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Otago Plain Packaging of Tobacco Products

Otago Plain Packaging of Tobacco Products

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Published by Dick Puddlecote

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Published by: Dick Puddlecote on Oct 25, 2012
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10/03/2013

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2012
vol
. 36
no
. 5
AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH
405
 © 2012 The Authors. ANZJPH © 2012 Public Health Association of Australia
I
nternationally, smoking remains a serious public health problem. The World Health Organization (WHO) estimatesthat deaths rom smoking will rise to more than eight million by 2030 and reach one billion in the 21
st
century.
1
Governmentsaround the world have responded to the threat tobacco poses byadopting progressive measures that will reduce smoking initiation, prompt cessation and lower overall smoking rates. One suchstrategy, tobacco ‘denormalisation’, exposes tobacco as a toxic product peddled by an unscrupulous industry and undermines thesocial cachet o smoking.
2
Denormalisation rerames smoking associally unacceptable and challenges the connotations o glamour,sophistication and ruggedness that tobacco brands have used toattract young people. Over time, denormalisation reduces smoking’saspirational attributes, undermines the value tobacco brands deliver to smokers and reduces tobacco consumption.
3,4
Plain packaging extends this approach by moving beyond smokeree social marketing campaigns to ocus directly on tobacco packages, which represent a tangible symbol o the emotional benets smokers derive rom ‘their’ brand.
5
These measures refectincreased knowledge o the role packaging plays in promotingsmoking, the meticulous research undertaken into branding and  packaging by tobacco companies, and the tobacco industry’sgrowing reliance on packaging as promotion in traditional massmedia becomes more restricted.
6
 The tobacco industry has strongly opposed plain packaging; itargues this measure lacks proportionality and supporting evidence,and claims it will impose unair costs on manuacturers.
7
WhenAustralia proposed plain packaging, tobacco companies launched marketing campaigns entitled ‘No Nanny State’ and ‘I Deserve to be Heard’ to muster opposition to the legislation. Philip Morrisadopted the same tactic when launching the ‘My Opinion Counts’site in New Zealand to coincide with the release o the government’sconsultation document on plain packaging. These campaigns drawon deep-seated concerns over measures that curtail individualreedoms and suggest plain packaging will stigmatise smokers, whoare depicted as marginalised and disenranchised.However, when these initiatives ailed to elicit the Australian publics sympathy the tobacco companies moved to the legal arenaand introduced suits challenging the constitutionality o plain packaging and its compliance with international trade agreements.Because not all countries may have Australia’s resolve in the aceo well-unded and vocal opposition, these moves could deter theintroduction o plain packaging elsewhere. In these situations,strong public support may provide politicians with an additionalmandate to act.To understand tobacco companies’ arguments and publicsympathy or these, we analysed two claims they have repeatedlymade: as packaging only promotes brand switching, plain packagingwill neither persuade smokers to quit, nor dissuade young peoplerom starting to smoke; and plain packaging misappropriates brand assets and denies air use o these. We reviewed the public healthcounter-arguments: that a toxic product such as tobacco requires prominent warnings without distracting brand imagery; and thatattractive branding promotes experimentation and continued smoking. To test how the public regard these claims, we conducted a survey that compared New Zealand smokers’ and non-smokers’ perceptions o plain packaging, and examined their views on policymeasures.
Tobacco branding: implications, effects and rights 
Brands unction by linking aspirations, attributes and valuesto products and services, which consumers buy as much or their symbolic value as or their utility. Smokers use the symbols and imagery evoked by brand attributes to construct and communicatean identity. Branding thus enables tobacco manuacturers to sellstatus, social acceptance and glamour, rather than a mere nicotinedelivery device.Internal documents available as part o US legal settlementsreveal tobacco companies’ reliance on branding’s symbolic valuesand expose their meticulous research into pack designs and brand imagery. Industry documents also make explicit the importancetobacco companies have placed on recruiting young adult smokers by developing brands that appeal to them. Furthermore, theseonce-condential documents illustrate the growing importanceo packaging as a communications medium in markets wheretraditional mass media channels are restricted.Given how brands unction, and the research undertaken toensure their eectiveness, tobacco companies’ reaction against plain packaging is predictable. Either directly or through ront groupsand consultants, they have argued there is no evidence that plain
doi: 10.1111/j.1753-6405.2012.00907.x
Strong public support for plain packagingof tobacco products
Janet Hoek , Philip Gendall, Ninya Maubach
Department o Marketing, University o Otago, New Zealand 
Richard Edwards
Department o Public Health, University o Otago, New Zealand 
Research commentary
Tobacco and Smoking
 
