Is plain packaging the best option to lower smoking rates?

The federal government has vowed to rely more on science than on beliefs in its conduct of public policy. This noblest of sentiments is currently being put to the test, as Health Canada started toying with the idea of imposing plain packaging on tobacco companies.

The idea is to make cigarette packs as unattractive as possible: nondescript colour, same size and shape, and no distinctive brand colours, logos or other design elements. Such repulsive packaging is intended to send the signal loud and clear that smoking is bad. People will therefore quit en masse and smoking rates will go down.

Such is the theory, but the science behind plain packaging lacks concrete evidence of its effectiveness.

Any advocate of plain packaging would need to answer at least three crucial questions in order to be able to say that this policy is well thought out and ready to implement.

First of all, is the effectiveness of plain packaging proven? Until May, 2016, Australia was the only country in the world to have adopted plain packaging. Consequently, the best answer a proponent of plain packaging can possibly give comes from the postimplementation review published by the Australian government last February.

It states that smoking prevalence has decreased, but admits that “[t]hese decreases cannot be entirely attributed to plain packaging given the range of tobacco control measures in place in Australia, including media campaigns and Australia’s tobacco excise regime.”

Furthermore, the Australian report prudently attributes what effectiveness it does find to a bundle of measures: “[T]he 2012 packaging changes (plain packaging combined with enhanced graphic health warnings) have contributed to declines in smoking prevalence.”

In other words, the impact of plain packaging alone is still unknown at this time, because it is impossible to disentangle the respective impacts of the two measures that were rolled out at the same time.

Quarterly tobacco expenditure figures collected by the Australian Bureau of Statistics also suggest that a 12.5-per-cent hike in cigarette taxes that came into force on Dec. 1, 2013, 12 months after the introduction of plain packs, and a second 12.5-per-cent increase from the start of September the following year, have been more responsible for any recent decline in smoking than plain packaging. Higher taxes are not a quick fix in the Canadian context, though, if only because of the need to keep illegal activities in check.

Second, can Canada replicate the Australian experiment? Since tobacco regulation in Canada is among the most stringent in the world, plain packaging would be piled on top of an already heavy burden of rules and bans.

The new and enhanced graphic health warnings that were introduced in Australia in 2012 along with plain packaging now cover 75 per cent of the front surface. The previous warnings covered just 30 per cent.

Meanwhile, in Canada, graphic health warnings already cover 75 per cent of the front of cigarette packs. The federal government could adopt only plain packaging, but this would be an experiment in itself, not a replica of the Australian experience, nor a policy scientifically proven to be effective.

Finally, what is the most efficient means of reducing smoking rates? Smoking being a health hazard, public health authorities may want to push the smoking rate in Canada even lower than its current 14.6 per cent. The best way to do so is education, information and sensitization. But these solutions are not flashy and do not score political points. Also, they do not hurt tobacco companies, which seems a more important goal for some than actually addressing health issues.

Here’s a bonus question: How far down the regulatory road are we ready to go in order to get citizens not to consume a legal product? However unpopular or unfashionable, the tobacco industry is a legal one. In a free society, the rational approach to regulation should be to not infringe carelessly on companies’ rights, nor on personal choice, especially when the verdict of science is inconclusive as yet.

Youri Chassin is an economist and research director at the MEI, and author of "The State of Tobacco Policy in Canada: The Case of Plain Packaging"; Christian Kerr is a writer and commentator on Australian politics and public policy. The views reflected in this op-ed are their own.

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