Smoking is bad for our health and the use of? tobacco can lead to tobacco and nicotine dependence and serious health problems. That ‘understanding’ not new. In the United States, the Center of Disease Control and Prevention (CDC) has created educational tools to help people quit smoking – and, by doing so, greatly reduce the risk of developing smoking-related diseases. While this is indeed helpful, a group of long-term and staunch smokers are still persuaded to believe that smoking may not necessarily be harmful for them. They may think that one kind of cigarette is ‘less harmful’ than others.
An online survey, funded, in part, by the National Cancer Institute and the National Heart, Lung and Blood Institute,? of just over 900 smokers of three of the United States? most popular cigarette brands suggests that adopting standardized cigarette packing may reduce consumers? misconceptions that some cigarettes are less harmful than others.
This is the conclusion of a study by a team of researchers led by University of California San Diego School of Medicine published in BMJ Tobacco Control.
?Some companies have marketed their cigarettes as ?low tar,? ?natural? or ?organic? but cigarettes marketed with these terms are not safer. Despite passage of a 2010 law that banned this practice, there are still more than 2.5 million U.S. consumers who continue to believe they are using a brand of cigarettes that might be less harmful,? said first author Eric Leas, Ph.D, who was part of the research team while a graduate student researcher at UC San Diego and is now a postdoctoral scholar at Stanford University School of Medicine.
In previous research, 67% of Natural American Spirit consumers said their cigarettes were less harmful than other brands. In this analysis, led by John P. Pierce, Ph.D, Professor Emeritus in the Department of Family Medicine and Public Health at UC San Diego School of Medicine and Moores Cancer Center, the researchers assessed whether smokers thought that Natural American Spirit cigarette packaging, which contains terms like ?natural? and ?additive-free,? implies that this brand is safer and whether repacking them in plain containers would reduce that interpretation.
Australia and Europe
In Australia and several European countries, standardized packaging has been used to remove marketing cues that may lead consumers to perceive certain benefits from any one brand
In the Australian model, branding is replaced with a drab dark brown color and a graphic image and text on 75% of the pack surface.
?Australia?s model of cigarette packaging has altered how consumers see brands,? Pierce, a senior author of the study, noted.
?We wondered if standardized packing would also impact American smokers? perceptions of harm that is conveyed through cigarette packing. And, it did,? he added.
To test the hypothesis, researchers asked survey participants to rate their perception of the packaging design of Natural American Spirit or the two most popular U.S. brands: Marlboro Red and Newport Menthol.
A total of 909 American smokers were recruited to a between-subject survey experiment, including the 3 brands ? 3 packaging/labelling styles, using through Amazon Mechanical Turk (MTurk) web service enabling the researchers to programmatically access the research participants while rating their perception of whether a randomly assigned cigarette package conveyed that the brand was ?safer? on a three-item scale (Cronbach?s ?=0.92)[a].
The participants were between ages of 21 to 50, who smoked cigarettes from at least one of the brands within the past seven days of the survey, were randomly assigned to view and rate images of cigarette packages. They viewed either an existing cigarette package from the manufacturers or one of two plain packages that the researchers developed: one removed tobacco industry branding and replaced it with a single color, while the other had the plain packaging and a graphic warning image and label similar to the Australian model.
Survey participants rated the Natural American Spirits packaging 1.9 times (P?<0.001) higher (mean=4.6; SD=2.9) than Marlboro Red packaging (mean=2.4; SD=2.3) and 1.7 times (P?<0.001) higher than Newport Menthol packaging (mean=2.7; SD=2.4) on a scale measuring their belief that the packaging implied the cigarettes were safer.
Although the difference in implied safety between the latter two brands was not statistically different, the perceptions of implied safety were lower when plain packaging was used (Cohen?s d=0.66; P?<0.001) and much lower when Australian-like packaging was used (Cohen?s d=1.56; P?<0.001).
Furthermore, when comparing across packaging styles, respondents? ratings of the implied safety of the plain packaging of Natural American Spirits were 1.7 times lower than current U.S. packaging and ratings of the packaging of Natural American Spirits with graphic warning images were 5.4 times lower than current U.S. packaging.
?No tobacco brand has provided evidence that their products reduce the health risks associated with cigarette smoking. It is all about marketing,? Pierce said.
?Standardized packaging can reduce consumers? beliefs about the safety of cigarette brands that include words like ?natural? on packaging and instead display a common warning of the harms of smoking,? he further noted.
There was no clinically meaningful difference between implied safety of the three brands when respondents viewed the brands with the plain packaging or packaging with graphic warnings.
?These findings suggest that plain packaging may be a potential policy solution for ensuring that cigarettes are not marketed as ?safer,? a practice that is now essentially banned in the United States,? said Leas.
Last Editorial Review: December 18, 2017
Featured Image: Breaking Cigarettes. Courtesy: ? 2017 Fotolia | Used with permission. Photo 1.0: Long before Ronald Reagan became the 40th President of the United States, he was a popular actor appearing in many commercials and advertisements. Despite appearing in multiple Chesterfield advertisements, he did not smoke cigarettes. This Chesterfield ad was featured in the December 3, 1951 issue of Life magazine. In 1947, Chesterfield had changed their marketing strategy and heavily emphasizes celebrity endorsements. By the early 1950’s famous spokespeople for the brand had included Lucille Ball, Joan Crawford, Betty Grable, Rita Hayworth, Barbara Stanwyck, Gary Cooper, Bing Crosby, Kirk Douglas, Bob Hope, Gregory Peck, Frank Sinatra, and Jimmy Stewart. The Chesterfield campaigns were standard in a time when ‘big tobacco’ denied the harmful effects of smoking. Courtesy: ? 2017 | Used with permission.
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