Smoking Kills – Would More Warnings Change Your Mind?
A 2015-19 study moderated by Stirling University and published by Informa UK Ltd, trading as Taylor & Francis Group, has joined a collective wealth of similar research conducted since 2014, acting as the catalyst for proposing a new approach to stressing the health concerns of cigarettes.
In an attempt to curb the uptake of smoking and improve the rate of successful cessation, both the Scottish and Canadian governments are now considering implementing the printing of “Smoking Kills” on individual cigarette sticks.
The 20th of May 2016 marked one of the biggest changes to cigarette and tobacco packaging in recent memory, with all examples manufactured after this time being restricted to the infamous “pantone 448-C”, an olive green that many will be very familiar with. Alongside this mandatory colour change came the enforcement of far larger “Smoking Kills” and pictorial warnings being printed on said packaging.
This latest proposal is a natural extension of an ever-restrictive approach to tobacco regulation, particularly in the UK as the government works towards its goal of a smoke-free future. This would see less than 5% of the UK population actively smoking by 2030, with progressive milestones set for the years leading up to that date.
The Research Behind the New Proposal
While there will inevitably be a percentage of people who will view the proposal as fruitless, the studies behind its inception present a significant wealth of evidence that suggests perceptions may be impacted far more by the addition of warnings on cigarettes themselves as well as just the packets they are sold in.
Many previous trials of a similar nature have been conducted in the UK, with each presenting findings supporting the data now being called on as impetus for printing the additional warnings.
Among the earliest was an in-home survey conducted in 2014 which presented 1205 11–16-year-olds with an image of a cigarette featuring the “smoking Kills” warning on the paper itself. The participants were then asked a series of questions assessing the warning’s perceived impact on smoking initiation and cessation.
Of those questioned, 71% indicated warnings on cigarettes would put them off starting smoking altogether, while 53% felt it would encourage those already smoking to quit. An overwhelming 85% stated that they would support the enforcement of such warnings on all cigarettes moving forward as a deterrent.
Two subsequent online studies targeted 997 16-24-year-old smokers and non-smokers in 2015 and 1766 16-34-year-old smokers in 2016. In both cases, participants were shown an image of a normal cigarette, one with a warning printed on it, and another coloured with an intentionally off-putting green.
In both cases the data clearly found that participants perceived the examples carrying a warning or coloured green as less appealing, more harmful and would decrease their chances of wanting to try either altogether.
Similarly on the international stage, studies that compared similar images of cigarettes bearing different colours or warnings in both New Zealand (2014) and Norway (2016) yielded synonymous results with those found in the UK – participants found cigarettes printed with such deterrents to be less appealing, more harmful, and even worse tasting – a factor that would not in reality be impacted by the warnings or colours outside of placebo effect on participants.
The Taylor & Francis Study
Twenty focus groups were held in both Edinburgh and Glasgow, totalling 120 participants. The participating smokers were segmented by age (16–17, 18–24, 25–35, 36–50, >50), gender and social grade.
The intent was to explore perceptions of cigarettes which display the “smoking Kills” warning on the actual cigarette paper itself – and how these different demographics might respond to such a change in aesthetic.
Each demographic targeted found that the addition of a warning on each individual cigarette would have an impact on themselves, others or both. It was felt that the warnings would serve to prolong the health message, owing to the increased visibility once removed from the pack lit, left in an ashtray and with each drag taken, making avoidance behaviour far more difficult.
Many found that the visibility of the warning to others would be off-putting, bearing negative and embarrassing connotations in social settings. In particular, female participants across the demographics found that the warnings created a negative image that could be viewed as depressing, worrying and even frightening.
Younger participants were quick to suggest that at the very least, the warning would encourage them to stub out the cigarette earlier than normal, if not reducing consumption or quitting altogether as a result.
The most resounding consensus was that the warnings would be particularly impactful in preventing youth uptake, as well as that of non-smokers and those just beginning the habit.
Despite a broadly unified response, each demographic submitted at least one mention of warning-exhaustion, claiming that while not a terrible idea, the over-exposure to such warnings may ultimately lead to social desensitisation, nullifying their impact over time.
Reception of the Proposal
Aside from the data presented above, understandably the proposal has been met with positivity by a number of names synonymous with smoking cessation. Deborah Arnott, chief executive of Action on Smoking and Health (Ash), said:
“Warnings on cigarettes were suggested over 40 years ago by then health minister George Young. The tobacco companies, with breath-taking hypocrisy, protested that the ink would be toxic to smokers. The truth is cigarette stick warnings are toxic to big tobacco and this is an idea whose time has come.”
Beyond lobbying groups like ASH (who are behind the May 2020 UK menthol cigarette ban), the proposal has seen a staggering amount of parliamentary support from both Labour and Conservatives alike.
The overall amendment to the current law which would introduce the warnings has been spearheaded by Labour MP Mary Kelly Foy, who has stated that “We know that cigarettes are cancer sticks and kill half the people who use them. So I hope that health warnings on cigarettes would deter people from being tempted to smoke in the first place, especially young people…if they are putting that in their mouth and seeing that message on cigarettes every time they smoke, I hope it would have the desired effect”.
Conservative MP Bob Blackman, along with shadow health secretary Jonathan Ashworth and shadow justice secretary Alex Cunningham have backed Foy’s amendment and stand in support of her position on the matter.
In addition, former Conservative cabinet minister, and now peer, Sir George Young has introduced a separate private members bill into the House of Lords which would also seek to enforce mandatory warnings on cigarettes much like Foy, with the addition of alternative messages like “smoking causes cancer”.
Despite much support, however Simon Clark, director of pro-smoking group, Forest, has criticised Foy’s proposal, stating that:
“Everyone is aware of the health risks of smoking. There are huge, impossible-to-miss health warnings on every pack of cigarettes, including grotesque images of smoking-related diseases. Tobacco is sold in standardised packing and banned from display in shops. Enough is enough. If adults still choose to smoke that is a matter for them, not the government.”
Additional Implications of the Proposal
While the printing of “smoking kills” on individual cigarettes is the aspect making headlines currently, there are a number of additional implications of Foy’s proposal that may polarise the UK public and in particular, vapers.
One such implication would be the empowerment of government to impose a new levy on tobacco companies’ profits, with the proceeds being utilised to fund stop-smoking services in a twist of irony.
Beyond this however, under Foy’s amendments, the health secretary would also be able to:
Raise the legal age for purchasing tobacco products from 18 to 21, much as in the US – it is not yet confirmed as to whether this would impact e-liquids also.
Stop electronic cigarette manufacturers and those in the vaping industry from employing tactics that may entice children to try them such as sweet flavours or cartoon-based designs.
Outlaw the giving away of e-cigarettes for free as sample products.
The EDGE Perspective
Ultimately the amendments to the law are intended to improve wellbeing and reduce public harm through minimising exposure to, and maximising deterrents to smoking cigarettes and tobacco products – however the extent of the changes may be seen as over-reaching by some, with many in our industry actively trying to increase the legal distinctions between cigarettes and vaping.
EDGE supports smoking cessation, as demonstrated by our Best Practice Guide: Finding the Right Alternative, which forms a part of our Corporate Social Responsibility (CSR) activities, wherein we actively seek to forward our mission to help people worldwide quit smoking. Despite this we recognise there are unique factors to be considered for each individual quitting journey and there are no clear-cut blanket solutions that will suit all.
Time will now tell how much if any of the proposed changes will be brought into place, however it is likely that 2022 will set the stage for debate and further investigation. It is likely however that if such a proposal sees success in Scottish Parliament, it will almost certainly be followed by similar action UK-wide.