'It's like sludge green': Young people's perceptions of standardized tobacco packaging in the UK

Background and Aims Standardised tobacco packaging was introduced in the United Kingdom (UK) in May 2016, together with larger graphic warnings. This study explored young Scottish people's awareness of and perceptions about standardised tobacco packaging in the UK Design Qualitative study using 16 focus groups conducted February‐March 2017. Setting Four schools in Scotland based in areas of differing socioeconomic status (high vs medium/low) and two levels of urbanity (large urban vs small town/other urban). Participants Eighty‐two S2 (13‐14 years) and S4 (15‐16 years) students who were smokers or at‐risk non‐smokers. Measurements Focus groups explored perceptions of standardised packaging and health warnings. The qualitative data underwent thematic analysis. Findings Views about standardised packaging were generally negative. Packs were described as being unattractive, drab and less appealing than non‐standardised versions. The new health warnings generated negative affective, often aversive, responses. These varied depending on the image's perceived ‘gruesomeness' and authenticity. Most participants thought that the impact would be greatest on young non/occasional smokers. There were divergent views about whether established smokers would be affected. Conclusions The introduction of standardised tobacco packaging and new larger graphic health warnings in the United Kingdom seems have reduced the perceived attractiveness of cigarette packs among young people in the UK who smoke or are at elevated risk of becoming smokers, disrupting positive brand imagery (the brand heuristic), increasing the salience of health warnings, and contributing to denormalising smoking