Karine Gallopel-Morvan

Consumer perceptions of cigarette pack design in France: a comparison of regular, limited edition and plain packaging

Background In the face of comprehensive bans on the marketing of tobacco products, packaging has become an increasingly important promotional tool for the tobacco industry. A ban on the use of branding on tobacco packaging, known as ‘plain’ packaging, has emerged as a promising regulatory strategy. The current study sought to examine perceptions of cigarette packaging among adults in France. Methods Adult smokers and non-smokers (N=836) were surveyed using computer-assisted personal interviewing to assess perceptions of pack design by comparing ‘regular’ branded packs and ‘limited edition’ packs (with novel designs or innovations) with ‘plain’ versions of these packs with all branding, including colour, removed. Results Plain packs (PP) were less likely than regular packs, and particularly limited edition packs, to be considered attractive, attention grabbing and likely to motivate youth purchase. PPs were also rated as the most effective in convincing non-smokers not to start and smokers to reduce consumption and quit. Logistic regression showed that smokers motivated to quit, in comparison to smokers not motivated to quit, were significantly more likely to consider the PPs as the packs most likely to motivate cessation. Conclusions Novel cigarette packaging, in the form of limited edition packs, had the highest ratings of consumer appeal, ahead of regular branded packs and also PPs. Interestingly, PPs were perceived to be the packs most likely to promote cessation among those adults with quitting intentions. Plain packaging, therefore, may be a means of helping existing adult smokers motivated to quit to do so.

Perceptions of plain packaging among young adult roll-your-own smokers in France: a naturalistic approach

Background We explored, for the first time, young adult roll-your-own smokers’ response to using plain packaging in real-world settings. Methods Naturalistic research was employed, where 133 French young adult smokers (18–25 years of age) used plain roll-your-own packs for 10 days; the plain packs they were provided with contained their usual brand of rolling tobacco and displayed the name of their usual brand. Participants were recruited in five cities in France (Paris, Marseille, Metz, Nantes, Toulouse) and completed two questionnaires to measure their response to their own branded packs and the plain packs. Both questionnaires assessed pack perceptions, brand attachment, product perceptions (eg, taste, quality, natural), feelings about smoking (satisfying, pleasurable), feelings when using the pack in front of others (embarrassment, image), warning response (credibility, awareness of risks) and smoking-related behaviour (eg, consumption, quitting). Results Compared to their own fully branded packs, plain packs were associated with less positive pack and product perceptions, lower brand attachment and less positive feelings about smoking and feelings when using the pack in front of others. Participants were also more likely to report feeling like reducing consumption and quitting when using the plain packs, and more likely to feel like missing out on rolling a cigarette. No significant differences between the two pack types (plain and branded) were found in terms of credibility of warnings and perceptions of level of tar. Conclusions The study suggests that the impacts of plain packaging for roll-your-own cigarette smokers are the same as for smokers of factory-made cigarettes.

The Plain Truth about Tobacco Packaging

Hymenopus coronatus (the Malaysian preying mantis) has a cunning hunting technique. It disguises itself as an orchid; its four walking legs are exquisite replicas of petals and its lethal jaws blend into the background. This makes it beautiful to behold, but for the lizards and insects that are its prey, ruthless and deadly. What looks like a flower, and an enticing source of nectar, is actually a death trap. The tobacco industry has learnt well from H coronatus . It camouflages its deadly product in elegantly decorated packages making them look on the one hand uniquely attractive and on the other just like any branded product. Thus they acquire exclusivity and legitimacy. Like H coronatus , tobacco companies also succeed in hunting and killing small creatures. It is abundantly clear that young people are drawn into smoking by branding and that liveried packs play an active role in this process. The UK Government is therefore to be applauded for its proposal to mandate plain packaging for cigarettes.1 This would involve removing all distinctive signs from packs leaving only the name of the brand in a standard colour and font, along with the legally mandated information.2 It’s the equivalent of turning H coronatus into a piece of couch grass. The evidence for the harm done by liveried packs …

