Young people's perceptions of tobacco packaging: A comparison of EU Tobacco Products Directive & Ireland's Standardisation of Tobacco Act

Abstract

Objectives: To measure young people's perceptions of tobacco packaging according to two current pieces of legislation: The EU Tobacco Products Directive (TPD) and Ireland's Public Health (Standardisation of Tobacco Products) Act. Design: Within-subject experimental cross-sectional survey of a representative sample of secondary school students. School-based pen and paper survey. Setting: 27 secondary schools across Ireland, randomly stratified for size, geographic location, gender, religious affiliation and school-level socioeconomic status. Data were collected between March and May 2014. Participants: 1378 fifth year secondary school students aged 16-17 in Ireland. Main outcome measures: Young people's perceptions of attractiveness, health risk and smoker characteristics of packs according to EU and Irish branding and packaging guidelines. Results: Packs with more branding elements were thought to be healthier than standardised packs for Silk Cut (χ 2 158.58, p<0.001), Marlboro (χ 2 113.65, p<0.001), and Benson and Hedges (χ 2 137.95, p<0.001) brands. Generalized estimating equation binary regressions found that gender was a significant predictor of pack attractiveness for Silk Cut, with females being more likely to find the EU packs attractive (β=-0.45, p=0.007). Gender was a significant predictor for females with regards to the perceived popularity of the Silk Cut brand (β=-0.37, p=0.03). Conclusions: The removal of brand identifiers, including colour, font and embossing, reduces the perceived appeal of cigarette packs for young people across all three tested brands. Packs standardised according to Irish legislation are perceived as less attractive, less healthy and smoked by less popular people than packs which conform to the EU TPD 2014 guidelines.