- By Deborah Arnott
- Chief Executive
- Action on Smoking and Health (ASH)
In the UK, smoking kills around 100,000 people a year (1). To replace those who quit or die, the tobacco industry has to continually recruit new smokers. As most people start smoking before they’re 18 it is children and young people who the industry must recruit (2). Advertising and marketing has been shown to increase the appeal of cigarettes to children and tobacco manufacturers design their packs to be glitzy and glamorous with often novel designs resembling such things as perfume packaging.
This is a tactic that works: around 207,000 young people start smoking annually in the UK (3) and exposure to tobacco marketing has been shown to increase this risk (4). Children from the most deprived backgrounds, where smoking prevalence is highest, are most likely to be exposed to tobacco packaging (5). Of those who become lifetime smokers, 1 in 2 of will die of a smoking-related disease (6).
Standardised packaging is the best way to protect children from the lure of sophisticated tobacco industry marketing and the FPH’s new manifesto for public health in the next parliament rightly identifies standardised packaging as vital in giving children the best possible chance of achieving a healthy future (7). However, to maximise the public health gains possible from standardised packaging we need to act now to make sure legislation is voted on by this Parliament.
As part of The Children and Families Act, which became law in February 2014, MPs voted in favour of powers enabling the Government to introduce regulations requiring standardised packaging for tobacco products (8). Since then, the Government has published and consulted on draft regulations. To bring the legislation into effect, these regulations need to be put before Parliament for a further vote. The revised Tobacco Products Directive from the European Parliament, which contains a series of measures intended to deter young smokers including larger health warnings, will be implemented in the UK by May 2016 (9). Because measures have a cumulative effect, implementing standardised packaging at the same time will maximise the public health gain; for this to happen Parliament must be given the chance to vote on the regulations to introduce standardised packaging before the next General Election.
The tobacco industry is running a well-resourced and highly misleading campaign against the introduction of standardised packaging in the UK, but the evidence base for the measure’s effectiveness is now well-established. In April this year, Sir Cyril Chantler’s government-commissioned independent and comprehensive review of evidence reported that there is a strong public health case for the policy, concluding that “the body of evidence shows that standardised packaging… is very likely to lead to a modest but important reduction over time on the uptake and prevalence of smoking and thus have a positive impact on public health” (10).
Moreover, despite claims from the tobacco industry that standardised packs will lead to an increase in tobacco smuggling, the proposed packs would contain the same security markings as existing packs and would be no easier to counterfeit. Sir Cyril Chantler stated in his review that he was “not convinced by the tobacco industry’s argument that standardised packaging would increase the illicit market, especially in counterfeit cigarettes” (10).
An industry-commissioned report using sales data from Australia to claim that there has been an increase in tobacco sales since the introduction of standardised packaging has been widely dismissed. Although the industry reported a small (0.28%) increase in sales year on year, they did not report the increase in the Australian population between 2012 and 2013. Adjusted for population, tobacco sales per person have in fact fallen (11).
Tobacco industry efforts have also failed to dent the popularity of standardised packaging, which currently has strong support from the public, politicians across the political spectrum and the public health community (12). A YouGov poll in March 2014 found that overall 64% of adults in Great Britain support or strongly support plain standardised packaging with only 11% opposed to the measure (13) and when Parliament voted to give the Government the power to introduce standard packs through regulations, 453 MPs voted in favour and just 24 against.
Evidence from Australia, the first country to introduce standardised packaging in December 2012, has been encouraging. Soon after standardised packs began to appear in shops, smokers reported that they found cigarettes in these packs less appealing or satisfying (14). Research has also shown that smokers consuming cigarettes from standard packs were 81% more likely to have thought about quitting at least once a day during the previous week and to rate quitting as a higher priority than smokers using branded packs (14).
Every day since the publication of Sir Cyril Chantler’s review in Spring 2014 hundreds of children have started smoking and the public health community has a responsibility to ensure this number stops growing. You can help make the case for standardised packaging by writing to your MP and urging them to encourage the Government to bring regulations to Parliament as soon as possible.
References and notes
(1) ASH Fact Sheet, Smoking Statistics: Illness and death, 2014
(2) Office for National Statistics. General Lifestyle Survey Overview: A report on the 2011 General Lifestyle Survey. 2013.
(3) ASH Fact Sheet, Young People and Smoking, 2014
(4) The packaging of tobacco products. March 2012. The Centre for Tobacco Control Research. Core funded by Cancer Research UK.
(5) Marmot, M. et al. (2010) Fair Society, Healthy Lives: Strategic review of health inequalities in England post-2010 Marmot review secretariat, London
(6) Doll, R. et al. (2004) Mortality in relation to smoking: 50 years’ observations on male British doctors. BMJ 2004; 328: 1519
(7) Faculty of Public Health, (2014) Start Well, Live Better – a manifesto
(8) Children and Families Act 2014
(9) Tobacco Products Directive 2014
(10) Standardised packaging of tobacco. Report of the independent review undertaken by Sir Cyril Chantler. Kings College London, April 2014
(11) Is smoking increasing in Australia? The Guardian, June 2014
(12) The Smokefree Action Coalition an alliance of over 250 health organisations including medical royal colleges, the BMA, the Trading Standards Institute, the Chartered Institute of Environmental Health, the Faculty of Public Health, the Association of Directors of Public Health and ASH, all support the introduction of standard packs.
(13) The poll total sample size was 12,269 adults. Fieldwork was undertaken by YouGov between 5th and 14th March 2014. The survey was carried out online. The figures have been weighted and are representative of all GB adults (aged 18+). Respondents were shown what a standard pack could look like, including larger health warnings as in Australia.
(14) Wakefield M et al (2013); Introduction effects of the Australia plain packaging policy on adult smokers: a cross-sectional study; BMJ Open 2013