Qualitative exploration of young adult RYO smokers' practices

Background Although roll-your-own (RYO) tobacco often elicits negative connotations of a lower class product, uptake and use by young adult smokers has grown because RYO is more cost-effective than tailor-made (TM) cigarettes. We explored the practices and beliefs young adults develop to distance themselves from unattractive stereotypes of RYO smokers. Methods We conducted 20 in-depth interviews with New Zealand young adult RYO users aged between 18 and 30 years, and used thematic analysis to interpret the transcripts. Results We identified three themes: establishing the superiority of RYO tobacco; creating and enacting usage rituals, and ritual disruption. Participants regarded RYO tobacco as more natural and better-tasting; they used it to control their tobacco use and facilitate interactions with others. Many described rolling rituals where they used specific artefacts and microbehaviours to construct cigarettes they saw as personal and artisanal. Several, though not all, disliked unattractively coloured papers as these disrupted the value their rituals created. Conclusions Young adults imbue RYO tobacco with positive attributes, many of which centre on rolling rituals or draw on widely held misperceptions of RYO tobacco as less harmful. Excise tax increases could counter perceptions of RYO as more cost-effective while mandating that dissuasively coloured paper could disrupt reduced-harm connotations. However, evidence that erroneous harm beliefs are widespread and entrenched may justify restricting or eliminating the key artefact—the product itself.

The effectiveness of current French health warnings displayed on alcohol advertisements and alcoholic beverages

Background Many countries use health warnings in an attempt to regulate alcohol consumption. However, there is a lack of conclusive evidence in the research on alcohol warnings to support decision-making on effective health policies. This study explores the effectiveness of two mandatory warnings introduced in France in 1991 and 2007: the first (Alcohol abuse is harmful) is displayed on alcohol advertisements; the second (a pictogram) on bottles. Given that advertising content regulations have been implemented in some countries to reduce the attractiveness of alcohol marketing (e.g. the Evin law in France), this research also aims to explore whether such regulations can improve the effectiveness of warnings. Methods In-depth interviews were conducted with 26 French people aged 15-29 years. The effectiveness of health warnings was assessed in terms of recall, noticeability, credibility, comprehension, responsiveness, and ability to encourage moderate drinking and abstinence during pregnancy. Participants were shown alcohol advertisements and bottles that either followed or challenged content regulations. The data were analyzed using double manual coding and NVivo software. Results While both warnings suffered from a lack of visibility and noticeability due to their size, location, and outdatedness and because of competition from marketing design elements, the warning on the advertisement that followed content regulations was most visible. Both warnings were considered to be informationally vague, lacking in credibility and ineffective in terms of making participants feel concerned and influencing consumption habits. Conclusions Current French warnings are ineffective and require modification. Improvements are suggested regarding the design and content of warnings to help increase their effectiveness.

Impact of a negative emotional antitobacco mass media campaign on French smokers: a longitudinal study

Background Mass media campaigns to encourage smoking cessation have been shown to be effective in a context of comprehensive tobacco control programme. The effectiveness of antismoking ads that evoke negative emotions remains unclear, in particular in countries with high smoking prevalence and among smokers with low perceived susceptibility, low self-efficacy or who are not users of smoking cessation services. Objective To evaluate short-term and long-term effects of a 1-month French national highly emotional media campaign, with a focus on these specific targets. Design A 6-month longitudinal survey by Internet. A sample of 3000 smokers were interviewed before the media campaign (T0). They were contacted again just after (T1) and 6 months after the campaign (T2). Outcomes Perceived susceptibility to the risks of smoking, self-efficacy to quit smoking, use of smoking cessation services (quitline and website) and 7-day quitting. Methods The analysis was carried out on 2241 individuals who answered at T1 and T2. Multiple logistic regressions were computed to test the association between the change in each outcome at T1 and T2 and the level of exposure based on self-reported recall. Results Self-reported recall was associated with an increase in perceived susceptibility and with use of cessation services. Campaign recall was also associated with higher 7-day quitting immediately after the campaign (OR=1.8 (1.0 to 3.2), P<0.05). Conclusions Fear-appeal mass media campaigns can be effective in encouraging cessation among smokers in a country with high smoking prevalence (France), but should be accompanied by convincing self-efficacy messages.

