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Plain packaging of cigarettes: do we have sufficient evidence?

Authors Smith C, Kraemer J, Johnson A, Mays D

Received 3 February 2015

Accepted for publication 24 February 2015

Published 2 April 2015 Volume 2015:8 Pages 21—30


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4

Editor who approved publication: Professor Frank Papatheofanis

Collin N Smith,1 John D Kraemer,2 Andrea C Johnson,1 Darren Mays1

1Department of Oncology, Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, DC, USA; 2Department of Health Systems Administration, School of Nursing and Health Studies, Georgetown University, Washington, DC, USA

Abstract: Tobacco industry marketing is a primary factor influencing cigarette smoking behavior and the cigarette pack has become an important marketing vehicle for tobacco companies. Standardized “plain” cigarette packaging is advocated as a public health policy to prevent and reduce morbidity and mortality caused by smoking by reducing youth smoking initiation and promoting cessation among smokers. Plain packaging was implemented in Australia in December 2012, and several other countries are considering doing so, but each faces foreseeable legal resistance from opponents to such measures. Tobacco companies have challenged these public health policies, citing international trade agreements and intellectual property laws. Decision-making in these court cases will hinge in part on whether the evidence indicates the public health benefits of plain packaging outweigh any potential harm to tobacco manufacturers’ interests. We reviewed the available evidence in support of plain packaging, finding evidence from observational, experimental, and population-based studies. Results indicate that plain packaging can reduce positive perceptions of smoking and dissuade tobacco use. Governments deciding to implement plain cigarette packaging measures can rely on this evidence to help make a strong case that plain packaging plays an important role in the context of comprehensive smoking prevention efforts.

Keywords: cigarette smoking, tobacco, plain packaging, regulation, policy

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