Smoking: Standardized packaging with large graphic health warnings encouraged more thoughts about quitting

In introducing standardized tobacco packaging with large graphic health warnings in December 2012, the Australian government's main aim was to reduce the attractiveness and appeal of tobacco products to young people and so reduce the likelihood of them taking up smoking.

In other studies the researchers from Melbourne in Victoria found that standardized packaging did reduce the appeal of tobacco products to both young people and adult smokers, but in this study they focused on the impact on adult smokers. They found evidence that adult smokers were more likely to show short-term increases in quitting intentions, and to engage in quitting behaviours after implementation of the packaging changes.

Between April 2012 and December 2013, the researchers surveyed more than 5,000 adult smokers (aged 18-69 years) by telephone and followed them up approximately one month later. They split the smokers into four groups according to when they were surveyed at follow-up: in the couple of months before implementation of standardized packaging; just as the new standardized packaging was being introduced; later in the introductory period; and after standardized packaging was fully implemented.

Smokers surveyed as standardized packaging was being implemented were most likely to report that they intended to try to quit smoking in the next month (odds ratio 1.42, when compared with smokers at the very start of the study).

Also when compared to the smokers who completed the surveys before standardized packaging was introduced, those surveyed in the first year of the new packs were more likely to conceal their packs from view (odds ratio 1.65), stub out their cigarette prematurely (odds ratio 1.55) and attempt to quit (odds ratio 1.52).

The authors said that their findings "provide some of the strongest evidence to date" that standardized packaging with larger graphic health warnings are associated with increased rates of thinking about quitting and attempting to quit amongst adult smokers.

The focus of the study was to follow up smokers' thoughts about quitting and quit attempts rather than examining smokers' quitting success, so the follow-up period was relatively short to ensure participants could accurately recall their quit attempts. As a result, the authors said: "The extent to which the positive outcomes we observed may be maintained and translate into longer-term reductions in smoking prevalence still needs to be determined."