had taken part in the study were given a post-study interview

14. Perceptions and feelings of packaging and smoking Pack Perceptions Plain packs were rated negatively on all pack perceptions (not stylish, unfashionable, cheap, uncool, unattractive, poor quality, unappealing). Mean scores ranged from 1.35 to 2.07 for plain packs and 2.64 to 3.48 for their own packs. Pack Feelings Plain packs were associated with negative feelings (embarrassed, ashamed, unaccepted). Mean scores ranged from 2.24 to 2.70 for plain packs and 3.18 to 4.20 for their own packs. Feelings about smoking Plain packs were associated with more negative feelings about smoking (less enjoyable, less satisfying). Mean scores ranged from 2.53 to 2.78 for enjoyment for plain packs and 3.13 to 3.37 for their own packs. Mean scores ranged from 2.58 to 2.70 for satisfaction for plain packs and 3.13 to 3.35 for their own packs.

15. Perceptions of health warnings on plain packs and avoidant behaviour and behavioural change Health warnings At weeks one and two only, warnings on plain packs were rated as more noticeable relative to their own pack. However, overall ratings of the salience of health warnings did not differ between the packs. Behavioural change/avoidant behaviour Smokers were more likely to report that they had forgone a cigarette when using the plain pack, compared with their own pack (e.g. at week four, 30% had forgone a cigarette from the plain pack compared with 9% from their own pack). When using the plain pack, smokers were more likely to: keep the pack out of sight; cover the pack up; smoke less around others; think about quitting. In addition, at weeks two and four, smokers were more likely to indicate that they wanted to quit when using the plain pack.

16. Perceptions and feelings of packaging and smoking Examples of respondent comments Pack perceptions Even the colour of the pack just made me think, oh God, are my lungs this colour as well? (Female, 25- 35, C2DE) Not a fan, I wouldn't buy them. But then that is a good thing then really isn't it? (Female, 25-35, ABC1) Pack feelings It made me feel bad and gave me a guilty conscience (Female, 25-35, C2DE) With the brown pack I did feel a wee bit, not ashamed, but I did feel different (Female, 18-24, ABC1) Feelings about smoking It definitely did feel more horrible to actually smoke (Female, 18-24, ABC1) It almost didn't taste as good (Female, 25-35, C2DE)

17. Examples of respondent comments Health warnings With the lack of advertisement, the health warning is the only thing you really notice on the packet. That stands out (Male, 25-35, C2DE) You notice them more because there is nothing else on the packaging for the eye to go to...I think because you notice them more, I think it tends to make you think about it a bit more (Male, 25-35, C2DE) Behaviour change It did make me cut down a wee bit because see taking the packet out it was quite embarrassing (Female, 18- 24, C2DE) The colour puts you off, you know, makes you smoke less (Female, 25-35, C2DE) Perceptions of health warnings on plain packs and avoidant behaviour and behavioural change