Plain cigarette packaging a hit with anti-smoking advocates, but debate about whether it works continues

Anti-smoking advocates whosupportthe Liberal government's proposal to require plain packaging on tobacco products argue thatAustralia's implementation ofsimilarregulations hashad a significanteffect on smoking rates in that country.

"Australia has seen the biggest decline in smokingprevalence that they'veever recorded after plain packing [was introduced]," said David Hammond, an associateprofessor ofpublic health andhealth systems at the University of Waterloo. "All the data we have suggest that plain packing has reduced smoking in Australia."

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Rob Cunningham, senior policy analyst for the Canadian Cancer Society, agrees and saysresearch supports the effectiveness of plain packaging.

Ifit wasn't effective, the tobacco companies wouldn'tbe so strongly opposed.- Rob Cunningham,Canadian Cancer Society

"Ifit wasn't effective, the tobacco companies wouldn'tbe so strongly opposed," he said. "And it's precisely because it's going to have an effect on sales that they are going to lobby hard against it, threaten legal cases."

But not everyone believes that Australia's policy of imposing blandtobacco brandinghasdone much to deter smoking, which has beensteadily decliningfor decades,according toJulian Morris, vice-president of research at the libertarian think tank the Reason Foundation.

"The decline in smokingseemsto have been continuous and not dramatically effected, one way or the other, by the introduction of plain packaging," he said.

Three-month consultations

On Tuesday, the Canadiangovernment announced it would hold three months of public consultationson the proposed plain-packaging requirements, which would regulate size and shape and require a uniform colour and font.The idea is that theremoval of logos, colours and images from packagingmakes tobacco products less appealing, in particular,to youth.

It's a move that's being hailed by Canadian health groups like the Heart and Stroke Foundation andthe Canadian Cancer Society, as well as bythe World Health Organization.

Although other countries like the United Kingdom and France have begun the process of bringing inplain packaging rules, so far, only Australia has fully implemented them.

The country introducedthe regulations in December2012, and according to Australianhealth officials, they're working.

"[The] tobacco plain packaging measureis having an impact by reducing the appeal of tobacco products, increasing the effectiveness of health warningsand reducing the ability of the pack to mislead,"the Australian health departmentclaims on its website.

"The studies also provide early evidence of positive changes to actual smoking and quitting behaviours."

The website citesTasneem Chipty, aneconometric analyst who examineddata from a series of surveys. Chiptyfound that the packaging changes accounted for a decline insmoking prevalence of 0.55 percentage points by September 2015 and108,228 fewersmokers.

Tobacco company rejects analysis

But EricGagnon, a spokesman for Imperial Tobacco Canada,rejected that analysis, arguingthatthe rate of decline hasn't accelerated since theintroductionof plain packaging.

There's no evidence that people start or stop smokingbecause of the packaging they see on a carton of cigarettes, but there is evidence that kids start smoking mostly because of peer pressure, he said.

Meanwhile, Morris pointed to reviews conducted by economicprofessorsSinclairDavidson andAshtondeSilva fromRMITUniversity in Melbournewho said therewasno evidence to support the notionthat the plain packaging policy has resulted in lower household expenditure on tobacco.

Davidson and de Silva also claimed that the analysis conducted by the Australian government of the effectiveness of plain packaging"fails on a number of criteria, including independence, transparency, replication and rigour."

Morris said other factors could account for the decrease in Australiansmoking rates, including the rise in the price of cigarettes, which were hit with a tax around the same timeplain packaging was introduced.

"We do know that, historically, public information about the harms of smoking on health as well as significant increases in the price of cigarettes do reduce consumption," he said.

He saidit's difficult to untangle the effects of historicrestrictions onadvertising,public information campaigns, cigarette taxes andgraphic warning labels.

"That'snot to say [packaging]had no effect on cigaretteconsumption. It's just that it's difficult to discern," Morris said.

There's also been an increase in the number of illegalcigarettesconsumed in Australia, he said.

However, Chiptytook many of those variables into consideration when analyzing the data.

It's difficult to say how much the decrease in smoking rates in Australiacan be attributed to plain packaging, but Cunningham said thatafter the new rules came into force, calls to quit-smoking helplines increased, and surveys showedsmokers were more likely to want to quit and try to quitandwere less likely to buy cigarettes because of the packaging.

"Itwas certainly one of the main factors in those historicdeclines," he said.