Effect of UK plain tobacco packaging and minimum pack size legislation on tobacco and nicotine product switching behaviour

Abstract

Background and aims The introduction of plain tobacco packaging and minimum pack size legislation in the United Kingdom between May 2016 and May 2017 was accompanied by substantial changes in tobacco product diversity and pricing. This study investigates the extent to which these changes were associated with consumer switching between tobacco product types and price segments, and from tobacco to non‐tobacco nicotine products. Design Longitudinal study (changing trends in product and price choices) and survey (reasons for consumer choices). Setting Great Britain Participants We used 11 695 British households from Kantar Worldpanel who purchased tobacco and non‐tobacco nicotine products from March 2011 to December 2017. Measurements Product choice was defined using household's monthly purchases of tobacco (cigarettes, roll‐your‐own (RYO) tobacco, cigar/cigarillo and pipe tobacco) and non‐tobacco nicotine products (e‐cigarettes and nicotine replacement therapy), while price was defined using price paid by pack size and by price quartiles. Our switching analysis considered three switching alternatives: switching to a different tobacco product or to a combination of tobacco products, switching to any non‐nicotine tobacco product, and switching out of our dataset. We explored changes in price quartile purchasing behaviour using binary variables for whether a household purchased or not from each price quartile monthly. Finally, self‐declared consumer's choice was assessed through survey responses. Findings The introduction of plain packaging and minimum pack sizes coincided with major switching to purchasing of pack sizes of 20 cigarettes or 30 g or larger RYO tobacco (>99% of purchases in December 2017) and a migration towards lower‐price cigarettes, as for cigarettes, around 80% of purchases were in the lowest price quartiles at the end of the study period compared to about 50% at the start of the study period. During the first 6 months of implementation there was also a marked increase in the likelihood that cigarette smokers would switch to non‐tobacco nicotine (OR 1.74, 95% CI: 1.18 to 2.57), predominantly e‐cigarettes, compared with the period before May 2016. Survey results suggest that price was the main driver of changes in purchasing behaviour. Conclusions Implementation of plain packaging and minimum pack size legislation in the UK appears to have been associated with tobacco users switching to lower price tobacco products and to e‐cigarettes.

Compliance With Tobacco Control Policy and Visibility of Cigarette Retailers Around Educational Facilities in Riyadh, Saudi Arabia

“…However, other studies found relatively lower compliance in Indonesia (December 2017) ( 16 ). Furthermore, while countries like the United Kingdom and Sri Lanka have banned single cigarettes ( 21 , 22 ), other countries like Indonesia and India have not ( 23 , 24 ).…”

Impact of Standardised Packaging of Tobacco Products Regulations on cigarette consumption and youth smoking in England: interrupted time-series analysis

“…Based on data from a representative UK consumer panel conducted before the minimum pack size regulation took effect, around 68% of FM cigarette pack sizes purchased included between 11 and 19 sticks, and roughly 13% contained 10 sticks. 10 These data indicate that most people smoking FM cigarettes would have had to switch to larger pack sizes after the policy implementation. In contrast, the effect on RYO tobacco purchases was less pronounced.…”

“…Prior to the regulation, around 60% of RYO purchases were already packs containing more than 30 g, and 12.5 g to 29 g and <12.5 g pack sizes were at only about 15% each. 10 It is important to investigate whether the introduction of minimum pack sizes has led to an increase in daily cigarette consumption among people smoking cigarettes given the direct and indirect health benefits of smoking reduction. In a metaanalysis, Chang et al 11 found that reducing cigarette consumption from heavy to moderate, or by at least 50%, significantly decreased lung cancer risk.…”

Was the implementation of standardised tobacco packaging legislation in England associated with changes in smoking prevalence? A segmented regression analysis between 2006 and 2019

“…Evidence from Australia, which in 2012 became the first country to introduce standardised packaging, suggests that implementation led to an increase in quitline calls [8] and increased the rate of decline in smoking prevalence [9]. Research on the introduction of standardised packaging in England has demonstrated that implementation has been associated with considerable increases in the price of tobacco products, switching to less expensive tobacco products and increased use of e-cigarettes among smokers [10][11][12][13]. However, the effect of standardised packaging on smoking prevalence in England has not yet been explored by researchers independent of the tobacco industry's funding.…”