Awareness and correlates of noticing changes to cigarette packaging design after implementation of the European Tobacco Products Directive: findings from the EUREST-PLUS ITC Europe Surveys
Author:
Kyriakos Christina N12, Driezen Pete34, Girvalaki Charis12, Hitchman Sara C5, Filippidis Filippos T67, Gravely Shannon3, Balmford James8, Nikitara Katerina2, Mons Ute9, Fernández Esteve10111213, Przewoźniak Krzysztof141516, Trofor Antigona C1718, Demjén Tibor19, Zatoński Witold1420, Tountas Yannis7, Fong Geoffrey T1321, Vardavas Constantine I12, Vardavas Constantine I, Glahn Andrea, Kyriakos Christina N, Nguyen Dominick, Nikitara Katerina, Radu-Loghin Cornel, Starchenko Polina, Tsatsakis Aristidis, Girvalaki Charis, Igoumenaki Chryssi, Papadakis Sophia, Papathanasaki Aikaterini, Tzatzarakis Manolis, Vardavas Alexander I, Bécuwe Nicolas, Deaconu Lavinia, Goudet Sophie, Hanley Christopher, Rivière Oscar, Demjén Tibor, Kiss Judit, Kovacs Anna Piroska, Fernández Esteve, Castellano Yolanda, Fu Marcela, Nogueira Sarah O, Tigova Olena, McNeill Ann, East Katherine, Hitchman Sara C, Mons Ute, Kahnert Sarah, Tountas Yannis, Behrakis Panagiotis, Filippidis Filippos T, Gratziou Christina, Katsaounou Paraskevi, Peleki Theodosia, Petroulia Ioanna, Tzavara Chara, Trofor Antigona Carmen, Eremia Marius, Lotrean Lucia, Mihaltan Florin, Rohde Gernot, Asano Tamaki, Cichon Claudia, Far Amy, Genton Céline, Jessner Melanie, Hedman Linnea, Janson Christer, Lindberg Ann, Maguire Beth, Ravara Sofia, Vaccaro Valérie, Ward Brian, Willemsen Marc, de Vries Hein, Hummel Karin, Nagelhout Gera E, Zatoński Witold A, Herbeć Aleksandra, Janik-Koncewicz Kinga, Przewoźniak Krzysztof, Zatoński Mateusz, Fong Geoffrey T, Agar Thomas K, Driezen Pete, Gravely Shannon, Quah Anne C K, Thompson Mary E,
Affiliation:
1. Laboratory of Toxicology, School of Medicine, University of Crete, Heraklion, Greece 2. European Network for Smoking and Tobacco Prevention, Brussels, Belgium 3. Department of Psychology, University of Waterloo, Waterloo, Canada 4. School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada 5. Addictions Department, King's College London, London, UK 6. Department of Primary Care and Public Health, Imperial College London, London, UK 7. Center for Health Services Research, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece 8. Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg im Breisgau, Germany 9. Cancer Prevention Unit and WHO Collaborating Centre for Tobacco Control, German Cancer Research Center (DKFZ), Heidelberg, Germany 10. Tobacco Control Unit, Catalan Institute of Oncology (ICO), L'Hospitalet de Llobregat (Barcelona), Catalonia, Spain 11. Tobacco Control Research Group, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Catalonia, Spain 12. School of Medicine and Health Sciences, Bellvitge Campus, Universitat de Barcelona, L'Hospitalet de Llobregat, Catalonia, Spain 13. Consortium for Biomedical Research in Respiratory Diseases (CIBER of Respiratory Diseases, CIBERES), Madrid, Spain 14. Health Promotion Foundation, Warsaw, Poland 15. Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland 16. Collegium Civitas, Warsaw, Poland 17. University of Medicine and Pharmacy ‘Grigore T. Popa’ Iasi, Iasi, Romania 18. Aer Pur Romania, Bucharest, Romania 19. Smoking or Health Hungarian Foundation, Budapest, Hungary 20. European Observatory of Health Inequalities, President Stanislaw, Wojciechowski State University of Applied Sciences, Kalisz, Poland 21. Ontario Institute for Cancer Research, Toronto, ON, Canada
Abstract
Abstract
Background
The European Tobacco Products Directive (TPD), which went into effect in May 2016, regulates packaging design and labelling of cigarettes and roll-your-own (RYO) tobacco. The aim of the current study was to examine whether smokers and recent quitters in six European Union (EU) countries (Germany, Greece, Hungary, Poland, Romania and Spain) reported noticing TPD-related changes to packaging, and correlates of noticing these changes.
Methods
Cross-sectional data from the Wave 2 of the ITC 6 European Country Survey in 2018 after implementation of the TPD. Bivariate analyses included adult smokers (n = 5597) and recent quitters (n = 412). Adjusted logistic regression analyses were restricted to the subset of current smokers (n = 5597) and conducted using SAS-callable SUDAAN.
Results
Over half of smokers (58.2%) and 30% of quitters noticed at least one of five types of TPD-related pack changes. Over one-quarter of all respondents noticed changes to health warnings (30.0%), standardized openings (27.7%), minimum pack unit size (27.9%), and the removal of tar, nicotine and carbon monoxide information (26.7%) on packaging. Cross-country differences were observed across all measures, with noticing all pack changes markedly lower in Spain than the other countries. Correlates of noticing specific pack changes included sociodemographic characteristics, smoking behaviours and related to packaging.
Conclusions
This is one of the first cross-country studies to examine the extent to which TPD changes to cigarette and RYO tobacco packaging are being noticed by smokers and recent quitters. Findings indicate that the majority of smokers noticed at least one type of pack change, but this varied across countries and sub-populations.
Funder
European Union’s Horizon 2020 Research and Innovation Programme University of Waterloo Canadian Institutes of Health Research Ontario Institute for Cancer Research Ministry of Universities and Research Government of Catalonia Instituto Carlos III European Regional Development Fund FEDER Government of Spain
Publisher
Oxford University Press (OUP)
Subject
Public Health, Environmental and Occupational Health
Cited by
5 articles.
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