406
AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH
2012
vol
. 36
no
. 5
 © 2012 The Authors. ANZJPH © 2012 Public Health Association of Australia
 packaging will reduce smoking prevalence. Since no country hasimplemented plain packaging, it is tautologically true that no directevidence o plain packaging’s eectiveness exists: none can untilthe policy is implemented and evaluated. However, experimentalstudies show plain packaging decreases brand attractiveness, reduces people’s preerences, and increases the salience and impact o healthwarnings.
8-10
Tobacco companies argue that branding only promotes brand switching by current smokers (while simultaneously havingno eect on primary demand). This claim stands in contrast toempirical evidence that smokers have unusually high brand loyaltyand industry documents that reveal branding’s role in attracting newusers.
11,12
Legal experts have questioned claims that plain packagingmisappropriates tobacco companies’ intellectual property and pointout that, as governments have no wish to use tobacco companies’ brands, they can hardly be misappropriating them.
13
 To examine how the public assess these competing claims, weexamined support or public health or tobacco industry argumentsand addressed the ollowing questions:
•
Do the New Zealand general public support public healthclaims that toxic products such as tobacco require large healthwarnings?
•
Do they support industry claims that plain packaging will havelittle eect on smoking initiation or quitting?
•
Do they support industry claims that plain packagingmisappropriates their brand assets and denies air use o these?
Method
We obtained a sample o 418 smokers and 418 non-smokers roma commercial Internet panel (Research Now) and conducted anonline survey in March 2012. Data were weighted beore analysisusing SPSS’s Weight Cases unction so the age, sex, ethnicityand smoking status o respondents in the sample matched the proportions in the New Zealand population, according to the mostrecent census data (2006).The survey tested the industry and public health argumentsoutlined above, which we phrased as statements that respondentsevaluated using ve-point, ully labelled agree-disagree scales.The scales were anchored by ‘Strongly disagree’ and ‘Stronglyagree’, with a ‘Neither disagree nor agree’ mid-point and a ‘Don’tknow/Can’t choose’ option. We also estimated support or plain packaging using an 11-point scale ranging rom 0 (no support atall) to 10 (ull support). The scale was numbered rom 0 to 10 butlabelled only at each end.First, to examine whether views on plain packaging varied bysmoking status, we analysed smokers and non-smokers separately.Then we analysed support or the introduction o plain packagingoverall and among dierent age, gender, ethnicity and smokingstatus groups. For the purposes o analysis, the support scalevalues were multiplied by 10 so the results could be presented as percentages.
Results
Most respondents (77%) agreed or strongly agreed thatharmul products such as cigarettes and tobacco should have very largewarnings on them and thought attractive tobacco packagingencouraged young people to experiment with smoking (57%). Non-smokers had signicantly higher levels o agreement withthese statements than smokers.Although respondents elt less certain about the role o packagingin encouraging smokers to try new brands, or the likely eects o  plain packaging, they were more likely to agree than disagree with public health arguments. The only exception was plain packaging’seects on cessation, where equal proportions agreed and disagreed that this policy would encourage smokers to quit and a nearly equalnumber were undecided.Predictably, there were large dierences in the attitudes o smokers and non-smokers. Smokers rejected the tobacco industry’sargument that packaging encouraged them to experiment with new brands; less than a third agreed with this claim compared to justover hal the non-smokers. Around a th o smokers believed plain packaging would promote quitting or deter initiation, while morethan twice as many non-smokers believed these outcomes would eventuate. Neither smokers nor non-smokers accepted claims that plain packaging unairly denied tobacco companies’ use o their  brand imagery and, overall, respondents were nearly three timesmore likely to reject than accept this argument. Table 1 containsthe details o these ndings.The general level o support or plain packaging, estimated at69%, was consistent with respondents’ attitudes to plain packaging. Non-smokers’ support or plain packaging was 30 percentage pointshigher than smokers’ and support among women was 10 percentage points higher than among men. These dierences are large and statistically signicant. Support or plain packaging among M
ā
oriand Pacic people was higher than among other ethnicities, and younger and older respondents were more supportive than thoseaged between 25 and 64, but these dierences are relatively smalland non-signicant.
Conclusions and Implications
Although tobacco companies question the benets o plain packaging, New Zealanders strongly support this measure and  believe attractive packaging encourages smoking experimentationamong young people. Respondents supported suggestionsthat tobacco products should eature large warnings and werenot persuaded by industry arguments that plain packagingmisappropriated their intellectual property. Interestingly, ahigher proportion o respondents (57%) elt attractive packagingencouraged experimentation than thought plain packaging would discourage this behaviour (39%). This discrepancy may arise romthe perception that some young people will always take risks,irrespective o arguments to dissuade them. The act that more thana third o respondents thought plain packaging would reduce thisinnate tendency is important, as too is the need or complementarymeasures that reduce tobacco’s aordability and accessibility, suchas increased excise taxes and ewer retail outlets. Non-smokers showed consistently higher support or publichealth arguments than smokers, who were less likely to attribute benets to plain packaging. Although empirical data suggests plain
Hoek et al. Research commentary

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