factFiction3 FactCheck: Does plain packaging reduce smoking rates?The claim

“The real evidence from Australia… is clear: plain packaging has not had an impact on tobacco consumption but a KPMG report shows there has been an increase in illicit trade.”
Imperial Tobacco, 28 November 2013

The background

Labour called it a U-turn on a U-turn.

The coalition appeared to kick the idea of switching to plain cigarette packaging into the long grass over the summer, only to revive it again today.

Paediatrician Sir Cyril Chantler will head a new independent review into the evidence on whether standardised packaging will encourage people to quit smoking – or lead to fewer young people taking up the habit.

Sir Cyril will no doubt be looking to Australia for an insight into the effects of unbranded cigarette packs.

28 australia cigarettes g1 FactCheck: Does plain packaging reduce smoking rates?

The Aussies were the first country to do away with branded packs, switching to a uniform drab brown design emblazoned with graphic health warnings, from 1 December 2012, amid howls of outrage from the big tobacco companies.

Governments around the world are now looking to Australia for the first good evidence of whether the move will have its intended effect.

The analysis

An early academic study of changes in attitudes in Australia found that plain pack smokers thought about quitting more and rated quitting as a higher priority in their lives than people who smoked branded packs.

But the study didn’t actually tell us whether more people have actually quit as a result of the change in policy.

One interesting factoid it did throw up is that people perceived cigarettes from plain packs to be of worse quality and less satisfying than a year ago.

There’s no suggestion that the cigarette manufacturers changed anything about their products. This appears to be a curious psychological phenomenon.

Most of the other evidence we have come from studies paid for by Big Tobacco.

A new report into smoking rates in Australia by London Economics, commissioned by Marlboro maker Philip Morris International, showed… not very much at all.

The researchers did three online surveys, one before the ban came in and two afterwards. Here are the results:

28 londoneconomics2 FactCheck: Does plain packaging reduce smoking rates?

We would suggest that it’s difficult for either side to claim victory on the basis of these numbers.

Anti-smoking lobbyists have pointed out that smoking rates did actually fall over the eight months it took to carry out these three surveys.

The percentage of people who said they had never smoked went up from 45.6 to 46.6 per cent. The proportion of people who said they smoked every day fell by 0.4 percentage points.

The proportion of adults who said that they smoked any form of tobacco went down from 24.8 to 23.4 per cent.

But all of these changes are so small as to be statistically insignificant.

The authors of the study say: “From a statistical perspective, none of these changes were different from zero. Over the timeframe of the analysis, the data does not demonstrate that there has been a change in smoking prevalence following the introduction of plain packaging.”

They also insert this important warning: “It is not possible to assign a causal relationship between the changes in the noticeabilty of health warnings or smoking prevalence and the introduction of plain packaging, as there have been a number of other confounding factors that have occurred before and during the period of this analysis.”

The “confounding factors” – other things that happened at the same time plain packs came in that could affect people’s behaviour – include tax rises, seasonal trends, and a pre-existing downward trend in smoking behaviour.

This point is a good one to bear in mind – and in fact it is something the tobacco giants rely on when other evidence suggests that tobacco sales have been in decline since December 2012.

This report by KPMG was commissioned by all the big three baccy giants: Philip Morris, British American and Imperial.

It contains an important fact that the companies are not massively keen to talk about: their sales volumes have gone down in Australia since plain packaging came in. Here’s the key graph:

28 kpmg1 FactCheck: Does plain packaging reduce smoking rates?

So the legal tobacco market shrank slightly between 2012 and 2013. But there is a long-term trend of decline: there’s no sudden drop in the first half of 2013, after the switch to plain packs.

And this report goes to great lengths to document an apparent dramatic rise in illicit tobacco sales, which appears to bear out dire warnings issued by the tobacco lobby prior to the introduction of the ban on branding.

Industry spokesmen have long said that the move to uniform packs would encourage the tobacco black market, because counterfeiters would find it easier to fake the simpler design.

But of course we can’t say for sure that this is what has happened. If the drop in legal sales after December 2012 was merely the continuation of a decades-long trend, perhaps the rise in the illicit tobacco trade is part of an equally long-term process, and nothing to do with public policy:

28 kpmg2 FactCheck: Does plain packaging reduce smoking rates?

And there is another big confounding factor to remember. Since 2010, the Australian government has hit tobacco with a string of big excise duty hikes, meaning Australians pay more for a pack than most other smokers in the world.

Could this be the real reason for the apparent rise in cigarette smuggling, counterfeiting and so on? The tobacco companies insist that both tax rises and plain packaging could boost the illicit trade, but it’s almost impossible to isolate the effects of the different measures.

The tobacco companies’ main assertion is that rates of smoking haven’t really dropped in Australia, on this evidence: smokers are just switching to black market tobacco instead, so there’s no real health dividend from plain packs.

Of course this isn’t the last word. Perhaps smokers take a while to screw up the courage to quit, and it’s too soon to tell whether there has been a delayed reaction from plain packs.

And crucially, the studies carried out so far have not specifically looked at the effect on smoking rates among young people – one of the most important areas in the whole debate.

The verdict

We’d love to be able to produce a definitive piece of evidence, like a rabbit from a hat, that will settle this debate one way or the other. But we think the evidence from Australia just isn’t strong enough one way or the other.

Let’s hope that by the time the Chantler review is over, we have better figures.

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