How effective was plain packaging in France?

Plain packaging is a tool to combat smoking: on the one hand, it allows packaging to be broken as an advertising medium. On the other hand, it helps to highlight health warnings. In France, the adoption of plain packaging has been effective from a public health perspective, in that it has helped to denormalize tobacco, and in that it has been followed by an increase in attempts to quit by smokers. This is the conclusion of the results of a study published in the journal Tobacco Induced Diseases.

The study was conducted in France between 2016 and 2018 using data from surveys conducted by Santé publique France on samples of 15,216 people in 2016, 25,319 in 2017, 9,074 in 2018, and all aged 18 to 75. This study pursued several distinct objectives. First, the researchers wanted to determine whether the adoption of plain packaging resulted in a feeling of discomfort for smokers when they took out their packet of tobacco. Then, the research looked at the link between the adoption of the packet and the motivation of smokers to quit smoking, in particular according to the gender, age, level of income, education, or tobacco consumption of individuals.[1].

Plain packaging, a powerful factor in the denormalization of tobacco

The results of the study tend to demonstrate that the adoption of plain packaging in France has had a strong impact on the discomfort felt by smokers when taking out their packet of tobacco. Thus, smokers were twice as likely to feel embarrassed following the introduction of plain packaging for cigarette packets as well as rolling tobacco, and the enlargement of health warnings, compared to 2016, when the measure had not yet been implemented. As the authors of the study point out, this feeling of discomfort is a good indicator of the level of denormalization of tobacco. Previous studies have also shown that plain packaging tends to reinforce negative opinions about smoking, reduce initiation, and reduce the presence of tobacco in the overall environment, whether bars, restaurants, or places frequented by children.

Increased motivation among smokers to quit smoking

According to the study, plain packaging was a contributing factor in motivating smokers to quit. In 2018, more than 28% of former smokers surveyed said that the appearance of their pack was a motivating factor. These results corroborate those of a 2018 literature review, demonstrating that plain packaging was effective in increasing smokers' intentions to quit smoking. Similarly, a study conducted in Australia, the first country to adopt plain packaging, highlighted its impact on smoking prevalence. Unsurprisingly, this motivation to quit is even stronger among smokers likely to be bothered by the appearance of their pack.

Effectiveness varies depending on gender, income level, and quantity consumed

The results show that the plain packaging was more of a motivating factor among former female smokers (29.3%) than among former male smokers (24.5%). For nearly a hundred years, the tobacco industry has been developing marketing strategies specifically targeting women, associating tobacco consumption with a socially valued practice, an adjuvant to their femininity.

In Spain, a similar study was conducted, highlighting that women were more sensitive to the packaging of the packet, and that the plain packet had a stronger impact on women's perception of tobacco than on men's. Similarly, the study tends to demonstrate that the introduction of the plain packet increases motivation to quit more in the wealthiest third of the population (31.2%), than in the least wealthy tercile (19.7%). For the researchers, the implementation of new warnings, as well as the enlargement of health messages would probably have a greater effect on the most popular categories.

Finally, the effectiveness of plain packaging on motivation to quit varies depending on the smoker's level of consumption. In 2018, 20.71% of former smokers smoking more than ten cigarettes per day indicated that plain packaging was a motivating factor, compared to more than a third of smokers smoking up to five cigarettes per day.

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[1] Pasquereau A, Guignard R, Andler R, Gallopel-Morvan K, Nguyen-Thanh V. Plain packaging on tobacco products in France: Effectiveness on smokers' attitudes one year after implementation. Tobacco Induced Diseases. 2022;20(April):35. doi:10.18332/tid/146600.