Perceptions and Behavioural Responses of Smokers to the Introduction of Cigarette Plain Packaging: Preliminary Results. Martin S.

Transcription

1 Perceptions and Behavioural Responses of Smokers to the Introduction of Cigarette Plain Packaging: Preliminary Results Martin S. Hagger

2 Acknowledgements Faculty Sarah Hardcastle (University of Brighton, UK) Sarwat Sultan (Bahauddin Zakariya University, Pakistan) Doctoral Students and Postdocs Jo Cranwell (University of Nottingham, UK) Derwin K.C. Chan (Curtin University, Australia) Kim M. Caudwell (Curtin University, Australia)

3 Smoking and Health Smoking tobacco is responsible for one in ten deaths Second major cause of mortality, worldwide (WHO, 2009) Smoking is the largest single preventable cause of death and disease in Australia (Australian Medical Association, 2005) 3.3 million Australians smoked cigarettes (23% of Men and 19% women) ( National Health Survey)

4 Plain Packaging Health warnings an important tool for promoting health risks of tobacco Plain packaging recently implemented in Australia: prohibits the use of logos, brand imagery, and promotional text on tobacco products and packaging, and includes restrictions on colour, size, format, and materials of packaging, as well as the appearance of brand and variant names. (Department of Health and Ageing, 2013) Size and prominence of health warnings increased as a result Introduced in December 2012

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6 Aims Plain Packaging reduce the appeal of cigarettes to prevent uptake reduce brand recognition and loyalty make smoking generally less appealing Also increase attention to the health warnings health warnings increase knowledge of health risks and may encourage cessation and prevent uptake pictorial health warnings increase beliefs about health risks and motivation to quit

7 Plain Packaging in Australia

8 Plain Packaging Increased recall of health warnings by adolescents (Rootman & Flay, 1995) Plain package perceived as cheaper and of poorer quality compared to branded (Van Haal et al., 2013) Branded package perceived more trustworthy and reliable (Van Haal et al., 2013) To date only one study on smokers perceptions introduction of plain packaging for cigarettes in Australia Wakefield et al. (2013) Smokers smoking from plain packs perceived: Lower quality tobacco, satisfaction More likely to think about and prioritise quitting More likely to support the plain packaging policy

9 Aims Examine smokers attitudes toward plain packaging Identify effects of plain packaging on the behaviour, beliefs and perceptions of smokers Effects of more prominent health warnings Explore strategies of coping with the change

10 Design and Method Participants. Regular smokers (N = 168; 62.5% female, M age = 33.57, SD = 11.97) smoking (SD = 9.09) cigarettes per day recruited via social networking and Design. Qualitative online questionnaire-based design Procedure. Open-ended online questionnaire one month before introduction of plain packaging (Dec 2012) and follow-up questions 6-8 weeks later

11 Pre-introduction Questions Overall, what do you think your usual brand of cigarettes means to your identity? What do you think of the Australian Government s initiative to change the packaging of cigarettes? Overall, how do you anticipate your smoking behaviour might change, following the introduction of plain cigarette packaging? Post-introduction How has plain packaging policy affected your smoking behaviour? Do you feel the quality or taste of your preferred brand of cigarettes has changed following the introduction of plain packaging? If so, how? Have you taken any steps to limit the impact of plain packaging on your smoking behaviour? If so, how?

12 Analysis Inductive thematic content analysis (Neuendorf, 2001) Emerging themes linked to plain packaging and behavioural responses since the Multiple readings to generate Quotes representative of the emergent themes assigned in to higher order themes Relate themes to current research and theory relevant to the explanation of smoking behaviour change.

13 Results Main themes Mixed views plain packaging initiative Limited impact on smoking behaviour Coping behaviours hiding the warnings out of sight Also.No themes on brand identity, preference or taste just some minor confusions Source: Hardcastle, Caudwell, Cranwell, Sultan, Chan, & Hagger (in submission), Nicotine and Tobacco Research.

14 Mixed views It may cut down on the uptake of smoking but I doubt existing smokers will take much notice, particularly among young people (Male, 25, 3 CPD) It may stop young people starting to smoke (Female, 55, 22 CPD It may well influence young people to not start smoking. For those of us who are addicted it will make no difference (F, 60, 20 CPD) A good idea if it causes people not to take it up (M, 41, 31 CPD Clearly the government is quite happy to profit off the death of smoker through the taxes whilst they are alive. Instead of spending money on repackaging, they should ban cigarettes altogether (F, 22, 5 CPD);

15 Mixed views I did not begin smoking because of the packaging and I certainly do not think that I m cool because of it. If anything, it seems less cool to be smoking (F, 22, 15 CPD Smoking is an addiction not a fashion statement. Cigarettes in plain packaging are like alcohol in a glass. Just because you can t see the brand makes no difference to the choice to partake (F, 36, 15 CPD).

16 Limited impact on smoking It hasn t really affected my smoking at all. If need be I would use a cigarette case (F, 59, 16 CPD) It hasn t affected the amount I smoke but has increased my feelings of shame around being a smoker (F, 28, 6 CPD) At first the packaging was really confronting and made me feel terrible but now I m becoming used to it (F, 29, 14 CPD) Initially I was confronted with gross imagery that made me think about the consequences of smoking. But you soon become desensitised to the images very quickly and now I don t notice them. It didn t actually affect my behaviour in any way (F, 25, 4 CPD)

17 Limited impact on smoking The health warnings are almost too gruesome that I find it hard to believe that it would happen to me (M, 28, 14 CPD) I do not feel that the health risks are terribly high compared to a pack-a-day smoker I view it as generally low risk and high pleasure (F, 21, 1 CPD) (the government) will show the worst of the worst to try and scare us (M, 21, 14 CPD) (If I saw) someone close to me get ill due to smoking (F, 30, 15 CPD) Its become a joke around here with the shopkeeper as you see what disease they give you (F, 29, 41 CPD) It hasn t affected my behaviour at all. If anything I ve smoked more than I was before (F, 19, 8 CPD)

18 Coping: Hiding 90 % of the people I know put electrical tape over the warnings and then draw pretty pictures on their pack (M, 21, 14 CPD) You can cover up the picture on the package, my aunt uses a card that she slips in to cover up the picture on the front (F, 28, 20 CPD Many smokers I know have bought cigarette cases to cover up the horrible picture (F, 57, 23 CPD) I transfer the cigarettes into a leather cigarette box (F, 56, 15 CPD I have kept packets of tobacco from Europe that don t have plain packaging- re-use them (M, 47, 11 CPD) I have kept two old packets which I refill (F, 48, 12 CPD When they first came out I would wrap electric tape around my packet but now I don t bother (M, 21, 14 CPD)

19 Coping: Out of Sight I m more careful about keeping them hidden in my bag out of sight (F, 28, 6 CPD) I do hide them in my handbag because some of the pictures freak my kids out (F, 40, 15 CPD) I prefer not to look at the packet whilst smoking (F, 46, 12 CPD)

20 Summary and Implications There were three main findings 1. Generally negative views of plain packaging; 2. Little influence on smoking with almost all continuing to smoke; 3. Coping strategies used to avoid the health warnings The finding that plain packaging had no effect on brand preference or taste is important since research indicates that plain packaging may reduce the appeal of cigarettes

21 Summary and Implications Packaging had no effect on brand preference or taste contradicts research that plain packaging may reduce the appeal of cigarettes Although threat was increased participants denied or underplayed either the severity or susceptibility of the threat Health warnings appeared to have the opposite effect some keen to smoke more in defiance Active avoidance of health warnings due to the threatening nature Smokers became desensitised to the messages and images, little effect on actual smoking