Will cigarette plain packaging work amongst highly socioeconomically disadvantaged smokers? The results of an experimental study

Background: Packaging is a key marketing tool in the promotion of tobacco products. Evidence shows that packaging colours, branding imagery and logos impact on a consumer’s perceptions and experiences of a product. Previous research has demonstrated that progressively plainer packaging for cigarettes that incorporates larger health warnings and fewer company branding elements are perceived as less attractive and are associated with cessation intentions. The effect of plain packs remains untested with severely socially disadvantaged individuals who have among the highest smoking rates. Methods: Clients attending a community service organisation for welfare support were invited to complete a computer touchscreen survey. A 2 (Winfield Blue 25 versus Benson& Hedges Smooth 25) x 2 (branded versus plain) experimental cross-over trial was conducted using a touch screen computer tool to expose participants to one randomly selected cigarette pack, which they were asked to rate on pack, smoker and experience characteristics. Results: The survey response rate was 76 %. A total of 400 smokers completed the survey (59 % female; mean age 38 years). The smoking prevalence rate in this setting is 65 % (daily and occasional). Most respondents had not completed high school, three-quarters had an income of less than AU$400/week, and 18 % identified as an Indigenous Australian. In comparison to branded packs, plain packs reduced smoker’s ratings of ‘positive pack characteristics’, ‘positive smoker characteristics’ and ‘positive taste characteristics’. Respondents who were only exposed to plain packs were more likely to choose not to purchase any pack compared to those smokers who were only presented with branded packs. Conclusions: Plain packaging policies that strip tobacco products of most branding elements are likely to be successful in reducing cigarette brand image associations amongst severely disadvantaged smokers.