The impact of standardized cigarette packaging among young women in Canada: A discrete choice experiment

Cigarette packaging is the most prominent form of tobacco promotion in Canada. Tobacco companies are increasingly selling cigarettes in innovative packaging, including the use of slim and super-slim “lipstick” sizes that are primarily marketed towards females. Australia is currently the only country that regulates the shape and size of cigarette packaging. The current study examined the relative importance of five cigarette packaging attributes—pack shape (e.g., “slims”) , brand, plain packaging, warning label size, and price—on perceptions of product taste, harm, and interest in trying, among young women in Canada. A discrete choice experiment was conducted online with smoking (n=211) and non-smoking (n=292) females, aged 16 to 24, recruited from a commercial sample. Respondents were shown 8 choice sets, each containing four packs displaying different combinations of the attributes: pack structure (slim, lipstick, booklet, standard); brand ( ‘Vogue’, ‘du Maurier’); branding (branded, plain); warning label size (50%, 75%); and price ($8.45, $10.45). For each choice set, respondents chose the brand that they: 1) would rather try, 2) would taste better, 3) would be less harmful, or “none”. For each outcome, the attributes’ impact on choices was analyzed using a multinomial logit model, and the relative importance (RI) of each attribute was calculated. The results showed that pack structure significantly influenced interest in trying (RI = 16%) and perceptions of taste (RI = 8%), whereas perceptions of harm were driven by pack structure (RI = 46%). Branding was the most important contributor to trial intent decisions (RI = 39%) and perceptions of taste (RI = 48%). Interest in trying among females significantly increased for booklet (p < 0.0001) packs compared to the traditional design. As well, females were significantly more interested in trying branded packs, female oriented ‘Vogue’ brand, and a 75% warning label size (p < 0.0001, for all). In terms of taste related perceptions, females believed that slim (p=0.02) and booklet packs (p=0.006) were significantly better tasting than traditional designs. Similarly, branded packs (p < 0.0001), ‘Vogue’ brand (p < 0.0001), 75% warning (p < 0.0001), and higher priced packs (p=0.04) significantly increased perceptions of taste among females. Among young females, booklet (p=0.03), lipstick (p < 0.0001) and slim (p < 0.0001) pack sizes were perceived as significantly less harmful compared to traditional designs. As well, women believed branded packs, ‘Vogue’ brand, and more expensive brands would be significantly less harmful (p < 0.0001, for all). Given that the discrete choice design did not include all pack profiles that could be generated with attribute-level combinations of branding, brand, and warning labels, and in particular, due to the absence of “branded Vogue packs with smaller warnings”, the findings on warning label size should be interpreted with caution. Overall, the findings suggest that “plain” packaging and prohibiting variations in pack shape and size may decrease interest in trying and reduce false perceptions of reduced product harm among young females