Plain packaging: legislative differences in Australia, France, the UK, New Zealand and Norway, and options for strengthening regulations

By July 2018, five countries (Australia, France, the UK, New Zealand and Norway) had fully implemented plain (standardised) packaging. Using government documents, we reviewed the key legislative differences between these five countries to identify best practice measures and potential lacuna. We then discuss how governments planning to introduce plain packaging could strengthen their legislation. Differences between countries include the terminology used (either ‘plain’, ‘standardised’ or ‘plain and standardised’), products covered and transition times (ranging from 2 to 12 months). Myriad differences exist with respect to the packaging, including the dimensions (explicitly stated for height, width and depth vs minimum dimensions for the health warnings only), structure (straight-edged flip-top packs vs straight, rounded and bevelled-edged flip-top packs and shoulder boxes) and size (minimum number of cigarettes and weight of tobacco vs fixed amounts) and warning content (eg, inclusion of a stop-smoking web address and/or quitline displayed on warnings on one or both principal display areas). Future options that merit further analysis include banning colour descriptors in brand and variant names, allowing pack inserts promoting cessation and permitting cigarettes that are designed to be dissuasive. Plain packaging legislation and regulations are divergent. Countries moving towards plain packaging should consider incorporating the strengths of existing policies and review opportunities for extending these. While plain packaging represents a milestone in tobacco-control policy, future legislation need not simply reflect the past but could set new benchmarks to maximise the potential benefits of this policy.

Consumer Perceptions of Cigarette Design in France: A Comparison of Regular, Slim, Pink and Plain Cigarettes (Forthcoming/Available Online)

INTRODUCTION The cigarette, like the cigarette pack, is used by tobacco companies as a promotional tool. We explore how the cigarette could potentially be used as a dissuasive tool. METHODS An online survey was conducted with 15-30-year-old smokers and nonsmokers (N = 998) in France to explore their perceptions of a plain cigarette (gray with no brand name) and three branded cigarettes (regular, slim, pink). Participants were randomly assigned to view the plain cigarette and either the regular, slim, or pink cigarette. They were asked to rate the cigarettes by Appeal (tastiest, highest quality, and most expensive), Harm (most dangerous and most effective for motivating people to talk about tobacco dangers), and Perceived behavioral impact (most effective to convince teenagers not to start and to motivate smokers to reduce consumption and quit). RESULTS In comparison to the gray cigarette, each of the branded cigarettes were considered more appealing, less harmful, and more likely to motivate teenagers to start and less likely to motivate smokers to reduce consumption or quit. CONCLUSIONS The study suggests that altering the appearance of the cigarette may reduce cigarette appeal, increase harm perceptions, and deter both young people and smokers. IMPLICATIONS Very little research has focused on dissuasive cigarettes whereas the cigarette stick has become very important for tobacco companies for communication purposes. This is the first study to compare the effect of various branded cigarettes (regular, slim, and pink) with a plain gray cigarette on young adult smokers and nonsmokers. The findings suggest that a plain gray cigarette can reduce cigarette appeal, increase perceptions of harm, and may deter use among both smokers and nonsmokers.

Perceptions of plain cigarette packaging among smokers and non-smokers in Andalusia (Spain)

OBJECTIVES Each year tobacco is responsible for 650,000 deaths in Europe and 55,000 in Spain. With tobacco advertising and promotion banned in Spain and most of Europe, the last bastion of marketing is the packaging. Plain tobacco packaging -which involves packs having a standardised appearance- has been proposed to counter this. The objective of this study is to research perceptions arising from the plain packaging of tobacco products. METHODS We employed a qualitative research methodology -focus groups- with smokers and non-smokers in in two medium-sized Andalusian towns (Spain). RESULTS Results show the importance of plain cigarette packaging as a form of promotion, particularly among women and young people, how pack colour influences product perceptions, and how removing full branding increases the salience of the warnings. CONCLUSIONS Plain packaging, combined with pictorial health warnings, may reduce the capacity of packaging to be distinctive and a badge product. Altering pack design in such a way would make it more difficult for tobacco companies to create a favourable image of their brands and may help to reinforce the ability of the population to protect themselves from the dangers of smoking.