Impact and perception of plain packaging in Canada

Plain packaging for tobacco products was introduced in Canada in February 2020 as part of a package of measures aimed at achieving the goal of a tobacco-free generation by 2025.

A new report[1] presents the first results from the International Tobacco Control Policy Evaluation Project (ITC Project) related to the effectiveness of plain packaging in Canada. The report is based on data collected from 4,600 adult smokers before (2018) and after (2020) the introduction of plain packaging in the country. Data from Canada are also presented, taking into account data from other ITC Project stakeholder countries - including Australia, England, France, and New Zealand, where plain packaging has also been introduced. Plain packaging applies to all tobacco products, including manufactured cigarettes, roll-your-own tobacco products (cigarette tobacco, tubes, and rolling papers intended for use with tobacco), cigars and cigarillos, pipe tobacco, smokeless tobacco, and heated tobacco products.

Encouraging initial results in Canada for plain packaging

Canada's plain packaging regulations are considered the most comprehensive in the world and have set several precedents globally. Canada is the first country in the world to require slide-out packaging and to display a health information message, in English and French, on the back of the inner packaging when the package is opened. Canada is, along with Israel, the only country to have implemented plain packaging for heated tobacco products.

Canadian plain packaging regulations also require a dull brown color inside packages. It prohibits cigarettes longer than 85mm, as well as so-called "slim" cigarettes, which are less than 7.65mm in diameter, and are particularly popular with women.

The results of the ITC evaluation of plain packaging in Canada are consistent with the results of other ITC evaluation studies on plain packaging conducted in Australia, the United Kingdom, and New Zealand in two respects: the adoption of plain packaging in Canada significantly reduced the appeal of cigarettes, and smokers' support for plain packaging increased after its adoption. After its introduction, 45% of smokers reported disliking the appearance of their cigarette pack, compared to 29% before the law. Smokers' support for plain packaging increased from 26 % before the law was implemented to 34 % after it came into force.

Unlike France, the United Kingdom, Australia, and New Zealand, Canada has not adopted new, larger health warnings on tobacco packages with its new plain packaging regulations. However, results from other countries suggest that plain packaging is likely to have a greater impact when introduced in combination with new, larger health warnings.[2]. However, the health warnings already occupy a very large area: 75 % of the front and back of the pack. They will also be the largest in the world in terms of total surface area when the mandatory slide-on pack format is introduced in November 2021.

The effectiveness of neutral packaging internationally

Plain packaging of tobacco products is one of the measures recommended for the application of Article 11 of the Framework Convention on Tobacco Control (FCTC) on the packaging and labelling of tobacco products and also for the implementation of Article 13 relating to the ban on advertising. In 2017, the WHO published a guide[3] to help countries develop and implement this measure. This document provides an update on studies demonstrating the effectiveness of this measure. Plain packaging of tobacco products is being adopted by an increasing number of countries around the world. As of 1^er As of January 2021, 14 countries had introduced this measure: Australia (2012); France (2016); the United Kingdom (2017); New Zealand, Norway and Ireland (2018); Uruguay and Thailand (2019); Saudi Arabia, Turkey, Israel and Slovenia (January 2020); Canada (February 2020) and Singapore (July 2020). By January 2022, Belgium, Hungary and the Netherlands will join these countries.

One of the main goals of plain packaging is to reduce the appeal of tobacco products. Research conducted in different countries has consistently shown that plain cigarette packs are less attractive to smokers than inlaid packs. According to studies, smokers were more likely to dislike the appearance of their cigarette pack in countries where graphic health warnings and plain packaging have been adopted (New Zealand, Australia, England, Canada, and France).

In France, according to a survey[4] from Inserm and Inca[5], since the introduction of plain packaging in 2017, fewer young people have experimented with tobacco: 1 in 5 young people aged 12 to 17 (20.8%) experimented with tobacco for the first time in 2017 compared to 1 in 4 (26.3%) in 2016. The survey also highlighted a positive progression in the perception of smoking as " dangerous » by adolescents (83.9% in 2017, compared to 78.9% in 2016). Young smokers also appear « less attached to their tobacco brand » in 2017 (23.9%), compared to 2016 (34.3%). According to a survey by Public Health France[6], the proportion of smokers who say they like the appearance of their cigarette packet was divided by three in 2017 (16 %) compared to 2016 (53 %).

Keywords: Canada, plain packaging, smokers, France, tobacco control Photo credit: ITC Project ©Generation Without Tobacco

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[1] ITC Project. Plain Packaging for Tobacco Products in Canada: Policy Impact Results from the Tobacco Control Public Policy Evaluation Project. University of Waterloo, Ontario, Canada. March 2021. [2] Moodie C, Best C, Lund I, Scheffels J, Critchlow N, Stead M, McNeill A, Hitchman S, Mackintosh AM. The response of smokers to health warnings on packs in the United Kingdom and Norway following the introduction of standardized packaging. Nicotine Tob Res. 2021; nta027, https://doi.org/10.1093/ntr/ntab027 [3] World Health Organization. Plain Packaging of Tobacco Products: Evidence, Policy Development and Implementation. Geneva: WHO [4] F. El-Khoury et al. “Plain tobacco packaging, increased graphic health warnings and adolescents' perceptions and initiation of smoking: DePICT, a French nationwide study” BMJ Tobbaco Control, November 2018. doi:10.1136/tobaccocontrol-2018-054573 [5] CNCT, Plain packaging: its effectiveness proven once again, November 26, 2018, accessed April 6, 2021 [6] Pasquereau A, Andler R, Guignard R, Richard JB, Nguyen-Thanh V and the Public Health France Barometer groups 2016 and 2017. Perception of cigarette packets by smokers before and after the introduction of plain packaging. Results of the Public Health France Barometers 2016 and 2017. Saint-Maurice: Public Health France, 2019. 10 p. National Committee Against Smoking |